Mobile health apps can play an important role in patient-centred care. For instance, Health Secretary, Jeremy Hunt, has announced that in two years’ time he wants NHS patients to be able to use apps to access their medical records, order repeat prescriptions and book GP appointments. NHS England has stated: ‘We want to enable people to access care in a convenient and coordinated way, through the digital tools that all of us are now familiar with in other areas of our lives.’ To support this mission and as part of the Digital Standard for Health and Care, NHS England has announced two new platforms to provide an online resource for healthcare app developers: the NHS Digital Apps Library and a new ‘Mobile Health space’ providing resources for developers on Developer.nhs.uk.
NHS England’s interoperability strategy commits to defining a set of open application program interfaces (APIs) that patient record system suppliers will have to provide to other providers in the NHS. Within the primary care sector, NHS Digital has established a programme called GP Connect, which aims to define the open APIs that GPs must provide.
According to a mobile health app survey from market research company Vanson Bourne, commissioned by Red Hat in October 2016, productivity gains, better patient engagement, and a shift towards patient-centric care are key drivers for mobile healthcare apps.
The survey found that 41 per cent of European respondents expected a shift to patient-centric healthcare compared to 29 per cent of respondents in the USA. This may explain why European respondents appear to be developing more apps to support outpatients in monitoring chronic conditions such as diabetes than their US counterparts.
In the same Vanson Bourne survey, 32 per cent of European respondents reported that they planned to develop more than twenty custom healthcare apps by the end of 2017, compared with 19 per cent of US healthcare provider respondents. On average, the number of custom mobile healthcare apps developed was expected to increase by 36 per cent.
It was apparent that, rather than producing ad hoc apps, healthcare providers are becoming more strategic about the creation and ongoing management of mobile apps. The survey also found that the implementation of mobile app strategies was higher in the UK than in France and Germany.
A separate report by the Kings Fund – A Digital NHS – an introduction to the Digital Agenda and plans for implementation – reports that two years ago there were already 165,000 smartphone healthcare apps available in the iOS and Android app stores and Deloitte has forecast that the European market for smartphone health apps is set to overtake that of North America by 2018.
Indeed, the NHS App Store contains a whole range of apps to assist patients in managing a range of conditions including: depression and anxiety (SilverCloud); Type 1 diabetes (mumoActive); breast cancer treatment (OWise); phobias (FearFighter), as well as offering apps to support healthier lifestyles such as SugarSmart which provides guidance on reducing sugar consumption and Drinks Tracker to help people to manage and reduce their alcohol intake. There is even a Brush DJ app, which plays a two-minute track to help people to brush their teeth for the correct length of time.
In spite of the rising number of mobile healthcare apps being developed, the Vanson Bourne/Red Hat survey found that security, cost and regulation are still key barriers to adoption. The need to maintain governance over patient data is the probable reason behind over half of the respondents using full or partial on-premises deployment for their mobile apps, rather than pure Cloud deployment. Healthcare organisations could balance efficiency and data protection compliance by investigating app development and delivery platforms that can be deployed on-premises.
Survey respondents only anticipated a 15.5 per cent increase in app investment to support the creation of new apps. This indicates a potential shortfall in healthcare budgets allocated to support mobile app development, deployment and maintenance. The NHS developer platform includes Digital Assessment questions that help developers to create digital products to the required and recommended standards. However, this does not provide a gauge of the elements of app creation that can add time, complexity and cost.
To assist organisations in assessing the resources required, Red Hat’s Mobile App Development Assessment Tool poses key questions that should be answered before embarking on development. By guiding decision-makers through ten questions related to user requirements, device OS, APIs, access controls, deployment requirements and back-end integrations, and using an algorithm to calculate the resource requirement, an estimate is provided on how much time and complexity is involved in the creation of each app. This can help to prioritise mobile app projects that deliver most benefit to patients and healthcare providers, and which make best use of available resources.
As NHS England states: ‘We know that digital can make healthcare more coordinated, responsive and convenient. But in order to achieve this, the areas of greatest need have to be identified, so the market can create the right tools at the right time.’
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