Applying digital technologies for remote care in the real life context: A 3-year experimentation with postoperative...

Surgery remains the main curative treatment for lung cancer patients. However, operation has resulted in some-degree reduction in postoperative pulmonary function. The decreased pulmonary function could be rehabilitated to the preoperative level through restoring exercise, which is related to the ways and exercise time of rehabilitating. The Dignio platform is 1 digital telemedicine system and has been used maturely in Norway, however, it has not yet been widely promoted in China. In the present study, we adopted the telemedicine system, according to the formulated rehabilitation exercise program, to design a good way to recover pulmonary function for postoperative lung cancer patients, promoting early and quick recovery, and reducing the long-term postoperative complications and outpatient visits. This retrospective controlled study enrolled 250 postoperative lung cancer patients using a remote digital care platform and 250 matched controls receiving standard instructions. In the postoperative 1-week follow-up, we found that the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory volume in 6 seconds, FVC25-75, peak expiratory flow had an obvious upward trend, although there were no significant differences in the measurements on postoperative day 7 compared with day 1. From the long-term data at 1 month/3 months/6 months post-operation, we found that the recovery was better to varying degrees in the experiment group using the remote care digital platform, compared with that of the control, especially the FEV1 at 3 (P = .065) and 6 months post-operation (P = .037), and forced Expiratory Flow between 25% and 75% of forced vital capacity at 3 months post-operation (P = .084). However, most pulmonary values, such as the FEV1/FVC, FVC and peak expiratory flow have no significant difference (all P > .05) in the recovery at 1 month post-operation between the experimental group and control, the second time at 3 months and the third time at 6 months after surgery. Especially in the experimental group, 2 patients with sudden pneumothorax were timely detected after discharge through the Digino platform, the patient returned to the hospital in time, and both patients were out of danger ultimately. The Digino remote care indeed has some benefit in the pulmonary function recovery in the long-term follow up, and reduces postoperative complications obviously.