Validation of a Patient Prioritization Tool: Addressing Decision-Support Tools’ Development in Complex Systems

As times to access health services have significantly increased worldwide in recent years, strategies and tools to better manage patients’ waiting lists have gained research interest. Computer-Based Patient Prioritization Tools (PPT) aim to manage access to care by ranking patients on waiting lists equitably and rigorously so that higher-priority patients are treated ahead of those with lower priority, regardless of when they were added to the list. However, healthcare systems are inherently complex, involving multiple stakeholders, dynamic interactions, and contextual constraints that make the implementation of such tools challenging. The development of decision-support tools in such environments follows an iterative life cycle that includes design, implementation, verification, validation, and deployment. Among these stages, validation is critical to ensure that the tool not only meets its intended specifications but also produces improved outcomes without unintended consequences when integrated into real-world workflows. Although the literature devoted to PPT is rich, works describing the transition of research prototypes to real-world applications within these complex systems are relatively scarce. This paper presents and discusses the validation process of a PPT, illustrating how this step contributes to improving the tool, building future users’ confidence, and providing insights into the challenges and difficulties related to expert evaluation in complex healthcare environments.