Digital health supports social prescribers in Humber and North Yorkshire

Case Study

Digital health supports social prescribers in Humber and North Yorkshire

Lucia Victor

Situation

In 2019, Humber, Coast and Vale Integrated Care System (ICS) (now Humber and North Yorkshire ICS) set out their Strategy for Digital Transformation. At the time, the population served by the ICS was 1.4 million people, with 23% of the population living in the most deprived areas of the UK, and a high proportion of this population living in extremely rural and isolated areas. 

The ICS was under a great deal of pressure. 8.9% of the population were aged 75+, and of the under-75s, cancer was the leading cause of death – killing over 4,000 a year, with lung cancer as the biggest contributor. Smoking, alcohol abuse and obesity were higher than the national average, and 14% of 16-24 year olds had mental health illnesses. 36% of A&E visits were due to unavailability of General Practice services, and 40% of patients visiting A&E required no treatment. 

If no transformational changes took place, the Humber, Coast and Vale ICS expected a budget deficit of at least £420 million by 2020/21. 

Digital transformation was fundamental to improving the health of both citizens and the system itself. By harnessing the innovative use of digital solutions to deliver high-quality care and empower citizens to self-manage their health, the ICS could support its population and health and care professionals, whilst improving efficiencies within the system.

During the process of developing its digital strategy, the ICS commissioned a public survey to ensure any digital transformation was aligned with their citizens’ needs. Amongst the responses to questions on digital improvements to the patient experience were several requests for patient-related healthcare apps.

Despite the fact that the growing adoption of digital health was clear, many health and care professionals had difficulty knowing how to incorporate it into their service delivery. Although there are a great many digital health technologies available for a huge range of conditions, staff reported it was hard to tell which of the hundreds of thousands of them available would be relevant and beneficial to the vulnerable people they support.

Solution

The Humber, Coast and Vale ORCHA Digital Health Library launched in 2019 at hcv.orcha.co.uk (now at hny.orcha.co.uk), with the intention of delivering quality-assured digital health to their population. The Library contained only apps compliant with safety standards, and provided an easy way to search for the highest rated apps across a wide range of issues. 

In 2020, the project team chose supporting healthy living and long-term condition management as key focus areas for their population, particularly with face-to-face services being halted during the COVID-19 pandemic. The team identified social prescribers as being particularly well-placed to deliver these services, and connected ORCHA’s team behind the implementation of the Library with teams such as Citizens Advice Clinic. 

Results

Social prescribers at the Citizens Advice Clinic found the inclusion of assessed digital health technologies within their work to be an incredibly valuable additional tool. 

Elaine Elsdon at the Citizens Advice Clinic was introduced to the Humber ORCHA Library in May 2020, and began using it right away. She has found that the assurance of being able to signpost people to the health technologies available, in combination with the robust review process behind their inclusion in the Library, is very reassuring to the people she supports. The wide variety of health and care technologies (including apps) that are identified in the Library for each condition area means that she can identify support for the wide range of people supported by the Clinic. If a client presents an issue which she hasn’t previously found a solution for, she can simply search to see which assessed solutions are available, and recommend them securely to her clients.

Mainly focusing on mental health and exercise and weight management apps, Elaine has adopted the recommendation of apps to her clients, with resounding success. Many of the clients being supported by the Clinic haven’t considered using apps for their health, but may be looking for support either in addition to or as an alternative to medication and traditional therapies. As accessing services became difficult during lockdown, Citizens Advice clients have found great use for apps to support the management of their own health. Furthermore, as many felt during the pandemic that they might be using up limited resources which would be better spent elsewhere, or that the complexities of trying to access these services was causing them stress, the instant accessibility of support provided by health apps was and remains very much preferable. As traditional services have begun to be reinstated, Elaine has found that health apps have continued to provide support to her clients, some of whom don’t wish to access helplines or face-to-face or group therapy sessions.

The ORCHA Pro functionality has also been incredibly helpful to Elaine, allowing her to keep track of which apps she has recommended to whom, and based on this, to find solutions for clients with similar health concerns. As well as being able to track previously successful apps, Elaine can find new apps, and apps for health concerns she hasn’t previously been presented with. Furthermore, through ORCHA’s Digital Health Academy, Elaine can continue to develop her understanding and use of digital health.

Elaine Elsdon, Link Worker at Citizens Advice Clinic said

“Without ORCHA, I just would not have ever considered recommending any app at all. So for me, it’s opened up a completely new world. And therefore, it’s influenced me. It’s made me a better practitioner because I have more tools available to me, and it’s opened up a wider conversation with my clients about different kinds of support that are available out there.  I think that can only be good, for me as a practitioner but also for my clients because it gives them a much broader opportunity to look into options that might be a better fit for their needs. Not everybody wants to go to a face-to-face group in the community, and something like an app might just prove to be a perfect solution for someone.”

