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.
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.
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
Amongst the 3.9 million confirmed COVID-19 cases in the UK to date, it is estimated that around one in five people experience symptoms that last for five weeks or longer, and one in ten have symptoms that last for twelve weeks or longer.
Termed long COVID, people report a myriad of symptoms including chronic fatigue, breathlessness, loss of sense of smell, depression and concentration difficulties. Already totalling an estimated 186,000 people, long COVID will bring mounting pressure on primary care services.
Within its COVID-19 rapid guideline for managing the long-term effects of COVID-19, NICE recommends health apps as part of giving advice and information on self-management.
Click on the PDF icon below to download the Long COVID Self-Management Report. Discover:
If you are experiencing any issues with downloading the report, or want to know more, please get in touch with us at hello@orcha.co.uk or on +44 (0) 1925 606542
We were delighted to feature in Zoe Kleinman’s recent BBC News article, which discussed the proportion of healthcare apps that are not up to relevant standards.
With approximately 370,000 health and care apps available online, it can be difficult to sort those that can be trusted as safe to use, from those that may potentially be harmful. ORCHA’s independent Review evaluates digital health solutions against 350+ criteria to determine their quality assurance.
Which apps offer complex support without visible input from professionals?
Under which criteria do many apps fall down?
The article also discusses the difficulties developers can have in knowing which regulations their product needs to meet.
Read the full article on the BBC News website to learn more.
The measure of what makes a good app is extremely important when embracing digital health across the NHS. As the world of what looks good is evolving, health bodies need an easy to access way to know which are good and which are not.
ORCHA supports more than 60% of the NHS in reviewing apps against the appropriate standards. We regularly update the ORCHA Baseline Review (OBR), to ensure new important medical, IT and usability standards are included.
Another new standard in digital health has now been launched. Developed by NHSX, the Digital Technology Assessment Criteria for health and social care (DTAC) is a new advisory assessment criteria for commissioning digital health technologies.
70% of its criteria is already covered by the OBR. The OBR also includes key criteria set out in other standards. For example, it includes checks adapted from the NICE Evidence Standard for Digital Health Technologies Framework.
We are able to support developers and health and care providers who want to have apps assessed against all of the DTAC criteria. This may be an app you have developed or apps you use as part of practice.
For developers: We can help you see if your technology meets the DTAC criteria. We can support you if your technology has or hasn’t already been assessed against the OBR.
For health and care providers: We can help you add DTAC checks to all apps in an existing or new App Library.
As you would expect, once we have assessed any app to the DTAC standards on behalf of any NHS or Local Government Client, we will of course make that assessment available for all to help avoid duplication of effort across the system and to share the burden of assessment across all our client community.
