Eleanor Smith MP chaired a parliamentary roundtable discussion on Tuesday 16 October 2018, supported by Roche Diabetes Care, to discuss and determine how the use of health apps can be encouraged across the NHS for the benefit of patients.

Experts were brought together to discuss:

• The potential benefits of health apps to patients and the NHS

• The key challenges and barriers to utilizing health apps in the NHS

• What advice and support should be provided to those wanting to develop or adopt a health app

• The role the life sciences industry should play in the health app NHS landscape

This note provides an overview of the key themes from the discussion, which was held under the Chatham House Rule.

Background 

Through proactive leadership from NHS England and NHS Digital, health apps are being increasingly utilized

at national and local levels across the NHS. This welcome leadership and ‘open-door policy’ is most evident in the

creation of the NHS Apps Library and the development of the NHS App. Attendees commended this proactive approach, noting that it is viewed as a global exemplar.

Alongside an update on both initiatives, attendees highlighted various health apps that have been developed by the NHS and by the digital industry, to meet specific healthcare challenges or requirements. These apps can provide different types of digital support, including:

Empowering patients and carers to self-manage and improve health outcomes

• Improving patient care from prevention to management

• Complementing existing care delivery

• Addressing health inequalities

• Acting as portals to other digital services

• Supporting administrative tasks

• Relieving pressure on the current NHS workforce

It was agreed that, despite the success to date, more can be done to fully realize the potential of apps.

Key themes from the discussion

There was consensus among attendees on the potential of health apps to support improvements in service delivery and patient

care. The group identified four interconnected themes and made several recommendations to improve the uptake of health

apps. These themes and recommendations are as follows:

1/ Facilitating greater data sharing

For the full potential of health apps to be realized within the NHS there must be effective data flow and

interoperability between apps and traditional services, for example by linking data from apps with an individual’s patient

record. Interoperability through suitable platforms and engagement criteria should be incorporated within plans for joined-up

national electronic patient records. Attendees referenced the ‘Blue Button’ concept – developed by the US Government

to signify that a site has the functionality to download health records – as a potential opportunity for learning for the NHS.

Recommendation A system of efficient and effective data sharing needs to be established for appropriate health apps

to be compatible with integration within electronic patient records.

Whilst debate continues around the ‘ownership’ of patient data, the importance of ‘intellectual property’ that is produced

by health apps should not be undermined. Attendees discussed the need to develop a centralized model of patient consent

to ensure effective data flow and interoperability. Before such a model could be introduced, attendees recommended that

an extensive public engagement campaign be undertaken around the benefits of data sharing to the individual and wider

health system.

Recommendation

A consultation should be launched by NHS England on establishing a centralized model of patient consent, alongside a public engagement program on the benefits of data sharing for individuals and the wider NHS.

2/ Expanding public engagement and education on the use of technology

The public should be made aware of the ‘trusted’ health apps that have been accredited by the NHS through sufficient

evidence submissions and how they could use these to achieve their health goals. The group suggested that public

engagement and education should utilize the most effective methods, both digital and traditional, for spreading messages

amongst all parts of the population to promote these evidence-based options over less regulated solutions. Attendees were

conscious of health inequalities and highlighted that any solutions and/or engagement should be focused on reducing

these inequalities across the country.

Recommendation

An extensive public engagement and education program should be undertaken, using digital platforms where appropriate, to showcase effective / evidence-based health apps and encourage

wider usage.

3/ Incorporating health apps into relevant clinical pathways

To encourage the uptake of accredited health apps, the group suggested an aim of including them in relevant clinical

pathways where appropriate as complementary or alternative options to traditional care. For this to happen, attendees noted

the importance of healthcare professionals understanding and trusting the various levels of evidence required for apps to be

accredited. Attendees commended the work of NHS England and NHS Digital to categorize the associated evidence required

for the app to be assessed. Healthcare professional ‘buy-in’ to health apps and new digital solutions was recognized as a key

component for successful uptake, alongside tailoring to a specific region or condition as needed.

Recommendation

Health apps should be incorporated into relevant clinical pathways, with engagement to secure

‘buy-in’ from healthcare professionals.

