Abstract 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.

Simple visual stimuli, with bright colours and dynamically evolving over time, are among the most effective mechanisms through which to engage a baby´s attention. In earlier work, we have developed a visual stimulating tool to aid rehabilitation programs, which can be used with infants of up to 2 years of age. The feedback from the early use of the device has been rather positive. Yet, until now, there was no explicit way to assess the degree of engagement of the infant’s attention, or even when the focus of said attention moved away from the stimulus. Hence, it has been difficult to understand whether the proposed specific rehabilitation procedure has failed, for a given infant, or the loss of attention led to a decrease in efficiency in the intervention. In the current work we develop and exploit a simple eye tracking tool, based on a laptop’s own webcam, to evaluate the child’s loss of attention to visual stimuli. The main differentiating criterion, set forth for this eyetracker, is that it should work without an explicit calibration stage. The use of the specific camera is motivated with the fact that the laptop can be used for visual stimuli deliver, as well as a series of data processing steps. The results attained thus far were rather encouraging, leading even to a subsequent study, replacing infants by adults undergoing a rehabilitation program, after suffering from brain stroke.

Strokes are a major cause of motor, perceptual and cognitive dysfunction. Thus, perceptual stimulation in individuals with stroke is a fundamental procedure in the rehabilitation process, since it contributes to improved performance in activities of daily living. Perceptive rehabilitation could be performed with conventional procedures or by applying technology. However, the methods used to evaluate and treat perceptual changes using visual stimuli are generic and not personalized. Therefore, an innovative platform called RehabVisual was developed and already used with little children. It has the objective of stimulating the visuomotor competence. The platform is now applied to 3 subjects with stroke. The purpose of this article is to describe the platform and present the results of the application in stroke patients.

Visual impairments affect the life of millions of people. Some of these impairments can be corrected or diminished. Visual stimulation is one way of visual rehabilitation, that has produced better results when used in the early years of life. As there is nothing standardized in this field, a platform named RehabVisual was developed (Machado et al., 2018; Santos, 2018). This platform has the objective of creating an individual visuomotor rehabilitation for children under two years old, that were born prematurely. In order to reach a therapists’ need, a video analysis tool was developed. This tool should be capable of following the motion of the patients’ eyes, with the purpose of facilitating and making the analysis of their reactions to the stimuli more objective. The solution developed on this paper consists on the creation of an eye tracker system, that does not need to be pre-calibrated and is low-cost. The eye tracker was tested in healthy individuals and the results show that is very effective in detecting horizontal eye variations.