85% of Health Apps in the U.S. Do Not Meet Quality Thresholds

WASHINGTON, DC and DARESBURY, UK, OCTOBER 15, 2020 – The American Telemedicine Association (ATA) today announced a new partnership with ORCHA (Organisation for the Review of Care and Health Apps) to create a review process for the U.S. to enable healthcare providers, insurers, and employers to give patients access to safe and effective health apps. ORCHA’s automated, intelligent review engine allows healthcare organisations to assess thousands of apps against more than 300 measures in order to build and manage a health app program. The partnership was announced today during the ATA’s special half-day event at the HLTH VRTL conference.

“The proliferation of health apps has created challenges for healthcare providers and patients seeking to find the most appropriate, safe, and effective health apps to monitor their health and wellness, maintain a healthy lifestyle, and securely collect and transmit personal health information. We are delighted to partner with ORCHA to address this critical need and give both patients and providers greater confidence in selecting safe and effective apps,” said Ann Mond Johnson, CEO, the ATA. “Chat-based interactions and asynchronous tools are an important component of telehealth offerings and can help ensure that everyone has access to safe, effective, and appropriate care when and where they need it.”

The ATA will work with ORCHA to develop a review process and criteria that meet the specific needs of the U.S. market. App developers will be able have their app reviewed against ORCHA’s more than 300 measures. If the app meets the criteria, it will be added to the ATA library of approved apps. Health providers, insurers and employers will be able to use this trusted platform to build their own dedicated health app library with high quality apps suitable for their patients.

“This partnership will enable healthcare providers to better spot the best health apps from the hundreds of thousands available in app stores. It can also arm clinical staff with the software that will enable them to connect the right apps with the right patients at the right time,” added Liz Ashall Payne, CEO, ORCHA.

ORCHA has evaluated more than 4,000 health apps currently available in the U.S. against its criteria and found only 15% meet quality thresholds. Most apps fail to meet healthcare, security or usability standards established to safeguard patients.  Such quality standards apply across apps for all health conditions, from fitness to heart conditions.  For example, ORCHA has assessed 584 apps designed to support people with mental health conditions and found only 29.6% meet quality thresholds.

“There are many safe and effective health apps built by U.S. innovation companies that have the potential to help individuals create and sustain healthy habits, monitor health conditions, and share important personal health information with their providers, family members, and caregivers,” said Joseph C. Kvedar, MD, President of the ATA; Professor, Harvard Medical School; and Editor-in-Chief, npj Digital Medicine. ”The mission of the ATA is to create access to quality care for all individuals and this is another important step, ensuring people have access to safe and appropriate digital health apps.”

Health apps offer immediate and convenient access to personalized and engaging health support. Thanks to the rise in smart phone ownership, 19% of Americans have downloaded or used health care apps and more than 8 in 10 rate health apps as either very or somewhat helpful. Yet, app stores have no regulation or criteria in place to help patients and providers select health apps that best suit their needs.

About the ATA

As the only organization completely focused on advancing telehealth, the American Telemedicine Association (ATA) is committed to ensuring that everyone has access to safe, affordable, and appropriate care when and where they need it, enabling the system to do more good for more people. The ATA represents a broad and inclusive member network of health care delivery systems, academic institutions, technology solution providers and payers, as well as partner organizations and alliances, working to advance industry adoption of telehealth, promote responsible policy, advocate for government and market normalization, and provide education and resources to help integrate virtual care into emerging value-based delivery models. Visit the ATA COVID-19 Resource Center. @americantelemed #telehealthishealth #ATApolicy

About ORCHA

The Organisation for the Review of Care and Health Apps (ORCHA) is the world’s leading, independent digital health evaluation and distribution organisation. It helps health and care organisations to deliver the right digital health apps, to the right people, at the right time. Its unique insight, assessment, and implementation services are improving the health of the population, the health of our health systems and the health of the health app ecosystem. ORCHA conducts reviews for government organisations across Europe, the Middle East, and Australasia.  In the UK, ORCHA conducts reviews for the NHS and is part of the NHS National Innovation Accelerator Programme.

Milestones in digital health since 16 March 2020

“Now is the time for everyone to stop non-essential contact and travel.” The year that followed the Prime Minister’s decision to place the UK in lockdown measures has transformed the role of digital health in our lives and NHS services.

There has been an explosion in the demand for digital health. Five million health apps are downloaded every day. But as 80% do not meet NHS standards, over the past 12 months around 1.5bn apps that do not meet standards have been downloaded. 

The past year has also seen the rapid launch of new apps and the advancement of much needed tools, especially when remote care was needed. For example, there are now more than 750 apps to help inform, track or gather COVID-19 data,¹ more than 858,000 people downloaded the Couch to 5K app in 2Q20 – a 92% increase over 2019.² The world’s 10 largest English-language mental wellness apps saw 10 million downloads in April 2020,³ and who didn’t appreciate Matthew McConaughey and Harry Styles’ collaboration with the Calm meditation app?

To help people access safe and reliable apps remotely, within 38 days from lockdown, ORCHA launched its free COVID-19 App Library available to all NHS and care staff. The NHS also rapidly stepped in to embed safe app libraries into services. An ORCHA App Library was part of the national COVID-19 response in Northern Ireland, bespoke libraries were also launched by the Chartered Society of Physiotherapy and the British Dietetic Society for their members. CCGs and Trusts in 70% of NHS regions now have an ORCHA app library in place, making safe and effective health apps easy to find.

