Cost-effectiveness of a novel smartphone application to mobilize first responders after witnessed OHCA in Belgium

Abstract

Background EVapp (Emergency Volunteer Application) is a Belgian smartphone application that mobilizes volunteers to perform cardiopulmonary resuscitation (CPR) and defibrillation with publicly available automatic external defibrillators (AED) after an emergency call for suspected out of hospital cardiac arrest (OHCA). The aim is to bridge the time before the arrival of the emergency services. Methods An accessible model was developed, using literature data, to simulate survival and cost-effectiveness of nation-wide EVapp implementation. Initial validation was performed using field data from a first pilot study of EVapp implementation in a city in Flanders, covering 2.5 years of implementation. Results Simulation of nation-wide EVapp implementation resulted in an additional yearly 910 QALY gained over the current baseline case scenario (worst case 632; best case 3204). The cost per QALY associated with EVapp implementation was comparable to the baseline scenario, i.e., 17 vs 18 k€ QALY−1. Conclusions EVapp implementation was associated with a positive balance on amount of QALY gained and cost of QALY. This was a consequence of both the lower healthcare costs for patients with good neurological outcome and the more efficient use of yet available resources, which did not outweigh the costs of operation.

A roadmap to building first responder networks: Lessons learned and best practices from Belgium and Switzerland

“…In Belgium, the EVapp system maximizes community resources by utilizing available AED and BLS trained individuals. 14 Recruitment is done mainly through interactions with professional and non-governmental organizations. The network’s current costs are covered by local authorities or governments.…”

“…In Belgium, a community-based emergency FR network has been established to respond to OHCA using the EVapp smartphone application. 14 EVapp mobilizes FR to perform CPR and uses publicly available defibrillators (PAD) in response to suspected OHCA before the arrival of EMS ( Fig. 1 ).…”

Empowerment Kader dan Perangkat Desa dalam Peningkatan Kapasitas Pertolongan Gawat Darurat Menggunakan Smartphone Android di Desa Pinggiran Sungai Kabupaten Banjar

“…Pengabdian masyarakat yang berjudul "Empowerment Kader dan Perangkat Desa dalam Peningkatan Kapasitas Pertolongan Gawat Darurat Menggunakan Smartphone Android di Desa Pinggiran Sungai Kabupaten Banjar" merupakan sebuah inisiatif yang bertujuan untuk meningkatkan kapasitas pertolongan gawat darurat di Desa Pinggiran Sungai, Kabupaten Banjar, dengan memanfaatkan teknologi smartphone Android (Del Pozo et al, 2019;García Fierros et al, 2021;Khan et al, 2018;Vercammen & Moens, 2020).…”

Responding to Cardiac Arrest in the Community in the Digital Age

“…9 EMS services around the globe have implemented these types of emergency response programs that use smartphones to activate lay people to act as first responders. These programs use GPS mapping to direct previously registered volunteers to SCA and AED locations via a mobile phone, either by short messaging service (SMS) alerts or through an app, are relatively inexpensive to implement and can increase SCA survival without major increases in costs to the health care system 48 (see Supplemental Table S1 for further details about these apps).…”