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

A Londral, Salomé Azevedo, P. Dias, C. Ramos, J. Santos, F. Martins, R. Silva, H. Semedo, C. Vital, A. Gualdino, J. Falcão, Luis Velez Lapão, P. Coelho, José G. Fragata

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
5 Downloads (Pure)


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.

Original languageEnglish
Article number680
JournalBMC Health Services Research
Issue number1
Publication statusPublished - 21 May 2022


  • Cardiac Surgical Procedures
  • Delivery of Health Care
  • Follow-Up Studies
  • Humans
  • Learning
  • Pilot Projects


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