Feature image: Sajid Javid, Secretary of State for Health and Social Care of the United Kingdom
“This report is long awaited and welcome. The pandemic left us with an over-burdened NHS, with unprecedented backlogs to tackle. But it also reminded us that necessity is the mother of invention. Digital health has already been implemented across many pockets of the NHS to help support patients at home and to ease the pressure on frontline staff. Use of our ORCHA Health App Libraries increased by 342% in the first months of the pandemic.*
“But we have to sound a warning note. A scattergun approach to the implementation of digital health, with dozens of different products and systems introduced by different NHS providers, without a sound infrastructure to support it and minus knowledgeable frontline staff, will cost the NHS more and cause enormous confusion.
“For digital health to be safe and sustainable, we need to view digital in exactly the same was as we view medicines. We need rock-solid and universal standards in place and we need doctors to be able to prescribe products exactly as they prescribe medication, with a product recall system in place.
“There’s also an urgent need to have all frontline staff trained in how, when and why to use digital health. Earlier this year we launched the ORCHA digital health academy, a free and CPD-accredited resource available for the entire NHS workforce, available on the Health Education England NHS learning hub.”
*https://bmjopen.bmj.com/content/11/10/e053891
**Digital Health in the UK: National attitudes and behaviour research, June 2022
Consumer research published on 9th May 2022 reveals that people aged from 18 to 44 years old would choose digital health to support a mental health condition over and above prescription medication, such as an antidepressant. Most notably, 55% of 18 to 24-year-olds would opt for a mental health app recommendation, with only 39% preferring medication. And 53% would even choose a health app in preference to one-to-one therapy via a video link or telephone call.
The independent research was carried out by OnePoll, which interviewed 2000 people for ORCHA, the Organisation for the Review of Care and Health Apps. ORCHA reviews health apps and runs Health App Libraries and Digital Health Formularies for NHS providers in 70% of regions.
Overall, more than a third (36%) of adults across the UK would be happy to receive a mental health app recommendation from their doctor. This is to help support conditions such as anxiety, stress, panic, depression, eating disorder or self-harm. This figure was even higher across many age groups, including; 45% for 35 to 44-year-olds, and 55% amongst 18 to 24-year- olds.
Head of research at ORCHA, Dr Simon Leigh, said:
“This feels like a tipping point, an acceptance that there are different ways to access support. There are now 1.6m people waiting for NHS mental health services and a further eight million people in England unable to get specialist help because they are not considered sick enough to qualify. And waiting lists are likely to get longer, as we tackle the NHS backlog. We all need to think differently – and this report shows, for the first time, that the tide could be changing.”
The research highlights key reasons that people opt for digital health:
Convenience: 37% of people report that a mental health app is available to give support any time they need it, especially during the night.
Immediacy: 35% of people value the instant nature of digital health.
Flexibility: 31% of people liked being able to access support without needing to miss work to go to appointments, or arrange childcare. This was significantly higher amongst women and age groups most likely to have young children.
Confidentiality: 29% of people value the privacy of digital health, although this is notably most valued by people aged 18-24 years old, with 37% valuing this aspect of health apps.
Cost effectiveness: 28% of people value that a mental health app can cost less than private therapy. At 41%, this was particularly valued by those aged 25 to 44 years old.
But there are also concerns:
46% of people are wary about using AI chatbots. 40% of people worry about whether the app has been designed by qualified doctors or psychologists. This concern was highest amongst those aged 65 and over.
35% of people worry about how safe their personal data will be when using an app.
28% of people worry they’d be agreeing to a subscription they couldn’t afford or wouldn’t know how to cancel. This concern was even more prevalent amongst younger age groups between 18 and 34 years old.
Dr Laura Pogue, clinical lead for mental health ORCHA and GP clinical lead for mental health at St Helen’s CCG, said:
“Mental health apps can be a great asset, offering evidence-based support to people exactly when they need it. However, ORCHA consistently finds that only 20-30% of apps are safe with personal data, so users should be alert and ideally use apps which have been recommended by a healthcare professional.”
To ensure the safety and security of digital health products, the government last year introduced an assessment framework, the Digital Technology Assessment Criteria (DTAC), as a quality benchmark. In addition, more and more NHS trusts are now using libraries of fully-assessed digital products, from which healthcare professionals can confidently choose top quality products to recommend to patients.
Access the full report here: https://info.orchahealth.com/digital-for-mental-health-attitudes-and-behaviour-report.
The Nordic region aims to be the most integrated health region in the world by 2030, according to the Nordic Council of Ministers. A shift towards digital health, and its focus on the self-management of health by Nordic populations, will be an important step on this journey, but it also brings new risks.
Despite the 350,000 digital health technologies on the market, no standardised regulation or risk management system is in place in any of the Nordic countries. This has left medical professionals unable to find and prescribe digital technologies safely.
To resolve this critical issue and lead the world in adopting connected health technologies on a large scale, the Nordic Digital Health and Evaluation Criteria (NordDEC) programme, has been created. The NordDEC is a world-first programme to unify digital health standards across multiple countries, delivering safe digital health across Sweden, Denmark, Norway, Finland and Iceland.
The NordDEC will be launched at HIMMS Europe on 15 June, 2022, by the Nordic Interoperability Project (N!P).
The accreditation framework was developed by UK-based, ORCHA, the Organisation for the Review of Care and Health Apps, and the project is funded jointly by NIP and the Nordic healthtech industry.
The NordDEC will provide a system for healthcare providers in all of the five countries to evaluate and identify trusted digital health technologies within healthcare and preventive care. It will also give guidance to product developers and technology owners, so they have clear parameters when planning new products and new market access strategies.
