Abstract
BACKGROUND AND OBJECTIVES: Electronic data capture may enhance efficiency and patient engagement in preoperative psychosocial evaluations for metabolic and bariatric surgery yet concerns persist about its feasibility in rural populations with historically lower mobile health adoption. This study evaluated the feasibility and acceptability of electronic patient-reported outcomes among metabolic and bariatric surgery patients in a rural setting. METHODS: In this quality improvement project, 202 patients undergoing presurgical psychosocial evaluation at an academic medical center in rural West Virginia completed a battery of psychological assessments on a clinic-provided tablet. Patients also completed a 9-item questionnaire assessing satisfaction, usability, and perceived impact on provider communication. RESULTS: Most patients reported high satisfaction with the tablet-based format (85%), and nearly all (96%) preferred it over paper-and-pencil forms. Usability ratings were strong, with the majority describing the tablet as "very easy" to read (86%), use (84%), and navigate (87%). Notably, 42% reported the tablet encouraged them to discuss eating or mental health concerns with their provider, and 49% indicated it helped them remember prior symptoms. Only 4% preferred paper-and-pencil assessments, and these patients were significantly older. CONCLUSION: Tablet-based electronic patient-reported outcomes collection is a feasible and well-accepted method for presurgical psychosocial evaluations in rural metabolic and bariatric surgery patients. These findings challenge assumptions about digital hesitancy in rural populations and support broader implementation of electronic data capture in bariatric care workflows.