BACKGROUND: To support care after discharge following surgery for anorectal malformations (ARM) and Hirschsprung's disease (HD), an eHealth device was invented, offering families bilateral communication through chat, photo, questionaries and video. AIM: To explore the impact of eHealth on postoperative patterns of expert consultation, complications and treatment after discharge following surgery for ARM and HD, respectively, compared to conventional care. METHOD: Interventional prospective case control study observing postoperative care 30 days after discharge after ARM and HD-reconstructions July 2018-July 2023, comparing outcomes between families using the eHealth device versus conventional care. RESULTS: Consecutively included were 95/141 families (eHealth: ARM n = 48, HD n = 25
respective conventional care: ARM n = 16, HD n = 6). Days to first contact after discharge were fewer for eHealth users, both for ARM 2 vs. 5.5 (p = 0.000) and HD 1 vs 7 (p = 0.000). Days with consultations were more numerous using eHealth: ARM 9 vs 4 (p = 0.000) and HD 12 vs 3.5 (p = 0.002) specifically nurse counseling
ARM 6 versus 1 (p = 0.000) and HD 11 vs 2.5 (p = 0.002). In ARM patients the complication frequency was 23 % (eHealth) versus 50 % (conventional), and the complication severity was lower: Clavien-Madadi 0 (0-4) versus 1 (0-3) (p = 0.040). Treatment adjustments were more frequent for HD patients using eHealth (3 vs. 2 (p = 0.041)). CONCLUSION: Use of eHealth after ARM respective HD reconstructions implies earlier and more frequent postoperative counseling, especially with nurses. When using eHealth complications were less severe in ARM-patients and treatment adjustments more frequent in the HD patients, compared to those under conventional care.