Value for Health CoLAB, Lisbon, Portugal.
Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.
BMC Health Serv Res. 2022 May 21;22(1):680. doi: 10.1186/s12913-022-08073-4.
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.
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.
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.
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.
现有的数字医疗解决方案需要一种服务开发方法，该方法评估需求、体验和结果，以开发高价值的数字医疗服务。本研究的目的是基于远程患者监测服务，为心脏手术后的患者随访服务进行数字化转型，以应对实际环境挑战。
该研究遵循设计科学研究方法框架，并结合精益创业方法的概念，从现有资源开始设计最小可行产品（MVP）。该服务在一项试点研究中进行，共有 29 名患者参与了 4 个迭代开发-测试-学习周期，涉及开发人员、研究人员、临床团队和患者的参与。
患者通过物联网（IoT）设备和移动应用程序每天报告手术后 30 天的结果。该服务的评估考虑了体验、可行性和有效性。它在用户中产生了高度的满意度和高度的依从性，减少了再入院率，平均每位患者有 7±4.5 次临床操作，主要是由于收缩压异常或伤口相关问题。
我们提出了一种六步方法论，用于设计和验证基于协作学习、实时开发、迭代测试和价值评估的高价值数字医疗服务。
