5 Big Issues For Your Health App or Digital Product

Last month I attended two major health tech events. First stop was E-Health Insider’s EHI Live 2 day healthcare IT conference. Two days later I was at MindTech’s national symposium on ‘Technological Innovations in Mental Health’.

Though both events were targeted at clinicians, most of the issues and opportunities that came out of them are just as relevant whether you’re a clinician or working for a private or third sector health initiative.

*This article uses the term ‘app’ as shorthand for a range of digital products including responsive websites, downloadable apps, social media initiatives, new software programmes etc.

1. Safety & Regulation

The last few years has seen an explosion in the number of health apps. Most of these are unregulated. The NHS wants to make sure that all digital health products are safe, appropriate and, most importantly for clinicians, that if they are going to be ‘prescribed’, that they are ‘approved’. The current debate around this isn’t straightforward; here’s a summary.

This doesn’t mean that the app you’re using or developing isn’t effective or safe. It just means that it hasn’t been submitted anywhere for approval yet.

Currently the main way of getting approval is via submission to the NHS apps library. The approval process is laid out clearly and is more achievable than it may at first appear.

Some apps may also fall under the category of being a ‘medical device’. These need to be authorised and kite-marked by the MHRA (Medicines and Healthcare products Regulatory Agency).

Review sites may also play a role in regulation. Mindapps.org is one example set up by a group of clinicians and academics. However, it’s also worth noting that the debate, led by Jeremy Wyatt Professor of Ehealth Research at the University of Leeds, also presents a very strong argument for self-regulation by developers, clear labeling and harnessing the power of user reviews for assessing app safety and effectiveness.

2. Interoperability

This is about your app’s technical and non-technical interaction. Technical interation is about how your app interacts with other technology. For example, does the platform you are using for your product enable it to work smoothly alongside other digital tools like Electronic Health Records? If an app stops meeting your needs, or if you outgrow it, is there a natural progression route to another app? What are the technical or design commonalities between your app and others?

Non-technical interaction is typically about how it interacts with existing features of the human world. For example how does your app work with face to face services? Does it make it easier for workers to deliver human-powered services? Does it improve efficiency, meaning more people can be supported more quickly for the same amount of money?

3. Do Apps Work?

This key question came up repeatedly at both events. Until we have large scale evidence of apps clinical effectiveness it’s unlikely to go away.

Clinicians wanted to be assured not only that ‘apps’ are safe but that they also help patients with recovery. During 2014-15 the Labs Product Evaluation will try and assess this across three Lab products. At this point if you’re developing an app it’s important to create easy ways to gather user feedback and other measurements that can demonstrate changes to people’s mental health and wellbeing. A good starting point is to identify at least one outcome that can be measured through your product and then work out a way to gather feedback on it over a long period of time.

4. Adoption

The use of technology in healthcare provision is big. There’s a lot of momentum behind creating new digital products, with a recognition that not all will thrive and survive. It’s worth remembering the Gartner Hype Cycle that tries to predict the adoption of new technology.

General feedback was that a ‘successful’ health app may only get around 2,000 downloads. Even good model health apps like My Journey has only been downloaded 600 times.

5. Sustainability

Most health apps and digital products are still trying to find sustainable business models.

At EHI Live it was claimed that only 1 in 4 downloaded apps is ever used more than once.

However, it was also highlighted that income generation is possible in a number of ways:

• Sponsorship & advertising,
• Business to Consumer (B2C) selling i.e. charging users to download or selling subscriptions
• Business to Business (B2B) i.e. selling and enhanced features to services or linking the social outcomes of your product to outcomes that commissioners and other third parties are already focusing on or contracting others to achieve. You could do this through contracts, white labelling or franchising.
• Integrating the digital product into your current service delivery to improve offer and increase sales/margins
• Follow on funding through grants, philanthropy, general fundraising, partnerships

It’s also worth considering that currently many health apps and digital products are developed by clinicians or researchers with limited service user input. From a sustainability perspective this increases the chance of developing a product that isn’t wanted or even worse is wanted but isn’t used because it isn’t user centered in its design.

What Do You Think?

What’s your view on regulating health apps? Are there any issues you think should have been included here? Drop any comments or questions into the box below and we’ll make sure you get a personal reply.