JMIR Publications

ABSTRACT

Background:

There was an urgent need of developing an automated COVID-19 symptom monitoring system during the COVID-19 pandemic to reduce the burden of the healthcare system and to provide better self-monitoring at home.

Objective:

This paper aims to describe the development process of CoSMoS (COVID-19 Symptoms Monitoring System) and the lessons learned. We describe all the essential steps from clinical perspectives and technical approaches in designing, developing, and implementing the system during a pandemic.

Methods:

CoSMoS was developed in three phases: (1) Requirement formation to identify clinical problems and drafting the clinical algorithm. (2) Development-testing iteration using agile software development method. (3) Implementation setup to design an effective clinical implementation workflow using repeated simulations and role plays.

Results:

A total of 19 days was used to complete the development of CoSMoS. In phase 1 (requirement formation), we have identified three main functions: (1) daily automated reminder system for patients to self-check their symptoms, (2) safe patient’s risk assessment to guide patient in clinical decision making, and (3) active telemonitoring system with in-time phone consultation. System architecture of CoSMoS involved 5 components: Telegram instant messaging, clinician dashboard, system admin (backend), database, and Develops infrastructure. The implementation setup of CoSMoS involved the consideration of the COVID-19 infectivity and patient safety.

Conclusions:

Developing a patient’s symptoms monitoring system within a short period of time during a pandemic is feasible using the Agile development method. Time factor and communication between technical and clinical teams were the main challenges in the development process. Lessons learnt from this development would guide the future development of eHealth innovation in a pandemic.