The health apps themselves have had a really beneficial effect for many clients. Mental health apps in particular had very positive effects for those who had perhaps been guided through various coping strategies, but, due to the nature of mental health illnesses, found it difficult to remember what they were supposed to do when they were struggling. By accessing mental health support on their phones, however, they found that they could practice these strategies as many times as they needed to, without feeling judged in any way, or as if they were taking up time or resources. One mental health app in particular, an AI chatbot app called Woebot, has been very successful in supporting Citizens Advice clients, as it allows them to work through and reframe thought patterns they are struggling with, as many times as they need to. One user described it as “a friend in my back pocket 24 hours a day, seven days a week.”

Chloe, a client at Citizens Advice Clinic said

“[The app] is very good.  It helped me to change my mindset.  I can have self-destructive and negative thought patterns and it helped me to challenge those thoughts.  It’s such a shame I didn’t have this app in Lockdown.  It’s so helpful because I can just offload to the app any time of the day or night and clear my head.  I think of this as my little buddy, and I look forward to the next goal we can work on together.”

To date, the Humber Library (now relaunched as Humber and North Yorkshire, in line with changes to the ICS) has had almost 10,000 page views. There are over 100 ORCHA Pros registered to the Humber site, with the most popular apps being recommended residing within the mental health and healthy living categories, and having a particular focus on anxiety and depression, relaxation techniques, and cognitive behavioural therapy. Mental health is by far the most searched term within the Library, but searches for diabetes, fitness and weight management apps are also common.

About ORCHA

Founded by NHS clinicians, ORCHA is the world’s leading digital health evaluation and distribution organisation. We provide services to national health bodies across three continents, including the NHS in 50% of UK regions, delivering national accreditation frameworks, bespoke Digital Health Libraries, and professional recommendation tools, specific to the needs of our clients. ORCHA’s unique Review Engine assesses digital health solutions against more than 300 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, plus additional criteria depending on needs.

See how ORCHA works

Discover how our services, including Reviews, Digital Health Libraries, and market intelligence reports, can work for your specific needs.

Sign up to our newsletter

For regular updates on digital health, apps, industry news, and more, sign up to our mailing list here.

Your Health and Care App Library

Search ORCHA’s App Library, featuring thousands of independent app reviews across a broad spectrum of health conditions. Every app is evaluated against more than 300 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, making it easy for you to find the best apps for your needs.

Oops! We could not locate your form.

ORCHA partners with Best For You – transformative mental health care for children and young people

Case Study

Digital health supports social prescribers in Humber and North Yorkshire

Lucia Victor

ORCHA is very proud to announce a partnership with Best For You: a new initiative from leading NHS organisations that will transform mental health services for children and young people. By integrating a range of healthcare services into one patient-centred model of care, Best For You will provide personalised, comprehensive and long-term mental health support to children, young people, and their families. The service will use next-generation therapeutic interventions and digital tools to provide the best possible care for patients – including the use of digitally and clinically assured digital health solutions from their ORCHA digital app library. 

This much-needed service is in response to the public health crisis surrounding children and young people’s need for mental health support. A survey commissioned by NHS Digital found that the number of children and young people with clinically significant mental health conditions was 50% higher post-COVID-19 than the previous survey three years earlier. New data shows that referrals to child and adolescent mental health services in March 2021 were more than double those in March 2020. Mental health has been a top search query in ORCHA Digital Health Libraries since January 2019; during lockdown, however, searches for mental health apps increased by over 200%. And this number is still rising, at an average rate of 55% per month. Best For You will help to tackle this issue through tailored, holistic care which seamlessly integrates mental health services and digital tools.

Data shows us that children and young people are both critical and vulnerable users of mobile health devices and software. While young people are highly likely to go online to find health-related information and guidance, many find it difficult to assess the accuracy of health information from the multiple and varied sources available online. However, the pandemic has also shown that many children respond well to digital counselling.

ORCHA already works with a number of child and adolescent mental health services (CAMHS) teams and NHS Trusts around the UK to create bespoke digital health libraries of assessed mental health technologies. Studies show that mobile health technologies can be just as effective as face-to-face mental health therapies. ORCHA also works directly with children and young people via its Digital Healthy Schools programme, which provides age-appropriate digital health education to schoolchildren. Anxiety, mental health, and depression are among the top five search terms across ORCHA’s Digital Healthy Schools digital health app libraries.

By including compliant digital therapies in its care pathways through the ORCHA partnership, Best For You can address the rising levels of children and young people facing serious mental health difficulties, while safeguarding them from any harmful digital health solutions. The Best For You ORCHA library can be found at /bestforyou.orcha.co.uk/

About ORCHA

Founded by NHS clinicians, ORCHA is the world’s leading digital health evaluation and distribution organisation. We provide services to national health bodies across three continents, including the NHS in 50% of UK regions, delivering national accreditation frameworks, bespoke Digital Health Libraries, and professional recommendation tools, specific to the needs of our clients. ORCHA’s unique Review Engine assesses digital health solutions against more than 300 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, plus additional criteria depending on needs.