Drawing from international best practice, the NordDEC establishes a common benchmark of criteria across the entire region, which provides safety and effectiveness assurance in digital health.
However, the framework needs to work seamlessly across five different countries, each of which has an autonomous healthcare system. To cater for this, it allows each country to add on localised accreditation criteria, over and above the region-wide baseline criteria.
The NordDEC will be an extremely robust digital health assurance system, testing products against more than 500 measures across data and technical security, clinical assurance and usability. To strengthen it even more, new criteria have been added, not seen in any other standards, for example, evidence of PEN and vulnerability testing will be required.
NIP’s CEO, Anders Tunold-Hanssen, said:
“The Nordics is home to a vibrant and growing health tech industry. This programme provides suppliers with an attractive platform to reach the whole of the Nordics healthcare system, breaking down current barriers to market access. The next stage will be the creation of a digital library for the Nordics, containing thousands of top-quality apps which healthcare professionals can use safely and confidently.”
Founding CEO of ORCHA, Liz Ashall-Payne, said:
“This has been a landmark project for ORCHA and all the countries involved and the learning can be rolled out across other geographical regions. It also gives suppliers a good springboard to easily meet the requirements to enter other geographies, such as the UK, Netherlands, Canada and the US.”
Further information about the framework can be found at: norddec.org
As the government sets ambitious targets for the use of the NHS App, independent research into the nation’s use of health apps asks, for the first time, whether health apps are actually helping us self-manage our health – and the result is ‘striking’.
The research was carried out with 2000 consumers during May on behalf of ORCHA, the Organisation for the Review of Care and Health Apps, which reviews digital health products for many areas of the NHS.
The respondents talked about their use of all health apps, not just the NHS App.
The research revealed:
Health apps get results: Eighty-three per cent of people surveyed who have used a health app found it actively helped to improve their health and wellbeing, with 35% of those finding it very helpful. Plus, after downloading the product, 75% of respondents had used it weekly or more often, with almost half of this group using it multiple times a day.
Simon Leigh, Head of Research at ORCHA, said:
“These figures are striking and this feels like a pivotal moment, as digital health represents a massive opportunity to both improve patient outcomes alleviate some of the burden on the NHS.”
Growth: Overall, the research found that more people are using health apps than in 2021 (47% in 2022 as opposed to 38% last year). Sixty-two per cent agree that it is vital we look at new ways to manage our health, including using high-quality health apps. Fifty-five per cent had had an app recommended by a health or care professional and the most active recommenders had been GPs and pharmacists (in 11% and 10% of cases respectively).
Simon Leigh said:
“Despite all this good news, still, only around half our respondents had digital health from a healthcare professional, leaving the rest in the hands of Google and friends. We wouldn’t do that with medicines or any other aspect of healthcare – it’s a huge risk. Only around 20% of the many thousands of health apps we review here at ORCHA meet our quality standards, demonstrating they are clinically backed and safe with patient data.”
A step change in mental health support: Those aged from 18 to 44 would choose digital health to support a mental health condition over and above prescription medication, such as an antidepressant. And 55% per cent of 18 to 24-year-olds would opt for a mental health app recommendation, with only 39% preferring medication. Fifty-three per cent would even choose a health app in preference to one-to-one therapy via a video link or telephone call.
Meanwhile, opportunities for improvement include:
Levelling up: There are marked differences between regions. Supported by tech-savvy doctors and nurses, Londoners, in particular, are trailblazers of this new approach to self-managing their health. In the Capital, 21% of those surveyed had been recommended an app by a healthcare professional. Nearly seven in ten respondents (68%) had used a digital health product and the same percentage were positive advocates (68%). In East Anglia, where levels of recommendations by doctors were the nation’s lowest, at 9%, only 35% had used an app at all. Fifty one per cent of East Anglia respondents, though, said they were open to using apps as a new approach to healthcare.
Liz Ashall-Payne, founding CEO of ORCHA, which is based in the North West, said:
“We have to level up with digital health, providing nationwide tools and training for all frontline NHS staff so they know how to recommend the best products, or we’ll have pockets across the UK where citizens are disenfranchised from this revolution in healthcare. Earlier this year, ORCHA launched a free, nationwide and CPD-accredited Digital Health Academy for all frontline NHS staff, to help tackle the knowledge gap in digital health.”
Focusing on women’s health: Healthcare professionals had recommended digital health support to 29% of men but only 19% of women. But women, more than men, said they would actively have chosen digital support, particularly for mental health conditions such as anxiety, because they were immediate (39%) and flexible (34%) around jobs and healthcare.
Supporting older people: As seen in 2021, age significantly affects the odds of using a health app. 18-24-year-olds are the most activated at 82% having used a health app. This decreases gradually as age increases, at 34% for ages 45-54, then reaching its lowest point in the 55-64 age group, where just 20% of people surveyed have used a health app before. Interestingly, the over 65 age group is more activated than the groups spanning 45-64, with 42% of people having used digital health. Of the over 65s that have used health apps, 39% of them use their app daily or more often, which is higher than all other age groups.
Commenting on the report overall, Simon Leigh said:
“Whilst digital health in the NHS is improving, much more can be done to bridge the digital divide, to remove the digital postcode lottery, to tackle prejudices that older adults won’t want digital support and to overcome any gender bias.”
Access the full report, Digital Health in the UK: National attitudes and behaviour research, here: https://info.orchahealth.com/digital-health-attitudes-behaviours-2022-report