OBJECTIVES: Remote patient monitoring (RPM) offers the potential for efficient and high-quality healthcare. To successfully implement it, practitioners need to assess RPM in a real-world context and optimize its added value. Using participatory action research (PAR), we sought to co-create with practitioners a scorecard to improve the assessment of cardiothoracic surgery RPM services.

METHODS: The PAR team included three surgeons, three nurses, and three researchers experts in RPM services design and cost analysis. The team worked for six months in three stages of the scorecard design: 1) identification of domain and outcome measures through synthesis and clustering of available databases, 2) assessment of practitioners’ agreement with the measures and associated analytical techniques through a focus group, 3) development and real-world validation of the scorecard through two focus groups. Clinical outcomes were analyzed using Wilcoxon signed-rank test, patient-reported outcomes using stability analysis, technical efficiency using data envelopment analysis, and costs using the Time-Driven Activity-Based methodology.

RESULTS: The scorecard includes four value domains and 16 outcome measures at the patient and population levels. Practitioners understood the need to measure the impact of clinical intervention calls on outcomes stability to better act upon unexpected outcomes. Stability analysis allowed the identification of those PROMs that were most important to monitor in an RPM service for cardiothoracic surgery. PROMs with the lowest number of stable days were, on average, pain (3.8 days), steps (6.5 days), and heart rate and blood pressure (12.4 days).

CONCLUSIONS: