SAFE@home-II study: a telemonitoring platform for hypertensive complications in pregnancy

We compared SAFE@home with standard care for women with a high risk of hypertensive complications in pregnancy. SAFE@home combines daily at-home blood pressure measurements with health complaint questionnaires and a reduced number of antenatal visits. SAFE@home was co-created with Luscii, a partnership allowing the development of an app directly integrating blood pressure data and questionnaires in Electronic Health Records. Each participating center developed a care pad designed to fit their day-to-day clinical practice and specific patient population. We collected data on perinatal outcomes, implementation and cost-effectiveness.

With an increasing workload in (obstetric) health care due to an increase in the percentage of pregnancies requiring medical care, combined with an increasing shortage in healthcare professionals (HCPs), innovative solutions reducing workload are essential. SAFE@home, offering a reduction in the number of antenatal visits, could be this essential solution.

Compared to standard care (N=484), the use of SAFE@home (N=497) resulted in fewer complications and adverse events (23.9% versus 17.6). Patients and HCPs were satisfied with SAFE@home. The majority of patients would use SAFE@home again and would recommend it to others. The majority of HCPs expects and desires this innovation to become standard care. Moreover, SAFE@home led to a 9.4% (€732) reduction in costs per patient, reflective of a reduction in antenatal care burden. This indicates that from patient and HCPs point of view SAFE@home could be the solution for the growing healthcare workforce shortages, while maintaining current safety standards. Furthermore, SAFE@home could lead up to 2.4 million in cost savings per year if it became standard care in the Netherlands. 

With this study, we proved SAFE@home to be as safe as standard care. We identified facilitators and barriers of implementation amongst patients and HCPs. Moreover, we created a road map with generic lessons for the implementation of future digital health innovations.