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Londral A, Azevedo S, Dias P, Ramos C, Santos J, Martins F, Silva R, Semedo H, Vital C, Gualdino A, Falcão J, Lapão LV, Coelho P, Fragata JG. Developing and validating high-value patient digital follow-up services: a pilot study in cardiac surgery. BMC Health Serv Res 2022; 22:680. [PMID: 35597936 PMCID: PMC9123610 DOI: 10.1186/s12913-022-08073-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
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.
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Affiliation(s)
- A Londral
- Value for Health CoLAB, Lisbon, Portugal. .,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.
| | - S Azevedo
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,CEG-IST, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - P Dias
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - C Ramos
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - J Santos
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - F Martins
- Value for Health CoLAB, Lisbon, Portugal.,NOVA-LINCS, NOVA School of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - R Silva
- Value for Health CoLAB, Lisbon, Portugal.,NOVA CLUNL - Center of Linguistics, Nova University of Lisbon, Lisbon, Portugal
| | - H Semedo
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - C Vital
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - A Gualdino
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - J Falcão
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - L V Lapão
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,UNIDEMI, NOVA School of Science and Technology, Nova University of Lisboa, Lisbon, Portugal
| | - P Coelho
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - J G Fragata
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
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