Whilst digital transformation gathers pace in the NHS, patients are too often at the periphery of the conversation.
To tackle this, a new ‘Patient and Public Involvement and Engagement’ learning module has been created to support the development and delivery of patient-centric technologies.
The foundation level module is free at orcha-digitalhealthacademy.com and on the Health Education England NHS Learning Hub (learninghub.nhs.uk).
There are 300,000 healthcare apps currently live on the UK market (1) but only 6 in 10 innovators consult patients before development (2).
No training previously exists on conducting effective patient and public involvement and engagement (PPIE), leading to wasted resource on unsuitable technologies at a time when the healthcare system simply cannot afford it. The module aims to educate innovators who are creating new technology, and the clinicians who are prescribing these solutions. Crucially, the module also provides valuable support to the 500 NHS clinicians who are on the Clinical Entrepreneur Programme.
The module is an introduction to the first evidence-based framework for PPIE, launched by the University of Plymouth, the AHSN Network (the national voice of the 15 academic health science networks in England) and Boehringer Ingelheim UK & Ireland. It helps to fast-track learning for the EnACT principles described in the framework, outlining how to involve patients in product innovation and critical issues such as data privacy, intellectual property, inclusivity, reimbursement, useability, and recruitment of patients.
Dr Tom Micklewright, General Practitioner and Clinical Director of ORCHA spoke about the critical need for the new module,
“Digital health tools have the potential to transform how front-line workers deliver healthcare, but this will only work if patients use the tools. I’ve seen first-hand how some health apps have lost the confidence of patients because they were never really designed with usability in mind. I hope having this module on the Academy will help clinical entrepreneurs at a practical level and will also help my colleagues on the front line understand more about health app development.”
Liz Ashall-Payne, CEO of ORCHA, said,
“We’re very pleased to be adding this excellent module onto our Academy platform. The Academy exists to help front line health and care workers build their digital confidence and skills, and part of this learning is an understanding of how these digital tools have been developed by clinical entrepreneurs in the first place. This highly instructive video module, which is
based on an award-winning training manual, will do just that. ORCHA will also be making this module available to the digital health developer community, through a new portal.”
Naj Rotheram, Medical Lead for Partnerships at Boehringer Ingelheim UK and Ireland commented,
“The most effective patient resources are co-designed, so we are extremely proud to have been involved in the development of this latest module. The work conducted on the PPIE initiative reinforces Boehringer Ingelheim’s commitment to delivering patient-centric digital transformation, helping to create
a more sustainable healthcare system.”
The Digital Health Academy was launched in 2022 in response to the lack of mandatory digital health training for health and care professionals. Since its launch, the ORCHA Digital Health Academy has been consistently amongst the most-accessed courses on the Health Education England Learning Hub.
Notes and references
1. ORCHA Data Insight Report 2022.
2. Digital Innovation within the NHS, barriers & opportunities: An Innovator’s perspective. ORCHA 2021.
We are encouraged that the Government has announced it will invest £310 million over the next five years in digital health technologies to improve the health of the 2.3 million people unable to work due to long-term sickness(1).
This is a significant move towards a digitally integrated healthcare service. To realise the full potential of this opportunity, the whole NHS needs to look at how to accelerate the digitisation of mental health services plus other areas such as the NHS Health Check.
This may be a ringfenced investment targeted at just one population cohort, but the implications are much bigger. The safety, data privacy and health outcomes of the entire nation will depend on what the NHS does next.
Public expenditure will be impacted too. The right choices in digital health will ensure significant returns on investment, reducing costs and demand in both NHS and social services.
The NHS needs to consider how it can rapidly establish the core infrastructure for digital health that has long in place for medicine. The three most pivotal elements are:
£310 million sounds like a big sum, but without these core elements, the impact digital health delivers will not be realised.
With them, the health outcomes and savings seen will ensure the programme of work not only continues but lays the foundation for other services to follow.
But this isn’t virgin territory. ORCHA has already worked with Occupational Health, Musculoskeletal and Mental Health teams from across the NHS and seen real results. These practical everyday examples highlight this:
“Our elderly patients find it hard to come in for regular appointments here. So, if we can use apps on their tablets to assist in their progression, in addition to their therapy and not as a replacement for it, they don’t need to come in so often and it will help them progress.” Hannah Silcock, occupational therapist at Bolton NHS Foundation Trust.
“As a practice nurse we see a lot of patients with chronic conditions. We only see them once or twice a year to review. To be able to give them something to help them manage their conditions on a daily basis is really beneficial, for example to help those with diabetes manage their blood glucose levels.” Jane Patrickson, Bradford practice nursing team.
“Digital health is becoming part of the armoury of tools that our clinicians have…Service users and clinicians are tapping into this. Ultimately, if we get this right, this is about keeping people as people and stopping them from becoming patients in the first place.” Chris Chaney, CEO of CW+, the charity of the Chelsea and Westminster Hospital Foundation Trust.
At this time when the NHS is faced with unprecedented pressure, we welcome this funding from the Spring Budget, but urge caution around the next steps.
ORCHA has created the country’s first Digital Health Formulary, to help healthcare professionals prescribe safe digital health products and health apps to patients. Learn more about how ORCHA supports health and care organisations to deliver digital healthy safely.
