How have app developers been bypassing app store security?
Given the challenges the world is facing due to the COVID-19 pandemic, app developers have been quick to create digital solutions to help people manage their health and, potentially, slow the spread of COVID-19. But they have also been equally fast in spotting a loophole in app store security, in order to get their apps to market.
Apple’s App Store requires a COVID-19 app to have been developed in partnership with the NHS, or requires documentation from the NHS showing that they have authorised the distribution of the app’s content. The Google Play Store has also put similar requirements in place for any app claiming to be COVID-19 related.
To avoid these restrictions, app developers have spotted that, by entering their app under the category of ‘COVO 19’, they can bypass app store regulations needed in order to appear under ‘COVID 19’.
But should we be concerned by this move? As an independent assessor of health and care apps, ORCHA has reviewed 17 of the COVID-19 apps available on the Apple App Store and the Google Play Store. Cumulatively, these apps have been downloaded over 1,580,000 times on Google Play alone.
The outcome of our reviews has revealed that, yes, we should be concerned about the quality of COVID-19 apps, as they are of very mixed quality. It also revealed that the steps taken by app stores have failed, not just because developers found a work around, but because one NHS app didn’t list under COVID-19, and the fact that those apps that do not meet the stores’ criteria actually achieve a higher ORCHA Score than the apps that do.
Almost 60% of all COVID-19 apps reviewed scored below ORCHA’s quality threshold. Whilst some apps performed particularly well, many apps hovered just above or below the cut-off score, and some apps achieved dangerously low scores. The few apps that managed to enter app stores using the ‘COVO 19’ loophole achieved an average score of 71.6%. This is around ten percentage points higher than the average score achieved by all COVID-19 apps reviewed by ORCHA.
Looking at why apps achieved these scores, the strongest results were seen in User Experience, with the average score in this review domain being 76%. This is good to see, as, for an app to be used by all, it must be easy to use.
Data Privacy is where the biggest weaknesses lay. The average score for COVID-19 apps in this review domain is 55%. This is of concern and requires action, as, if we are asking people to use an app, they also need to have a very clear understanding of how secure their data is, so that they can make an informed choice as to when to use the app and what data to share.
It is to be expected that, due to the unprecedented nature of COVID-19, Clinical Assurance scores might not be as high as non-COVID apps that we have reviewed; the average score here was 57%.
The challenge remains, therefore, of helping consumers to understand which apps are potentially unsafe to use, and ensuring that consumers are armed with the full facts about the strengths and weakness of an app before it is downloaded.
Dr Tom Micklewright discusses his views on three apps for managing heart health that have scored well in ORCHA’s Review.
This week, we look at some of the best apps for heart health. After using the COVID-19 App Formulary, Dr Tom Micklewright gives another personal, practical view on three apps which can help patients better manage heart health at home.
ORCHA has reviewed a total of 221 apps for heart and stroke. This is a category of low-scoring apps, with almost 80% scoring below our quality threshold. This is worrying, considering that these apps have been downloaded 1,077,586,960 times on Google Play, and includes apps from well-known brands.
It illustrates why our independent app reviews should be consulted to check which apps are safe to use, before downloading or recommending to a patient.
In the video below, hear Dr Tom Micklewright introduce his independent reviews of heart health apps that can help during the COVID-19 crisis, and how professionals can recommend these solutions to patients via the ORCHA App Library.
Click below to watch the video:
Dr Micklewright looks at the way in which the Kardia app and device provides medical-grade single lead ECG tracing, meaning it can be used to detect atrial fibrillation (AF). Patients can take their own readings, which are recorded and can be tracked in the app:
Click here to access ORCHA’s review of Kardia on our COVID-19 App Library.
Dr Micklewright demonstrates the FibriCheck app, exploring how it can be used to detect AF, how it compares to a patch-based ECG trace, and what the clinician dashboard feature looks like:
Click here to view ORCHA’s review of FibriCheck on our dedicated COVID-19 App Library.
For his insight into another top-scoring app that can help with managing heart health at home, Dr Micklewright demonstrates how Fitbit goes beyond simply tracking steps and sleep, to also track heart rate. The Fitbit watch and app mean that tracking heart rate can become a routine part of the patient’s day:
Click here to read ORCHA’s review of Fitbit on the COVID-19 App Library.
Dr Micklewright summarises which apps can have a role in identifying heart arrhythmias, and which help with more general lifestyle changes. All apps mentioned can be accessed on ORCHA’s COVID-19 App Library.