It was noted that the current system primarily supports and rewards the initial innovators of apps, and not those adapting

or adopting health apps to meet local patient needs. To encourage and spread best practices, the group recommended

improving signposting to examples, as well as increased support both for the initial innovators and for future

adaptors/adopters.

Recommendation

Support needs to be from conception to roll-out for innovators developing health apps, as well as for those looking to adopt or adapt existing apps for local or regional contexts.

The group discussed the approach to the appraisal of health apps and the value of establishing reimbursement pathways at a

national and local level to provide structure to support the uptake and foster further innovation. The potential success of

personal budgets was raised by attendees. It was suggested that a similar scheme could be rolled out for the use of health

apps, by allocating additional budgets for people with long-term conditions to choose and purchase their health apps.

Recommendation

Reimbursement pathways, with clear evidence benchmarks, should be created at both local

and national levels to encourage the continued uptake of, and innovation in, health apps.

4/ Utilising health apps to support the NHS workforce

Health apps have the potential to reduce pressures on the NHS workforce, through providing time-saving efficiencies in

the delivery of care. For this to be exploited, healthcare professionals need to be sign-posted to approved and relevant

health apps for their specialism and trained on their use. As the NHS looks to the future, the potential of health apps should

be viewed as a key opportunity for improving the delivery of care and reducing pressures on the stretched NHS workforce,

with health apps being either prescribed or accessible ‘off the shelf ’ solutions that individuals can download themselves.

Recommendation

Sign-posting to newly approved health apps and training on their use should be included within

programs for newly qualified and established HCPs.

Attendees with experience in developing health apps highlighted the importance of sustainability by ensuring the

products and solutions are regularly updated through partnerships with end-users to get their feedback. As part of the

NHS Apps Library it will be important that mechanisms are established that enable both developers and users of apps

to share feedback and best practice.

Recommendation

Health app developers and end-users should be supported to share feedback and best practice

on the practical development and evolution of health apps.

The coming months exacerbate conditions and bring additional pressures to health services.

But apps can offer patients a simple, quick, and free way to improve their self-management and choose the right services, reducing winter pressures.

Take steps now and using health apps may reduce your demands.

Recommend apps to patients in practice, or better still, push out app recommendations to the most vulnerable.

TAKE A LOOK AT ORCHA’S TOP 3 HEALTH APPS FOR CHOOSING WELL THIS WINTER

Zephyr Guide: Help patients with COPD and asthma improve their inhaler’s effectiveness with the Zephyr guide.

Evergreen Life: Help keep your weekly flu stats down & get your patients and staff to book their flu jab with Evergreen flu jab booker.

Medelinked: Help patients keep a complete health record before an appointment, or access a symptom checker before making the appointment with Medelinked.

REDUCE A&E WAIT TIMES BY 11% WITH WAITLESS

With only 85% of patients currently seen within the government’s target of 4 hours (the Independent), reducing waiting times for those in need of emergency services has the potential to improve patient care significantly. Already used across eleven regions, WaitLess helps patients search across walk-in centers, minor injury units, and Emergency departments, to see which units have the shortest wait times for the treatment they need.

We spoke with the former General Manager within NHS A&E services and Waitless’ CEO, to find out why it was created, how it works, and the results were seen:

Reflecting on the success around ORCHA’s Digital Healthy Schools, CEO and NIA Fellow, Liz Ashall-Payne, discusses how digital health apps can positively impact young people, with education delivered as part of the PHSE curriculum in schools.

We live in a digital world and none are more digitally savvy than our young people. Over 90% of under 16s in the UK own a mobile, and their relationship with this device is more than just a phone – it’s an extension of who they are.

Access to social media, the internet, gaming, and the multitude of apps available via these devices is not always positively impacting behavior. However, we understand that young people regard their smartphones as a source of information and recommendations. We have a greater opportunity to positively impact and change behaviors by engaging with young people in a forum they understand and approve of.

Digital health apps are a powerful tool to help young people make better choices, but whilst many apps work, some apps can have a negative impact. So how do we take a route to engaging young people that we know works, and still safeguard them from potential risks?

ORCHA’s Mission

ORCHA is one of the innovations on the NHS Innovation Accelerator (NIA). It equips a growing number of NHS and local government organizations in supporting their populations to help prevent and assist in the management of health challenges through the uptake of digital health apps. The service ORCHA provides enables thousands of healthcare professionals to embrace the world of digital health apps and positively impact change within their communities, with the knowledge that every app recommended has been rigorously tested and reviewed.

