Londral, AAzevedo, SaloméDias, P.Ramos, C.Santos, J.Martins, F.Silva, R.Semedo, H.Vital, C.Gualdino, A.Falcão, J.Lapão, Luis VelezCoelho, P.Fragata, José G.2022-06-232022-06-232022-05-211472-6963PURE: 44520510PURE UUID: 99fda38e-246a-4adc-9225-cb74eed347d8PubMed: 35597936PubMedCentral: PMC9123610Scopus: 85130375105http://hdl.handle.net/10362/140655Funding This work was supported by Fraunhofer AICOS and Vodafone Portugal and funded by the National Foundation of Science and Technology under the projects DSAIPA/AI/0094/2020 and Lisboa-05-3559-FSE-3.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.1668051engCardiac Surgical ProceduresDelivery of Health CareFollow-Up StudiesHumansLearningPilot Projectsjournal article10.1186/s12913-022-08073-4