Previously submitted to: Interactive Journal of Medical Research (no longer under consideration since Oct 10, 2023)
Date Submitted: Jul 6, 2022
Open Peer Review Period: Jul 6, 2022 - Aug 31, 2022
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Implementation of a Digital Healthcare Management Ecosystem to Address Post Discharge Complications in India
ABSTRACT
Background:
Hospital to home transition disrupts care, challenging patients, caregivers, and clinicians. Innovative solutions are needed that maintain patient engagement thereby decreasing readmissions and reducing care cost. India is attractive for digital healthcare because of the large population, high teledensity, large out-of-pocket costs, and positivity towards telehealth.
Objective:
We developed a digital healthcare management ecosystem connecting patients to clinicians through an expert medical team and maintaining engagement via “personalized digital health.” It was implemented in a tertiary care hospital in India to address complications after coronary artery bypass graft (CABG) and percutaneous coronary angiography (PTCA).
Methods:
We retrospectively assessed outcomes and quality of experiences over a one-year implementation. We used an all-comers, real-world approach without exclusions based on internet access to assess feasibility of implementation. Net Promoter Scores (NPS) were used to assess patient satisfaction with the app and with the hospital
Results:
799 patients were enrolled (325 CABG, 474 PTCA). Clinical care escalations totaled 7665 (CABG=4772, PTCA n=2893) with 101 requiring increased care. 41 were resolved by the care team and 60 required hospital care. Of the latter, 35 required emergency department visits and 17 required hospitalization. Patient/caregiver Net Promoter Scores indicated patients were loyal and likely to recommend the system. Net Promoter Score increased by 60% for the hospital, from 47 to 75.
Conclusions:
This intervention resulted in serious clinical complaints in only 10.3% of patients after discharge with relatively few emergency department visits (4.4% of patients) and even fewer rehospitalizations (1.9% of patients). This work demonstrates successful development of a patient-centered digital healthcare management ecosystem to provide improved post-discharge patient care.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.