ACS Prototype for 'post-discharge self-management'- proposition for patients, medical staff and care institution.

Patients who have been discharged from hospital after being treated for a heart
attack (intervention, bypass) typically receive a program of care that includes
medication therapy and rehabilition. Patients also receive an information
package at discharge about their condition and details on how to manage their
condition (and symptoms) during and after their care plan. Health care
providers (cardiologists, nurse specialists, rehab nurses) are currently
dissatisfied with patient self management support because many patients drop
out of rehabilitation and their lifestyle reverts to pre-event patterns after
the rehabilition support. Patients often complain about being overloaded with
information directly post-discharge while lacking support at later moments in
their recovery. Hospitals (such as Alkmaar) are interested to work with
manufacturers and solution providers to give connected tools to their patients
to measure and manage their recovery. The ACS prototype is designed to support
these different stages of recovery to allow the patient to better self manage
and contextualize their condition (symptoms, heart rate, blood pressure,
weight) in relation to their activity and medication and helps them to better
communicate with their care provider. The ACS prototype also provides
information to the care provider about the status and concerns of their
patients during the consultations and between consults. Currently there is no
solution on the market that offers such a complete package for patients.

To gain qualitative insights into the value of the *ACS post-discharge
self-management proposition* for patients, medical staff and care institution.
Understand how this prototype is used in practice by patients and staff *
Investigate how it affects the self management and clinical workflow for ACS
post-discharge patients.
Gather feedback on overall prototype, and independent functionalities/features
for future development and scaling of the prototype.

This prototype test will be an explorative evaluation.

The patients will be recruited before the moment of discharge from the NWZ
hospital (after they had a cardiac intervention), and will test the prototype
for a period of 5 weeks. During this period, 2-3 weeks of rehabilitation is
provided by the rehab nurses as part of the standard post-discharge care
program as well as a cardiopulmonary exercise test to determine the patient*s
exercise capacity (again part of the standard procedure of the hospital). The
prototype consists of a prototype app installed on an iPhone, combined with the
connected healthwatch, bloodpressure cuff and weighing scale.
App usage data will be collected via automated tracking. Additional qualitative
data will be obtained through interviews with the patients at three points in
time: at the moment of intake/onboarding, after week 1, and at the end of their
participation after week 5. Patients will also receive a weekly short (digital)
questionnaire to share their immediate feedback / evaluation of the prototype.
Throughout the total duration of the study (3 months), also a selected group of
Healthcare professionals (HCPs) will participate in the study and use the
professional interface of the prototype app. Before the start of the study they
will receive a training and instructions for use, and halfway and at the end of
the study, focus group sessions will take place to gather to collect their
feedback / evaluation of the prototype.

Patients will wear a smart-watch watch connected to an i-phone for 5 weeks. The
watch contains a number of instruments that can measure heart rate and exercise
performances.
In addition, the patient receives an electronic weight scale and an electronic
blood pressure monitor. On request the patient is asked to measure the weight
once a day and measure the blood pressure a few times.

The application is installed on the phone and has a number of characteristics:
Displaying the measurements,
Ability to register and display complaints,
Chat function that can be used on the initiative of the patient
Video function that can be used on the initiative of the patient
A messaging feature that sends daily personalized messages to the patient;
focused on information and education

The potential negative burden is in terms of time load 90 minutes in 5 weeks
predominantly at the initiation and exit visits
The patient is asked to perform a few measurements daily