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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. |
