Health apps: The litmus test

9th Jul 2018

Published in PharmaTimes magazine - July/August 2018

Our Mobile Health is on a mission to build confidence in digital health by assessing and curating high-quality health apps. CEO Julie Bretland  tells us what the company looks for in a good app and how digital  health can change the industry

Tell us about Our Mobile Health – how did the company start, what are its goals?

Our Mobile Health helps identify, assess, review, curate and distribute good high quality health apps, so that health and care organisations can recommend, deploy and ultimately prescribe digital health services with confidence.

What that means is that we find really good apps and, depending on the project, we make them available in a library. For example, we assess apps for the NHS apps library and the NHS Tariff, we partner with EMIS to provide the EMIS App library powered by Our Mobile Health for GPs, we work with Parkinson’s UK to identify and make available apps relevant to people with Parkinson’s and we assess apps for London’s Good Thinking Project.

We started the company after I’d been working on mHealth in Africa. I’d worked in digital for a long time and was fascinated to understand why apps hadn’t been adopted by the health service. Especially given the benefits apps had brought in terms of connecting to citsens in other industries and the prevalence of apps amongst citizens. Although it’s easy to launch and publish an app, getting it adopted by the health industry was really difficult. Our research showed that much of it came down to a lack of awareness and understanding and trust amongst healthcare professionals.

And so we encourage healthcare professionals to get involved in the assessment. We co-developed the current NHS health apps and wearables assessment programme, over a number of years.

What is the importance of assessing healthcare apps?

We found that, quite rightly, many healthcare professionals didn’t trust apps, even though they can offer such tremendous benefits for patients in terms of understanding their own health, creating healthier behaviours and managing particular conditions. The reason for the lack of confidence by professionals is partially because they don’t really know how to judge them and you can’t judge an app just by downloading it and having a look at it. That doesn’t tell you about where the data is hosted or the encryption being used or whether the data is being used, shared or sold or whether they comply with patient safety standards or are registered with the relevant regulating body.

By assessing apps, healthcare organisations can adopt apps at scale. It means that companies work with a portfolio of apps, thus minimising their risk and increasing the choice of apps for patients, so that they can find one which suits them and that they are more likely to engage with over a longer period of time.

Prior to the assessment, we found that apps and digital solutions were being developed in isolation, either within the health service with little input from industry and the best practices. The user experience was often poor; data security standards were poor; and there were apps being promoted which stopped working when there was an update to the new operating system.
Or apps were being developed by industry without the input of the health service, and thus there wasn’t the necessary credibility and buy-in from health professionals.

As a result healthcare professionals quite rightly didn’t have confidence in digital solutions and so those solutions weren’t adopted.
What we aim to bring to the party is good practice from the mobile industry, and an understanding of the regulations, standards and best practices that are already the norm. We’ve been lucky enough to build a great team with years of experience in healthcare and a fabulous panel of clinicians, health professionals and academics who provide their independent expertise to help review products.

Our research showed that patients are quite happy to look at the app store for wellness apps, but when they want to look for medical apps, they turn to their GP or healthcare professional. When it comes to apps, healthcare professionals don’t have anywhere to turn. So we fill that gap.

How does the assessment process work? What qualities are you looking for in an app?

We really lift the lid on an app, and the assessment process we follow and indeed co-developed is the same as the NHS Health Apps and Wearables assessment process. It consists of a self-assessment and an independent expert review. There are ten areas we look at including understanding of and compliance with regulation, a lot about the data hosting and management, privacy and consent. Patient safety is obviously a key concern, as well as usability and accessibility. You typically want people to engage with the app on an ongoing basis and want to make sure it is evidence-based.

What are the most common mistakes people make when developing these apps?

It often varies depending on the background and expertise of the app owner. For example those with a digital background might not think about the evidence that needs to be developed, or some may not be aware of all of the regulations involved. But a common issue is not thinking beyond the initial development of an app. Once it’s developed, how are you going to ensure it remains compliant with changing regulations? How are you going to distribute it and deal with feedback?
There’s still a misconception that if you develop and launch an app, the hard work is done. Actually, that’s when the hard work starts, hosting the app, managing the data, promoting the app, refining the app, monitoring the app and making sure that you’re reaching and helping the people you created the app for in the first place.

Have apps reached their potential in pharma/healthcare yet? There’s still a long way to go before the market reaches maturity. Citizens are downloading health apps and clinicians are increasingly relying on apps, but offering patients a choice of apps which are integrated as part of a pathway still has a long way to go.

Part of that is providing healthcare professionals with a portfolio of apps they can use rather than just ignoring the issue.
It’s getting citizens and patients involved in their health in a way that’s convenient for the patient and integrates into their everyday life. And in reality that means that it needs to be an integral part of healthcare delivery too.

What unmet needs in pharma/healthcare can apps address?

There’s lots but patient engagement is the main one. Think of apps not in terms of a freebie disposable item, but rather in terms of an entry point – either for a patient to access a service or to deliver a service. Apps offer the ability to engage with a single patient or a group of patients. So anything from really getting an understanding from people living with a particular condition, understanding how patients are adhering to a treatment, how they are feeling following the treatment, post-market surveillance, recruiting people into research studies. Good apps have a real ability to become a companion in life and are thus a great conduit to understanding the life of a patient and thus a health condition much better.

What does digital health mean for pharma in terms of how it engages with the NHS and patients?

Digital health offers an opportunity for pharma companies to really question their core business – is it healthcare in terms of drugs or healthcare in terms of treatments, including prevention? For some pharma companies digital health can provide the opportunity to really get involved providing healthcare beyond and around the pill.

As with any industry facing disruption, it’s often easier to do nothing, maintain the status quo and protect the cash cows. It’s a brave but ultimately necessary move to look at taking a step towards patients, how to engage and make life easier for patients on their terms.

PharmaTimes Magazine

Article published in July/August 2018 Magazine

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