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While seemingly incompatible, combining global software development and agile practices is a challenge undertaken by many companies. Case study reports on the successful use of agile practices in small distributed projects already exist. How these practices can be applied to larger projects, however, remains unstudied. This paper reports a case study on agile practices in a 40-person development organization distributed between Norway and Malaysia. Based on seven interviews in the development organization, we describe how scrum practices were successfully applied, e.g. using teleconferencing and web cameras for daily scrum meetings, synchronized 4-week sprints, weekly scrum-of-scrums, and Jira for backlog management. Non-scrum agile practices included nightly builds, automated testing, and team rooms. Supportig global software development practices, e.g. frequent visits, unofficial distributed meetings, domain expert networks, and annual gatherings are described. Positive experiences of using scrum included improved communication, trust and motivation, as well as better perceived quality. Challenges included misunderstood requirements, lack of videoconferencing possibilities, and awkward communication in distributed meetings due to cultural and geographical distance. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, there was an urgent need to develop an automated COVID-19 symptom monitoring system to reduce the burden on the health care system and to provide better self-monitoring at home. Objective: This paper aimed to describe the development process of the COVID-19 Symptom Monitoring System (CoSMoS), which consists of a self-monitoring, algorithm-based Telegram bot and a teleconsultation system. We describe all the essential steps from the clinical perspective and our technical approach in designing, developing, and integrating the system into clinical practice during the COVID-19 pandemic as well as lessons learned from this development process. Methods: CoSMoS was developed in three phases: (1) requirement formation to identify clinical problems and to draft the clinical algorithm, (2) development testing iteration using the agile software development method, and (3) integration into clinical practice to design an effective clinical workflow using repeated simulations and role-playing. Results: We completed the development of CoSMoS in 19 days. In Phase 1 (ie, requirement formation), we identified three main functions: a daily automated reminder system for patients to self-check their symptoms, a safe patient risk assessment to guide patients in clinical decision making, and an active telemonitoring system with real-time phone consultations. The system architecture of CoSMoS involved five components: Telegram instant messaging, a clinician dashboard, system administration (ie, back end), a database, and development and operations infrastructure. The integration of CoSMoS into clinical practice involved the consideration of COVID-19 infectivity and patient safety. Conclusions: This study demonstrated that developing a COVID-19 symptom monitoring system within a short time during a pandemic is feasible using the agile development method. Time factors and communication between the technical and clinical teams were the main challenges in the development process. The development process and lessons learned from this study can guide the future development of digital monitoring systems during the next pandemic, especially in developing countries. JMIR Med Inform 2021;9(2):e23427 doi:10.2196/23427 [ABSTRACT FROM AUTHOR]