Commenting on Northern Ireland’s app library, Robin Swann, Health Minister, Northern Ireland announced in March:

“We are now able to support people to look after their mental health and this app library provides a one stop shop where the public can access safe and secure apps to help them during the pandemic.”

Cathy Connolly, CEO, Care Merseyside recently reported:

“Apps have been a lifeline to the people we support, particularly during COVID-19. Apps have given the charity a different way we can provide support to people. It has enabled us to give help to people with a wide range of challenges, recommending apps such as Sidekick to help with weight management to Sleepio, to help people to sleep better.”  

As we look forward to a return to life outside of lockdown restrictions, we hope that not everything returns to pre-COVID. We hope that:

•         Consumers continue to personally engage with their health, enjoying the insights, entertainment and social engagement that health apps bring.
•         Developers continue to innovate, driven to extend the reach of NHS services.
•         NHS commissioners and clinicians continue to embed safe and effective digital into everyday practice.

We look forward to the next 365 days.

Sources: 

(1) https://orchahealth.com/health-apps-for-long-covid-self-management-report/  

(2) https://www.england.nhs.uk/2020/07/around-one-million-downloads-of-fitness-app-during-lockdown-as-people-stay-fit/

(3) https://sensortower.com/blog/top-mental-wellness-apps-april-2020-downloads

Challenge

A partnership of health and social care organisations working together, Our Dorset holds the ambition for its 750,000 residents to lead healthier, fulfilling lives supported by sustainable health and care services. But the organisation faces real challenges. Dorset’s population is ageing, bringing more long-term conditions, which places a growing demand on services. Its funding cannot keep pace with this growth in demand and without changing its services, in five years it would face an annual shortage of £229 million a year(1).

To address its ambitions and challenges, the Integrated Care System has identified a clear plan, in which digital plays an enabling role.  It established a ‘digitally-enabled Dorset programme’ to increase the use of technology in the health and care system, to support new approaches to service delivery.

Solution

The programme first researched and established the building blocks needed to establish public facing digital health.  Alongside videos and the NHS choices website, apps were identified as a key building block to enable patients to better manage their own health.

To understand more about if and how health professionals could recommend the use health apps and what would be needed to support them, a pilot was run with 20 nurses.  This revealed the team didn’t know where to find good health apps, how to know if they could trust them, if they met policy or who to ask for advice.

Without the expertise to establish a closed-loop quality assured programme, or capacity to be able to test health apps, let alone test them again when they are updated, the team recommended partnering with ORCHA.  They selected ORCHA as they had seen how it had delivered testing at a national level and for other regional providers.  With ORCHA, Our Dorset could build a programme to mitigate risk and assure clinical teams they are recommending safe apps.

ORCHA tested apps against 350 standards and measures and worked with Our Dorset to identify the best health apps across each priority health area. A dedicated app library was built to house the apps and enable patients and staff to search.  It was also agreed that if an app doesn’t appear in the library it will not be recommended by any member of staff.  If an app is ever nominated that isn’t in the library it will first be reviewed by ORCHA before being used by Our Dorset.

Our Dorset also opted to include a feature to enable staff to recommend apps via email or text message from the app library directly to residents and patients. This eliminated human error and enabled recommendations to be monitored.

Once ready, the team ran a series of 30 onboarding sessions across all ICS providers and governance leads, including all non-clinical teams, including link workers, health coaching and social prescribers.  Over one or two sessions, teams were briefed on the value proposition of health apps, walked through the system and key apps were demonstrated.  The health app programme also saw the emergence of a local Community of Practice which became a regular fixture on team meetings, prompting people to share learnings, tips and good practice including hearing about cohorts that are responding well to health apps.

Alongside training staff, the app library was launched to the public, forming part of its #HereForYou campaign which reassures Dorset residents that their health services are still available should they need them and that they should seek help and advice despite the Covid-19 pandemic.  This included PR, social and paid digital activities.

Results

Since introduction, the teams have actively embedded the app library and the practice of recommending health apps into their service offer. The teams drive home the concept of self-management and pick out effective tools that are available.

There have been almost 25,000 pages viewed on the site (up to the end of November 2020), and in one month alone, the app library achieved nearly 5,500 page views.  Social prescribers are actively recommending apps to service users and vitally, this advice is being acted upon, with almost 1,500 apps recommended to date and 56% of recommended apps downloaded, which is a very good engagement rate, especially compared with other services.

The most popular search terms include Mental Health MSK, Dementia, Diabetes and Cancer. Some of the most popular apps to be viewed are Wysa: Stress, Depression & Anxiety Therapy, Sleepio, NHS Weight Loss Plan and Musculoskeletal (MSK) Self Care, providing a range of health interventions and show that apps are being selected to improve the physical and mental health of the population.

One of the most active recommenders of health apps is George Mitchell, Social Prescriber, Live Well Dorset. One app from the library he finds useful is Quit Now, as he shares that “it gives people support 24×7.” He regularly shares app tips with other prescribers, as he says “Don’t assume that just because you know about an app, everyone else does.”

Commenting on the programme Crystal Dennis, Interim Lead for Public Facing Digital Health Services, Our Dorset Digital said:

“ORCHA power our health app library. They help us to break down the barriers and mitigate issues around digital health. Previously our clinical leads didn’t recommend digital health technologies as they had no idea where to look, were concerned about implied liability and couldn’t tell if a technology was of a good standard.  Thanks to ORCHA we are building the trust with clinical teams and have put in place the tools and governance they need.”

Source: (1) https://ourdorset.nhs.uk/wp-content/uploads/2018/07/Our_Dorset_STP.pdf