The published base, and how we add to it.
The published evidence base for structured post-discharge monitoring, and Aescia’s approach to generating product-specific evidence through rigorous clinical evaluation.
The evidence base for post-discharge monitoring.
The published literature on early hospital readmission has been consistent across two decades of analysis. Jencks and colleagues, working in the United States Medicare population, established that a meaningful fraction of inpatient discharges are followed by readmission within 30 days. Van Walraven and colleagues, in a systematic review across multiple countries, reported that a substantial proportion of those readmissions are judged avoidable by treating clinicians on retrospective review.
Leppin and colleagues, in a meta-analysis of randomised trials, reported that interventions involving structured patient contact during the post-discharge window are associated with reduced readmission rates. Hansen and colleagues, in a parallel systematic review, classified the interventions that have been studied and noted that combinations of pre-discharge and post-discharge components tend to outperform single-element approaches.
This bears on hospital capacity as much as on the patient. Because an avoided readmission is an inpatient stay that does not happen, the readmission literature is, in effect, also a literature about bed-days: in high-acuity surgical units, where the bed is the binding constraint, fewer avoidable readmissions and a smoother recovery mean bed-days returned to the service. Whether any particular monitoring approach achieves that, and to what degree, is an empirical question that each product must answer in its own trial.
The literature describes the territory; it does not characterise any specific software product, including Aescia. Citations are listed below.
The findings above are observations about the published literature on post-discharge care. They are not statements about the performance, intended use, or expected outcomes of Aescia for Hospitals. Aescia makes no claim to reduce readmissions, length of stay, or bed-days; that is precisely what the SAFE-Discharge trial is designed to evaluate.
What happens before shapes what happens after.
A second body of published research looks at the period before a procedure or operation. Systematic reviews of prehabilitation in higher-risk patients before major surgery have reported associations with shorter hospital stays and fewer severe complications, though the evidence is still developing and not every study finds the same effect. In endoscopy, inadequate bowel preparation has been associated with longer inpatient stays and higher hospitalisation costs.
Aescia for Clinics is a workflow and patient-preparation platform. It delivers clinician-authored preparation pathways, medication-hold guidance, and timed reminders into a patient web app, in the patient’s own language. It is not a medical device and does not propose clinical decisions. The studies below describe the published evidence on preparation and prehabilitation; Aescia’s role is to deliver those clinician-authored steps reliably and at scale, not to claim a clinical outcome of its own.
These are observations about the published literature on preparation and prehabilitation. They are not statements about the performance or expected outcomes of Aescia for Clinics.
Our clinical programme.
Aescia’s product-specific evidence is generated through structured clinical evaluation. Our active programme is SAFE-Discharge: a prospective single-centre evaluation at the Royal Prince Alfred Hospital cardiothoracic surgical unit in Sydney. The trial is registered with the Australian New Zealand Clinical Trials Registry. This page does not recruit trial participants.
- Registration
- ACTRN12625001425482
- Site
- Royal Prince Alfred Hospital, Sydney
- Unit
- Cardiothoracic Surgery Unit
- Sponsor
- Sydney Local Health District (SLHD)
- Principal Investigator
- Dr Kei Woldendorp, The Baird Institute
- Population
- Adult patients post cardiothoracic surgery (CABG, valve, thoracic procedures)
- Sample size
- 550 patients (50 interim + 500 main), single centre
- Status
- Ethics approved. Site-specific governance in progress.
How we evaluate.
- Scoped evaluations
- Each clinical evaluation is scoped to a defined service line, population, and post-discharge window. Generalisation beyond that scope is not claimed.
- Predefined endpoints
- Endpoints, sample sizes, and analysis plans are pre-specified before enrolment opens. Interim analyses are pre-specified where used.
- Transparent reporting
- We report what the trial shows, whatever it shows. Negative or null results are reported in the same form as positive results.
- Ethics and governance
- All evaluations run under approval from the relevant Human Research Ethics Committee and site-specific research governance.
- Independent oversight
- Sponsor responsibility sits with the trial-sponsoring institution. Aescia does not arbitrate clinical interpretation of trial outcomes.
Where we are with regulators.
Aescia for Hospitals is an investigational Software as a Medical Device. The intended classification is Class IIa under TGA Rule 3.4. A regulatory submission for ARTG inclusion is in preparation; the product has not been submitted, is not registered, and is not available for commercial supply.
The software lifecycle follows IEC 62304:2006+A1:2015 processes, implemented and documented internally. ISO 13485:2016 quality-system implementation and ISO/IEC 27001:2022 information-security controls are in place; certifications under those standards have not been obtained and no third-party conformity assessment has been undertaken.
Clinical outputs from Aescia for Hospitals are advisory and require clinician review. The product does not autonomously act on patient responses; the treating clinical team remains the decision-maker for any change in care.
Published references.
- PaperJencks SF, Williams MV, Coleman EA (2009)Rehospitalizations among patients in the Medicare fee-for-service program.New England Journal of Medicine, 360:1418-1428
- Papervan Walraven C, et al. (2011)Proportion of hospital readmissions deemed avoidable: a systematic review.Canadian Medical Association Journal, 183(7):E391-E402
- PaperLeppin AL, et al. (2014)Preventing 30-day hospital readmissions: a systematic review and meta-analysis of randomized trials.JAMA Internal Medicine, 174(7):1095-1107
- PaperHansen LO, et al. (2011)Interventions to reduce 30-day rehospitalization: a systematic review.Annals of Internal Medicine, 155(8):520-528
- PaperSkořepa P, et al. (2024)The impact of prehabilitation on outcomes in frail and high-risk patients undergoing major abdominal surgery: a systematic review and meta-analysis.Clinical Nutrition, 2024; doi:10.1016/j.clnu.2024.01.020
- PaperYadlapati R, et al. (2015)Predictors of inadequate inpatient colonoscopy preparation and its association with hospital length of stay and costs.Digestive Diseases and Sciences, 60(11):3482-3490
For the regulatory and security posture in detail:
Read governance