See how ORCHA works

Discover how our services, including Reviews, Digital Health Libraries, and market intelligence reports, can work for your specific needs.

Sign up to our newsletter

For regular updates on digital health, apps, industry news, and more, sign up to our mailing list here.

Your Health and Care App Library

Search ORCHA’s App Library, featuring thousands of independent app reviews across a broad spectrum of health conditions. Every app is evaluated against more than 300 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, making it easy for you to find the best apps for your needs.

Oops! We could not locate your form.

Comparing applets and oranges: barriers to evidence-based practice for app-based psychological interventions

Case Study

Digital health supports social prescribers in Humber and North Yorkshire

Lucia Victor

Published in: BMJ Evidence-based mental health

Poor-quality pharmaceuticals and medical devices rarely make it to market; however, the same cannot be said for app-based interventions. With a high availability but low evidence base for mHealth, apps are an increasingly uncertain prospect to users and healthcare professionals alike.

Although in a first-best situation, the burden of proof concerning app safety, clinical and cost-effectiveness ‘should’ ultimately lie with app developers; a number of barriers to evidence generation, including the fact that ‘acceptable evidence’ itself is largely open to interpretation, mean that it may be folly to expect this paucity of real-world effectiveness research to improve.

While the health technology assessment of established therapeutic modalities including pharmaceuticals and talking therapies benefits from the existence of approved evaluative guidelines, unfortunately the same cannot be said for app-based interventions, specifically with regard to outcomes measurement.

As such, it would seem that in order to prevent the comparative assessment of apps simply becoming an exercise comparing apples and oranges, there is a clear need for consensus and guidance for app developers, as to which patient-reported outcome measures, among the hundreds available, are of clinical use to those making decisions, and should therefore be used when developing app-based interventions.

By negating the fear that any evidence collected may be of poor quality, we can reincentivise developers to engage in evidence generation, and in doing so, maximise the likelihood of evidence-based decision-making taking a firm hold. However, only by dispelling the ambiguity around what acceptable evidence can and should look like, can we begin to do so.

 

Read the full research piece here: https://ebmh.bmj.com/content/ebmental/19/3/90.full.pdf

About ORCHA

Founded by NHS clinicians, ORCHA is the world’s leading digital health evaluation and distribution organisation. We provide services to national health bodies across three continents, including the NHS in 50% of UK regions, delivering national accreditation frameworks, bespoke Digital Health Libraries, and professional recommendation tools, specific to the needs of our clients. ORCHA’s unique Review Engine assesses digital health solutions against more than 300 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, plus additional criteria depending on needs.

Oops! We could not locate your form.

Oops! We could not locate your form.

App-based psychological interventions: friend or foe?

Case Study

Digital health supports social prescribers in Humber and North Yorkshire

Lucia Victor

Published in: BMJ Evidence-based mental health

Poor-quality pharmaceuticals and medical devices rarely make it to market; however, the same cannot be said for app-based interventions. With a high availability but low evidence base for mHealth, apps are an increasingly uncertain prospect to users and healthcare professionals alike.

Although in a first-best situation, the burden of proof concerning app safety, clinical and cost-effectiveness ‘should’ ultimately lie with app developers; a number of barriers to evidence generation, including the fact that ‘acceptable evidence’ itself is largely open to interpretation, mean that it may be folly to expect this paucity of real-world effectiveness research to improve.

While the health technology assessment of established therapeutic modalities including pharmaceuticals and talking therapies benefits from the existence of approved evaluative guidelines, unfortunately the same cannot be said for app-based interventions, specifically with regard to outcomes measurement.

As such, it would seem that in order to prevent the comparative assessment of apps simply becoming an exercise comparing apples and oranges, there is a clear need for consensus and guidance for app developers, as to which patient-reported outcome measures, among the hundreds available, are of clinical use to those making decisions, and should therefore be used when developing app-based interventions.

By negating the fear that any evidence collected may be of poor quality, we can reincentivise developers to engage in evidence generation, and in doing so, maximise the likelihood of evidence-based decision-making taking a firm hold. However, only by dispelling the ambiguity around what acceptable evidence can and should look like, can we begin to do so.

 

Read the full research piece here: https://ebmh.bmj.com/content/ebmental/19/3/90.full.pdf

About ORCHA

Founded by NHS clinicians, ORCHA is the world’s leading digital health evaluation and distribution organisation. We provide services to national health bodies across three continents, including the NHS in 50% of UK regions, delivering national accreditation frameworks, bespoke Digital Health Libraries, and professional recommendation tools, specific to the needs of our clients. ORCHA’s unique Review Engine assesses digital health solutions against more than 300 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, plus additional criteria depending on needs.

Oops! We could not locate your form.

Oops! We could not locate your form.