We are proud to support Northern Ireland’s new Health App Library
On 5th May, Northern Ireland’s Minister of Health announced as part of NI’s Coronavirus News Conference that a new health App Library has been launched to help people manage their health and wellbeing, as part of the NI Government’s COVID-19 response. We are delighted to have worked with Health and Social Care in Northern Ireland (HSCNI), in collaboration with the Department of Health in NI, to facilitate this App Library.
Our aim is to continue helping health and care organisations to embed safe digital health into care pathways, and allow patients to access assured apps to help with self-management during the COVID-19 crisis.
Health Minister, Robin Swann, explained:
“Since taking up post as Health Minister I have made mental health and wellbeing a priority. In these unprecedented times it is hugely important to consider the impact that this deadly virus can have on our lives, including the impact on mental health and wellbeing.
“We must support people to look after their mental health and this new Apps library will provide a one stop shop where the public can access safe and secure apps to help them during the pandemic.”
Click below to watch the NI Health Minister announce the App Library launch:
How has COVID-19 impacted this increase? In which new areas is ORCHA working to drive digital health adoption?
As the NHS, social care organisations, and local authorities, continue responding to the COVID-19 crisis, ORCHA is seeing a growing number introducing bespoke App Libraries to help their patients, professionals and service users find the best health and care apps at this time.
Over the past month alone, the following organisations have worked with ORCHA to launch a bespoke App Library to help their patients and service users. These sites largely function as part of the COVID-19 response in the first instance, but also to support mHealth recommendation to patients and service users.
Additional organisations who are expected to launch an App Library to integrate with their services soon include: The Society of Occupational Medicine (SOM), Herefordshire and Worcestershire STP, Shropshire, Telford & Wrekin STP, Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH), Lancashire County Council, Home Instead, and Saints Community Development Foundation, the charitable arm of St. Helens rugby club.
This comes at a time when ORCHA is also providing a COVID-19 App Formulary so that all professionals, patients and consumers can access safe, digital resources to help with the self-management of their health and wellbeing. We hope these App Libraries will help to support populations, health and care workers, and vulnerable people throughout the COVID-19 crisis and beyond, facilitating continual access to safe digital health solutions that have been assessed by ORCHA.
Commenting on this growth in demand for App Libraries, ORCHA’s Founding CEO, Liz Ashall-Payne, explained, “Digital Health has a clear role to play to help tackle the COVID-19 pandemic. In both health and care settings, there are good quality apps that can help make a real difference to someone’s physical or mental health. We are driven to help people find them.”
To drive uptake of health and care apps, ORCHA provides tailored App Library sites, featuring a range of evaluated apps to help professional health and care bodies meet the health and support challenges in their region. Our platform is safe, efficient, and enables the best apps to be identified. ORCHA also provides customisable ‘microsite’ App Libraries, which health and care organisations/bodies, local authorities, and charities, can purchase to drive uptake of health and care apps. These tailored App Library sites enable clients to optimally target the audiences they want to activate or support.
The ORCHA Pro Account is the key to embedding and integrating digital health into day-to-day care delivery. Pro Accounts can be purchased as part of the microsite, App Library package, so that health and care professionals can recommend apps directly to patients and service users. A Pro Account provides all the tools and support required for professionals to interact safely and effectively with ORCHA’s digital health solutions, as well as providing health and care organisations and systems with the ability to monitor, manage and govern all elements of the digital health integration lifecycle.
The Pro Account offers a variety of ways to quickly find and recommend mHealth apps that have been reviewed by ORCHA, including functions such as: Favourites, Recommendations Sent, Recommendations Received, Quick Search, and the Advanced Search features. Professionals can also choose to share links to app Reviews, rather than recommending an app directly.
With over 365,000 health and care apps on the market, empowering people and professionals to know which apps are safe and trustworthy is essential. Working with ORCHA allows health and care bodies, professionals, patients and service users to access high quality digital health.
Embedding an ORCHA App Library into health and care pathways overcomes the barriers of awareness, access, trust and governance that so often inhibit the adoption of mHealth.
Our vision is to revolutionise care through the safe integration of digital health solutions into all aspects of health and care services, leading to more patient-centred, effective care.
As well as working with health and care bodies across the world, ORCHA continues to expand its service offering across the United Kingdom. The below map outlines which parts of the UK we currently work with, and those areas in which ORCHA App Libraries will be coming soon! We look forward to working with more health and care bodies to help even more patients and service users to access safe, high quality digital health resources.
English
Dutch
French
Spanish
German
Italian
Finnish
Norwegian
Swedish
Danish
Arabic
Polish
Icelandic
Romanian
Hungarian
Slovak
Czech
Bulgarian
Hindi
Urdu
Bengali
Gujarati
Punjabi