Patient follow-up after radical prostatectomy by internet medical file

The development of Internet and the need for regular follow-up of patients often living a long way from hospital have led us to develop a follow-up dossier for patients with localized prostate cancer treated by laparoscopic radical prostatectomy. This feasibility study is based on 100 patients who agreed to test this system. After approval by the Commission Nationale d'Informatique et de Libert (CNIL) (French Computers and Privacy Commission) ensuring medical secrecy and confidentiality of data, the website was opened on a server specifically devoted to this project and presenting all of the required computer securities. The website is composed of pages comprising the hospital discharge summary, and the operative and histology reports. A quality of life questionnaire based on assessment of urinary continence and sex life and a PSA assay form are also included. The patient is therefore able to enter his PSA level and complete the questionnaire at home and the results are then sent to the doctor who treated him. A contact page allows the patient and the doctor to exchange information by text. 92 of these 100 patients connected regularly to the site with a mean connection rate of 8 per patient (range : 1 to 22). 98% of patients were satisfied with the various sections of the site and 95 % were satisfied with their medical file. 11 % of patients encountered connection problems and 14 % reported technical problems essentially attributed to incorrect PSA data entry or incorrect functioning of videos due to the absence of appropriate software. This type of Internet medical service for patients who have undergone a surgical operation requiring regular follow-up appears to be a useful approach for the future by allowing: maintenance of close contact between the patient and his doctors while avoiding the problems related to hospital visits, regardless of the patient's place of residence. It also provides general practitioners with access to the patients file, with the patient's permission.