Challenge

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.

Solution

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.

Results

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

A high proportion of people in the UK are living with overweight or obesity, increasing their risk of severe illness and death from COVID-19. Meanwhile, social distancing and self-isolation impact face-to-face weight management services.

The use of technology is a good answer to providing services, but how can we provide evidence-based care, combat misinformation and ensure a rapid roll out of technology that is safe, effective and does not put the public at risk of harm?

Our report, developed with The Association of UK Dietitians (BDA), outlines the situation and shares advice and best practice on how to embed digital health in weight management services.

Click on the PDF icon below to download the Digital in Weight Management Services Report. Discover:

• Why do only 21% of weight management apps meet standards?
• What does the clinical evidence say about weight management apps?
• How does the public perceive digital health for weight management?
• Which 10 apps should you know about?
• What practical steps can you take?

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

As there are 4.7 million people in the UK with diabetes, management of this condition now makes up 10% of the NHS budget.¹ Health apps give patients tools to self-manage, reducing pressure on the NHS.

But how do you find the right ones? ORCHA has reviewed 229 diabetes apps, and 82% score below our quality threshold, indicating a market of low quality apps.

Today, Dr Tom Micklewright discusses his views on three apps for managing diabetes that have scored well in ORCHA’s Review.

In these videos, Dr Tom Micklewright looks at three top-scoring diabetes apps, giving his opinion on their features, benefits, and areas for improvement.

Intellin app demonstration: 

Dr Micklewright demonstrates the Intellin app, shares his views, and explores how the app simplifies the management of diabetes and identifies the risk of developing complications. Intellin gives personalised predictions on users’ highest risk areas and provides tips on how to prevent these complications.

Click below to watch the video:

Diabetes Forum app demonstration: 

Dr Micklewright next looks at the way in which the Diabetes Forum app provides a moderated peer-to-peer support network to people with diabetes (considered vulnerable under COVID-19). This includes elderly people, friends and caregivers. The app can be distributed through a mobile and web app:

Liva UK app demonstration:

For his insight into another top-scoring diabetes app, Dr Micklewright demonstrates how Liva UK provides personalised health coaching programmes to patients at risk of developing, or currently living with, chronic diseases such as Pre and Type 2 Diabetes:

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Sources

1) Diabetes UK: Us, diabetes and a lot of facts and stats

According to Diabetes UK, 4.7 million people in the UK have diabetes, a number which has more than doubled in the last 20 years. About 90% of people with diabetes have Type 2, about 8% of people with diabetes have Type 1, and about 2% of people have rarer types of diabetes. Considering that the NHS spends at least £10 billion a year on diabetes, making up 10% of its entire budget, it is becoming increasingly important that patients have access to additional forms of diabetes management care that don’t rely solely on the NHS.

As well as reducing the strain on the NHS, more resources are needed so that people can learn to self-manage their diabetes. On average, diabetes sufferers spend around 3 hours with a healthcare professional every year, meaning that, for the remaining 8,757 hours, they must manage their diabetes themselves. It is here that diabetes apps find their place as diabetes management tools.

But what are the best diabetes apps?

With over 300,000 health apps on the market, many of these aimed at people with diabetes, it can be difficult, if not impossible, to know which ones are trustworthy and effective. As the trusted source for health app advice, ORCHA has reviewed 60 diabetes apps so that users and health professionals can easily find the best diabetes app for their or their patient’s health needs.

ORCHA’s App Library cuts through the noise by showing which apps, out of the thousands available, are safe to use. Scored on Clinical Assurance, Data Privacy and User Experience, ORCHA has reviewed diabetes tracker/log apps, diabetes management apps, gestational diabetes apps, and diabetes apps that go alongside medical devices.

ORCHA’s Top 5 Diabetes Apps

Diabetes apps can aid condition-management, give patients an informed understanding of diabetes, and, thus, provide additional support to professional medical advice and treatment. Below, we look at 5 of the top apps for diabetes management, based on our ORCHA Review:

• RetinaRisk – The Risk Diabetic Retinopathy Calculator (DRC) is designed for people with diabetes, and calculates patients’ percentage risk of developing sight-threatening retinopathy over time. These risk estimates are based on each individual’s clinical data. With an ORCHA Score of 88% on both iOS and Android, RetinaRisk is the highest scoring app designed specifically for individuals with diabetes.
• mySugr – The mySugr App is a free diabetes logbook, allowing users to keep their diabetes data under control. As a diabetes journal app, it includes a blood sugar tracker, carb logger, bolus calculator (EU only) and an estimated HbA1c for each individual. The app achieved an ORCHA Score of 87% on Android and 85% on iOS.
• Dario Diabetes Management – Dario Diabetes Management is a diabetes monitor app that allows people with diabetes to keep a record of their diabetes history, from a logbook and timeline of blood glucose measurements, to the ability to share results and statistics with chosen family members or healthcare team. Users can also enable Emergency Hypo Alerts with GPS Locator, which is a useful safety feature. The app can connect to Dario’s Blood Glucose Monitoring System, a smart pocket-sized device that automatically records blood glucose measurements and provides analysis. Dario Diabetes Management achieved an ORCHA Score of 84% on iOS and 80% on Android.
• GDm-Health – GDm-Health is gestational diabetes app for women with or at risk of gestational diabetes, as well as those who are pregnant with pre-existing diabetes. Users can upload and track blood glucose readings. These readings can be viewed as a list, in diary-view, in a graph, and can be filtered to show trends. Users can also provide additional notes to their care team, and receive care guidance from their care professional direct to the app. The app’s ORCHA Score for iOS is 83%.
• Dip.io – To be used with the designated Dip.io kit, Dip.io turns your smartphone into a urine dipstick analyser. The Dip.io app and kit can aid in the diagnosis and monitoring of metabolic or systemic diseases, and can thus be used as a diabetes monitor app, as well as for the general evaluation of health. Dip.io achieved an ORCHA Score of 76% on iOS.

Take a look at how we are working with West Lancashire Clinical Commissioning Group to integrate health apps into their Healthier You: NHS Diabetes Prevention Programme (NHS DPP) in order to help prevent diabetes.

Due to our continual re-review process, all app scores are subject to change. As such, we’d always encourage you to view our app reviews on our App Library, as this reflects Live data and app updates which are continuously changing. Our re-review process ensures that the most up-to-date information for the latest version of an app can be accessed via our App Library.