Autor(es): 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, J
Data: 2022
Identificador Persistente: http://hdl.handle.net/10400.17/4312
Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
Assunto(s): HSM CCT; Humans; Cardiac Surgical Procedures*; Delivery of Health Care*; Learning; Follow-Up Studies; Pilot Projects
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.