ORCHA provides everything a health system needs from assessing digital health technologies and providing the safe deployment, workforce development and prescription infrastructure to achieve this, which complements other system initiatives. Our cloud-based system has been designed to easily integrate with existing NHS infrastructure, including the NHS App and Electronic Patient Records (EPRs). It also places very minimal demands on existing stretched NHS IT and digital transformation resources whilst ensuring a fully governed, safe process for the deployment and activation of these tools.
(1) Source: Office for National Statistics (INAC01 SA: Economic inactivity by reason (seasonally adjusted) – Office for National Statistics (ons.gov.uk))
ORCHA (the Organisation for the Review of Care and Health Apps) has been helping healthcare professionals and the public find trusted health apps since 2015, through its digital health libraries.
Following the rapid growth of the digital health sector, healthcare professionals and citizens now have distinct and different needs from their health app libraries – and so ORCHA has created products exactly tailored for each of these two audiences.
The UK’s first Digital Health Formulary
Nearly 75 years after the publication of the first British National Formulary (BNF), the essential prescribing tool depended upon by all healthcare professionals, the UK’s first Digital Health Formulary sets up a system for prescribing safe health apps to patients.
GP Tom Micklewright, ORCHA’s medical director, said:
“The original BNF was introduced because in the first half of the 20th century doctors were faced with an increasingly complex range of drugs and influential pharmaceutical industry. They realised they needed high-quality and independent advice. We are in the same situation again now, as pressures on our healthcare systems make us look at revolutionary new ways of doing things.”
The new formulary can be integrated into existing patient record systems, such as CERNER or EPIC dashboards. It’s a single source from which to find health apps which have been pre-selected and vetted by healthcare colleagues.
Within three clicks, healthcare professionals can send a health app recommendation to a patient via a secure text or email. Recommendations and patient downloads can be tracked, ensuring good governance. The healthcare provider can also take an overview, monitoring how many apps it is prescribing and which are being downloaded and used by patients.
A safe health app library for citizens
Consumer research* has indicated that 62% of people are interested in using apps and many are finding them themselves rather than through a healthcare professional (55% had received their recommendation from a healthcare professional). This raises serious concerns about quality, as only 20% of the 320,000 health apps currently available are safe to use.**
From now, ORCHA will be developing straightforward, easy-to-use app libraries in partnership with healthcare providers, which allow patients to easily find apps they can use unaided. Only consumer-friendly, over-the-counter apps which require no input from a healthcare professionals will be included on these libraries.
The app libraries are structured on simple, pre-built layouts. They can be presented in several languages and configurations and designed to support health strategies and key health priorities of each health care provider. The libraries can only be accessed within the geographical territory of the healthcare providers, ensuring that all the regulations for that territory area met safely and that data governance and residency requirements are met.
The reporting dashboard will enable the provider to have new population insights.
Tom Micklewright said:
“We want to get safe digital health to those who need it as safely and quickly as possible, so we’ve designed the libraries with usability and accessibility as an absolute priority. We’re proud that our libraries are rated AA for web content accessibility. They’re modern, responsive, and mobile first.”
These two new products are part of an expansive range of ORCHA products designed to give health and care providers everything they need to deliver digital health safely.
See a video about the new ORCHA products here.
* https://info.orchahealth.com/digital-health-attitudes-behaviours-2022-report
**ORCHA statistics
Researchers at ORCHA and the University of Warwick have identified that digital health products such as health apps could make a substantial contribution to tackling NHS urgent care pressures, by keeping patients out of hospital in the first place.
Both the NHS Confederation and Secretary of State for Health, Steve Barclay, have said that tackling preventable admissions should be a key strand of a new approach to urgent and emergency care – and that up to 20% of hospital admissions are avoidable with the right care in place.
The research team created a budget impact model which examined long-term conditions, acknowledging that these are just the tip of the iceberg when it comes to NHS pressures. Even so, they found that digital health tools, if deployed across primary care, could reduce pressure on the NHS and prevent annual attendances in:
By removing these pressures, each year the NHS could gain 106,000 surgical procedures in secondary care and the avoided GP appointments are the equivalent of recruiting 590 more GPs – a good move towards the target 5,000 more needed.
These avoided attendances would save the NHS around £553m annually.
Dr Simon Leigh, research director at ORCHA, said:
“Our budget impact model has shown how so much more can be achieved by innovative thinking. Because we simply can’t go on assuming that if we keep doing the same thing, something different will happen (Einstein’s definition of insanity). Digital health products can be used by thousands of people at the same time. No doctor could achieve this, especially when the number of doctors we have is decreasing in the first place.”
Along with these big-picture statistics, ORCHA’s new report, Reducing urgent care pressures with digital health, offers illustrations to show how individual digital health products can be deployed as strategic preventative measures.
Commenting on the report, founding CEO of ORCHA, Liz Ashall-Payne, who presented to the House of Commons Select Committee on digital health last month, said:
“Low complexity digital health tools which require no interoperability with NHS systems can be used extremely effectively in preventative care. Our research team has shown how much of an impact this could make. At ORCHA we are clinicians and allied health professionals first and foremost, and everything we do is grounded in evidence. We hope that our new report will help health policy makers recognise the game-changing potential digital health offers the NHS.”