As part of ORCHA’s mission to remove the barriers that currently inhibit the true potential of digital healthcare solutions, it has looked at how digital health apps can positively impact our young people and become part of the curriculum delivered in PHSE lessons.

Introducing Digital Healthy Schools

This unique approach called ‘Digital Healthy Schools’, is a library of online health apps and learning programs that safeguard young people from using harmful apps, whilst helping them to learn how to integrate the use of good apps in their everyday life, to support their mental health and wellbeing.

Digital Healthy Schools also encourages pupils to learn more about health conditions whilst exploring the topic of app development and how apps are reviewed to ensure the information they are given is factual and safe.

To understand and ensure that this approach was effective, ORCHA has worked with schools across Lancashire, South Cumbria, and Essex.

Pupils gained insight and information on the apps that are safe and effective, with discussions focussing on health conditions most common amongst these age groups, including nutrition, mental health, and oral care.

The impact of Digital Healthy Schools being integrated into the curriculum has been hugely positive – and not just with the pupils. There was also a positive impact on family and friends, with an average of four apps being shared and recommended by pupils to their families.

During this test pilot, there was a 217% increase in the awareness of health apps with the pupils involved and a 62% increase in the trust they had with health apps once they understand how to identify any potential risks. After the course, there was a reduction of 28% of pupils trusting all apps.

Student feedback

Here’s what pupils and teachers at Witton Park Academy in Lancashire thought about Digital Healthy Schools.

One student explained: “Since the course I have been more active. I used to get a car to school but now I walk. There’s a fitness app that counts your steps, gets you more active, and gives you rewards for everything you do – it’s really getting me out of the house a lot more. I think everyone I know should use this app.”

Another pupil added: “Before I started using digital health apps, I didn’t really think it would help me in any way, but they really do track how you’re feeling, your state of mind, physical state – so it really does help.”

Other students told the ORCHA team that the digital apps that were discussed and recommended during the course have helped them make positive changes, from drinking more water to helping them sleep and become more alert in class.

Head Teacher, Steve Archer, said: “There are a number of students who say that they have actively made changes to their lifestyles, which is really positive as it seems young people are taking responsibility for their long-term health.”

For Witton Park Academy and other schools participating in the program, Digital Healthy Schools has achieved the positive impact that ORCHA had anticipated.

Steve Archer added: “To colleagues in other schools, I would say that we shouldn’t miss any opportunity to promote the wellbeing and health of our young people. They ultimately are our future.”

Empowering young people to better understand their health

A child with a mental health issue will take, on average, ten years to ask for help after experiencing the first symptom. When you consider statistics like this, education through schools and empowering young people to better understand their health and the health of those around them through safe and trusted digital apps, can only positively impact change and the healthy development of the next generation.

For more information about ORCHA’s Digital Healthy Schools program, email hello@orchahealth.com.

If your patients have been motivated by campaigns such as Stoptober and Stay Sober for October, but now need additional help to make or maintain changes to their lifestyle, an app can help.

Effective health apps put practical support, encouragement, and tailored advice in the palm of your hand. Convenient and always with you, they can provide the right intervention at the right time. Here are three apps that we recommend for the 3-4 million trying to give up smoking, 20% wanting to cut back on alcohol, and 2/3rd trying to diet right now.

On behalf of NHS and care organizations across the UK, ORCHA conducts more independent evaluations of health apps than anyone else. This is a monthly round-up of some of the best mental health apps to know about.

TOP 3 APPS FOR MAKING CHANGES STICK

There is a wide range of apps that help embed changes into lifestyles. Here are the three that achieve the highest scores in our evaluations covering effectiveness, safety, security, and usability:

Quit Genius: With a 36% success rate for long-term quitting, it’s more effective than face-to-face therapy and going cold turkey.

Best-You: Set an alcohol consumption target and receive support and tracking on how you are performing against this.

Change4Life Smart recipes: Finder healthier alternative recipes for breakfast, lunch, dinner, or snacks, it includes step-by-step recipes and even creates your shopping list.

View 3 of ORCHA’s favorite apps for making changes stick HERE