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. 2022 May 21;22(1):680.
doi: 10.1186/s12913-022-08073-4.

Developing and validating high-value patient digital follow-up services: a pilot study in cardiac surgery

A Londral  1   2 , S Azevedo  3   4   5 , P Dias  3   4 , C Ramos  3   4 , J Santos  4   6 , F Martins  3   7 , R Silva  3   8 , H Semedo  6 , C Vital  6 , A Gualdino  6 , J Falcão  6 , L V Lapão  4   9 , P Coelho  4   6 , J G Fragata  4   6
Affiliations

Developing and validating high-value patient digital follow-up services: a pilot study in cardiac surgery

A Londral et al. BMC Health Serv Res. .

Abstract

Background: The existing digital healthcare solutions demand a service development approach that assesses needs, experience, and outcomes, to develop high-value digital healthcare services. The objective of this study was to develop a digital transformation of the patients' follow-up service after cardiac surgery, based on a remote patient monitoring service that would respond to the real context challenges.

Methods: The study followed the Design Science Research methodology framework and incorporated concepts from the Lean startup method to start designing a minimal viable product (MVP) from the available resources. The service was implemented in a pilot study with 29 patients in 4 iterative develop-test-learn cycles, with the engagement of developers, researchers, clinical teams, and patients.

Results: Patients reported outcomes daily for 30 days after surgery through Internet-of-Things (IoT) devices and a mobile app. The service's evaluation considered experience, feasibility, and effectiveness. It generated high satisfaction and high adherence among users, fewer readmissions, with an average of 7 ± 4.5 clinical actions per patient, primarily due to abnormal systolic blood pressure or wound-related issues.

Conclusions: We propose a 6-step methodology to design and validate a high-value digital health care service based on collaborative learning, real-time development, iterative testing, and value assessment.

Keywords: Cardiac surgery; Design science research; Digital healthcare; Patient-reported outcomes; Real-world validation; Remote patient monitoring; Service design.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Methodology to design and develop-test-learn cycles of the RPM service for cardiac surgery follow-up
Fig. 2
Fig. 2
The new telemonitoring process: process underwent in the hospital (yellow) and process implemented by the RPM service (blue)
Fig. 3
Fig. 3
Simulation of a literacy message sent in reply to the daily picture of the surgical wound that is sent by the patients (this image includes a fiction name and is translated to English language)
See this image and copyright information in PMC

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