A Practice-Proven Adaptive Case Management Approach for Innovative Health Care Services (Health Circuit): Cluster Randomized Clinical Pilot and Descriptive Observational Study (Preprint)

Abstract

BACKGROUND Digital health tools may facilitate care continuum. However, enhancement of digital aid is imperative to prevent information gaps or redundancies, as well as to facilitate support of flexible care plans. OBJECTIVE The study presents Health Circuit, an adaptive case management approach to support innovative healthcare services, and analyses its healthcare impact, as well as its usability and acceptability by healthcare professionals and patients. METHODS In 2018-19, health impact, usability (SUS) and acceptability (NPS) of an initial prototype of Health Circuit was tested in a cluster randomized clinical pilot (n=100) in patients with high risk for hospitalization (Study I). In 2021, a pre-market pilot of Health Circuit was conducted in 104 high risk patients undergoing prehabilitation before major surgery (Study II). RESULTS In Study I, Health Circuit resulted in reduction of emergency room visits [4 (13%) vs 7 (44%)], enhanced patients’ empowerment (p<0.001) and showed good acceptability/usability scores (NPS 31 and SUS 54/100). In Study II, NPS scored 40 and SUS 85/100. The acceptance rate was also high (mean score of 8.4/10). CONCLUSIONS Health Circuit showed potential for healthcare value generation, good both acceptability and usability despite being a prototype system, prompting the need for testing a completed system in real-world scenarios. CLINICALTRIAL NCT04056663 (clinicaltrials.gov, August 14, 2019)