Lean Assessment Process Methodology for RMD-Health: Evaluating Clinical Need Usefulness Adoption Barriers and Early Economic Value of AI in NHS Rheumatology Referrals
Author(s)
Krishana Parthipan, MSc1, Weizi Li, MSc2, James Rose, BSc, PhD1, Mamta Bajre, MSc1.
1Health Innovation Oxford and Thames Valley, Oxford, United Kingdom, 2Informatics Research Center, University of Reading, Berkshire, United Kingdom.
1Health Innovation Oxford and Thames Valley, Oxford, United Kingdom, 2Informatics Research Center, University of Reading, Berkshire, United Kingdom.
OBJECTIVES: To evaluate the clinical need, perceived usefulness, and potential adoption barriers of RMD-Health, a machine learning-based risk stratification tool designed to differentiate between inflammatory arthritis (IA) and non-inflammatory conditions (NICs) at the point of referral, using the Lean Assessment Process (LAP) methodology.
METHODS: The LAP is a structured, resource-efficient framework developed to support early-stage health technology development by aligning evidence generation with stakeholder needs and system priorities. It incorporates human factor tools and stakeholder engagement to identify unmet clinical needs, assess value propositions, and anticipate implementation challenges. The LAP enables rapid, iterative feedback to inform product design, trial planning, and serves as a precursor to early economic modelling. Semi-structured interviews were conducted with NHS clinicians, including GPs, rheumatology consultants, and registrars, across multiple Trusts in England. Thematic analysis was employed to extract insights into clinical utility, feasibility of integration, and evidence requirements. Quantitative data on perceived usefulness and stakeholder influence were also collected using validated tools embedded within the LAP framework.
RESULTS: The study showed that stakeholders were positive about the potential usefulness of RMD-Health, with key benefits including the improvement in the quality and timeliness of referrals, better triaging processes and appropriate healthcare resource utilisation. Conversely, barriers to adoption were highlighted, such as the potential increase in workload for clinicians and the reliability of the outputs was questioned. Stakeholders emphasised the importance of real-world evidence to validate diagnostic accuracy, cost-effectiveness, and usability across diverse NHS settings.
CONCLUSIONS: The LAP methodology provided a structured, stakeholder-informed approach to evaluating RMD-Health’s clinical and operational value. Findings support further evidence generation, including pilot studies and economic evaluations, to inform NHS commissioning decisions and facilitate adoption into routine care. As a flexible and scalable framework, the LAP proved effective in aligning early evidence generation with real-world clinical priorities and system-level decision-making.
METHODS: The LAP is a structured, resource-efficient framework developed to support early-stage health technology development by aligning evidence generation with stakeholder needs and system priorities. It incorporates human factor tools and stakeholder engagement to identify unmet clinical needs, assess value propositions, and anticipate implementation challenges. The LAP enables rapid, iterative feedback to inform product design, trial planning, and serves as a precursor to early economic modelling. Semi-structured interviews were conducted with NHS clinicians, including GPs, rheumatology consultants, and registrars, across multiple Trusts in England. Thematic analysis was employed to extract insights into clinical utility, feasibility of integration, and evidence requirements. Quantitative data on perceived usefulness and stakeholder influence were also collected using validated tools embedded within the LAP framework.
RESULTS: The study showed that stakeholders were positive about the potential usefulness of RMD-Health, with key benefits including the improvement in the quality and timeliness of referrals, better triaging processes and appropriate healthcare resource utilisation. Conversely, barriers to adoption were highlighted, such as the potential increase in workload for clinicians and the reliability of the outputs was questioned. Stakeholders emphasised the importance of real-world evidence to validate diagnostic accuracy, cost-effectiveness, and usability across diverse NHS settings.
CONCLUSIONS: The LAP methodology provided a structured, stakeholder-informed approach to evaluating RMD-Health’s clinical and operational value. Findings support further evidence generation, including pilot studies and economic evaluations, to inform NHS commissioning decisions and facilitate adoption into routine care. As a flexible and scalable framework, the LAP proved effective in aligning early evidence generation with real-world clinical priorities and system-level decision-making.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD68
Topic
Health Service Delivery & Process of Care, Health Technology Assessment, Medical Technologies
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)