WtsWrng Interim Comparative Effectiveness Evaluation and Description of the Challenges to Develop, Assess, and Introduce This Novel Digital Application in a Traditional Health System

Laura Sampietro-Colom (), Carla Fernandez-Barcelo, Ismail Abbas, Blanca Valdasquin, Nicolau Rabasseda, Borja García-Lorenzo, Miquel Sanchez, Mireia Sans, Noemi Garcia and Alicia Granados
Additional contact information
Laura Sampietro-Colom: Assessment of Innovations and New Technologies Unit, Research and Innovation Directorate, Clínic Barcelona University Hospital, 08036 Barcelona, Spain
Carla Fernandez-Barcelo: Assessment of Innovations and New Technologies Unit, Research and Innovation Directorate, Clínic Barcelona University Hospital, 08036 Barcelona, Spain
Ismail Abbas: Assessment of Innovations and New Technologies Unit, Research and Innovation Directorate, Clínic Barcelona University Hospital, 08036 Barcelona, Spain
Blanca Valdasquin: Assessment of Innovations and New Technologies Unit, Research and Innovation Directorate, Clínic Barcelona University Hospital, 08036 Barcelona, Spain
Nicolau Rabasseda: Mangrana Ventures S.L., 08006 Barcelona, Spain
Borja García-Lorenzo: Assessment of Innovations and New Technologies Unit, Research and Innovation Directorate, Clínic Barcelona University Hospital, 08036 Barcelona, Spain
Miquel Sanchez: Emergency Department, Clínic Barcelona University Hospital, 08036 Barcelona, Spain
Mireia Sans: CAP Comte Borrell, Consorci Atenció Primaria Salut Barcelona Esquerra—CAPSBE, 08029 Barcelona, Spain
Noemi Garcia: CAP Comte Borrell, Consorci Atenció Primaria Salut Barcelona Esquerra—CAPSBE, 08029 Barcelona, Spain
Alicia Granados: Mangrana Ventures S.L., 08006 Barcelona, Spain

IJERPH, 2022, vol. 19, issue 21, 1-19

Abstract: Science and technology have evolved quickly during the two decades of the 21st century, but healthcare systems are grounded in last century’s structure and processes. Changes in the way health care is provided are demanded; digital transformation is a key driver making healthcare systems more accessible, agile, efficient, and citizen-centered. Nevertheless, the way healthcare systems function challenges the development (Innovation + Development and regulatory requirements), assessment (methodological guidance weaknesses), and adoption of digital applications (DAs). WtsWrng (WW), an innovative DA which uses images to interact with citizens for symptom triage and monitoring, is used as an example to show the challenges faced in its development and clinical validation and how these are being overcome. To prove WW’s value from inception, novel approaches for evidence generation that allows for an agile and patient-centered development have been applied. Early scientific advice from NICE (UK) was sought for study design, an iterative development and interim analysis was performed, and different statistical parameters (Kappa, B statistic) were explored to face development and assessment challenges. WW triage accuracy at cutoff time ranged from 0.62 to 0.94 for the most frequent symptoms attending the Emergency Department (ED), with the observed concordance for the 12 most frequent diagnostics at hospital discharge fluctuating between 0.4 to 0.97; 8 of the diagnostics had a concordance greater than 0.8. This experience should provoke reflective thinking for DA developers, digital health scientists, regulators, health technology assessors, and payers.

Keywords: mHealth; innovation; technology assessment; digital health; digital application; triage; WtsWrng (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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