The efficacy of prehabilitation (PreHab) to reduce surgical complications, and facilitate postoperative recovery, has been demonstrated (Ann Surg. 2018; 267(1):50-56). Deployment of PreHab as mainstream service at Hospital Clínic de Barcelona (HCB) has been undertaken. However, there is a need for consolidation of modular digital health tools to address two main aspects of service scalability: to empower patients for self-management at community level and to support collaborative work among professionals.
Supporting technologies include an adaptive case management platform to enhance collaborative work among health professionals and patients themselves using a mobile application for self-management at community level.
The technological support with full integration between community (patient) and health information systems at HCB (professionals) was implemented and is currently being evaluated. Next steps, during 2019, are: i) regional deployment of PreHab; ii) integration of the self-management platform into the regional personal health folder (La Meva Salut© – lamevasalut.gencat.cat), iii) evolution of the service toward a perioperative care program with a population-health approach; iv) refinement of the adaptive case management functionalities using the Camunda© (camunda.org) open source workflow and decision automation platform; and, v) transferability of selected traits of PreHab to rehabilitation of chronic stable patients.
The supervised endurance training sessions are managed and tracked with the proprietary Technogym® equipment (i.e. Mywellness). Patient self-management is based on MyPathway® (mypathway.healthcare). Integration with hospital information systems is performed using an open source HL7 FHIR API (i.e. HAPI). System usability is planned to be assessed by means of a Net Promoter Score survey in case of patients and the User Experience Questionnaire (UEQ) in case of healthcare professionals.