A digital, patient-centered carepath for cardiac surgical care with continuous remote patient monitoring

Postoperative complications and readmissions remain common after cardiac surgery, and intermittent manual vital-sign checks leave patients unmonitored for much of the recovery period. We implemented a phygital care pathway combining Enhanced Recovery After Surgery (ERAS) protocols, and 21-day continuous remote monitoring (heart rate, respiratory rate, temperature, blood pressure, oxygen saturation) with daily review and escalation to a cardiac surgeon when indicated. Quality of Recovery (QoR-15) was assessed on preoperative days -1 and postoperative days 3 and 7, and patient-reported experience (PREM) on day 30. Outcomes in 221 monitored patients (May-November 2025) were compared, retrospectively, with a historical, non-monitored cohort of 206 patients. In the monitored patients, a good-to-excellent QoR increase from 25% to 56% between days 3 and 7 was noticed. Seventy-five patients (34%) required 98 interventions, most commonly primary-care referral or medication adjustment. Thirty-day readmission (12.7% vs 12.1%, Fisher p = 0.88) and mortality (0.45% vs 1.4%, Fisher p = 0.36) did not differ significantly from the control cohort; the monitored group was significantly younger (66.7 vs 70.1 years, p = 0.0004), reflecting probable selection bias from smartphone and digital-literacy eligibility criteria. PREM scores were high (>91%). This pilot demonstrates the feasibility of a digital, patient-centered cardiac surgical pathway; readmission and mortality findings are hypothesis-generating and require prospective confirmation.