Reflections on the NHS Innovation Expo (UK)

Editor Charles visited the Expo in Manchester on Tuesday 4th March – here are his personal reflections.

I decided to devote the one day I had to visit the NHS Innovation Expo to visiting stands to try to spread the word about DHACA that was launched last week.

The first thing I noticed about the event was that it seemed less crowded than previous ones. When passing them, I never saw the main auditoria full either, very much in contrast to earlier Expos.

The other principal observation was that (more…)

One more step in changing the patient:doctor relationship

We have written extensively in recent months about how technology is changing the way patients are using doctors, yet some, notably the RCGP in their vision of GP practice in 2022, seem unprepared, or unwilling to accept this. Well if more evidence of the coming change were needed, AliveCor’s announcement that it now has FDA approval for sales of its (iOS & Android) smartphone-enabled heart monitor direct to the public will perhaps provide some.

In particular, the announcement includes a service – available in the US only at present – called AliveInsights, that will (more…)

Certifying medical apps (contd.)

No sooner had I given my keyboard the final tap to publish the conclusions of my work yesterday on medical apps than the first item hit my inbox that suggest that certification is a flawed proposition.

The suggestion of this iMedicalApps article is that the Happtique saga has shown certification to be impossible. Instead it is suggested that people make up their own minds based on peer review on sites (you’ve guessed it) such as theirs, and a greater understanding of apps.  The key paragraph for me is (more…)

Driving up medical app usage in the UK – part III: conclusions

This series of posts covers some work I have been doing over the past three months: attempting to answer the question of how best to improve the perception by clinicians and patients of the efficacy of health-related apps. This work has been done for the i-Focus project, part of the Technology Strategy Board’s dallas programme.

Part I briefly summarised the EU regulations covering health-related apps. The point was made that any health-related app must comply with data protection and consumer protection requirements, irrespective of whether the risk level is sufficient for it to be classified as a ‘medical device’. Where an app is classified as a ‘medical device’ it also has to be classified so that the appropriate adjudication work can be determined for it to receive a CE mark (Class I, lowest risk, requires least investigation; Class III, highest risk, requires greatest investigation).

Part II summarised the principal findings from discussions with a very wide range of potential stakeholders, from patients to consultants, and from individual app developers to chief executives of app curation companies.  The key findings were:

  • There is currently little academically-endorsed evidence of medical app efficacy, though much anecdotal evidence;
  • There are too many bogus apps around;
  • There are safety worries – for example where clinicians are using unregulated apps to manage medication dosage;
  • The process for obtaining certification is unclear;
  • Some app developers are ignoring data privacy legislation;
  • The business model for achieving sales via the NHS is not well understood.

In addition, a theme running through both posts is that there is an international dimension to this issue, with some countries, notably the US, well advanced in certain aspects.

From these findings, four key conclusions emerge: (more…)

Royal Society of Medicine events that should appeal

This year the RSM kicks off with Recent developments in digital health on 27th February, in association with the Royal Academy of Engineering. This event aims to update attendees on all the latest advances in the field of digital health that will affect care delivery. Perhaps the highlight of the day will be the demonstration of a smartphone that, on its own, can measure a person’s systolic and diastolic blood pressures, pulse, blood oxygen saturation, respiration and temperature – as this is a facility that will appear on the next generation of smartphones, the discussion on how app developers and the medical profession will respond will be particularly interesting. In addition there will be presentations by leading thinkers in the field on topics like big data, mHealth, medical apps, point-of-care-testing, genomic technology, evidence gathering and NHS England’s digital priorities.

Another event, that sold out early last year, is our medical apps day, this year on 10th April, entitled  (more…)

Driving up medical app usage in the UK – part II

Introduction

This series of posts covers some work I have been doing over the past three months: attempting to answer the question of how best to improve the perception by clinicians and patients of the efficacy of health-related apps. This work has been done for the i-Focus project, part of the Technology Strategy Board’s dallas programme.

Part I attempted to summarise the EU regulations covering health-related apps. The point was made that any health-related app must comply with data protection and consumer protection requirements, irrespective of whether the risk level is sufficient for it to be classified as a ‘medical device’. Where an app is classified as a ‘medical device’ it also has to be classified so that the appropriate adjudication work can be determined for it to receive a CE mark (Class I, lowest risk, requires least investigation; Class III, highest risk, requires greatest investigation).

This post summarises the principal findings from discussions with a very wide range of potential stakeholders, (more…)

mHealth data privacy: a worrying finding

We reported last August on a YouGov poll that found nine out of ten people not knowing what the term ‘telehealth’ meant.  Now they’ve been at it again, this time looking at mHealth, sponsored by Pinsent Masons.  From a poll of 2000 people, they found that:

“Prior to being given a definition of mHealth, the majority (73%) of respondents didn’t know what the term meant, and when explained 90% stated they never used mHealth services, despite the examples given including established applications such as fitness apps.”

Perhaps there’s a little encouragement (more…)

Mainly mHealth: a few predictions for 2014, and some speculation

Editor Charles on what to watch for in 2014

As we have covered previously (and here), there’s no shortage of forecasts that the mHealth market will continue to grow faster, or of penetrating comments like that that won Research2guidance a What in the Blue Blazes award that smartphone user penetration will be the main driver for the mobile health (mHealth) uptake. mHealth apps continue to proliferate – there’s even shortly to be a Pebble apps store. There are a few straws in the wind that not is all well though – for example, as we covered recently, Happtique ceased, at least temporarily, its apps approval process, citing security concerns.  Elsewhere Fierce Mobile described serious data privacy issues with the iPharmacy app, and the ICO recently produced security guidelines for app developers in the UK.  The EU is also strengthening data privacy, moving from individual country directives to a pan-EU regulation. This leads us to our first prediction (more…)

Epocrates ‘Bugs + Drugs’ infectious disease app inaccurate, should be pulled: reviewer

For clinicians who increasingly rely on major reference apps via smartphone and tablet, this sounds a loud cautionary note. This pharmacist’s detailed analysis of the errors and misinterpretation contained in the recently released and best-selling Epocrates reference app on the highly sensitive topic of infectious disease (including those that plague hospitals such as MRSA) culminates in a call to pull it from the Apple App Store. In several instances, the app pointed to the wrong antibiotic for an organism. The other faults are in using Athenahealth information to create what is called an antibiogram, “to identify what organisms are susceptible to what antibiotics in that locale”. The iMedicalApps analysis by Timothy Aungst, Pharm.D., professor at Massachusetts College of Pharmacy and Health Sciences has created quite a stir in the usual places. FierceMobileHealthcare covers this but decides to further blow up the balloon (or move off the point) in citing the IMS Institute for Healthcare Informatics and Journal of Cancer Education on the plain ineffectiveness and non-validation of the vast majority of healthcare apps–mainly consumer.

Free Medical Apps Event

For the past few weeks I have been commissioned by the i3i project, part of the dallas programme, to examine what is necessary to improve clinical and patient confidence in the efficacy of medical apps.  I will shortly publicise my initial draft recommendations to seek reader feedback.

In the meantime, readers might be interested in a free event (more…)

Stats on medical apps on Apple & Android

iMedicalApps reports on the latest stats on medical apps on Apple & Android.  Overall figures show Apple with more than twice as many as Android.  It would be interesting to know how that split would be for apps aimed at patients – notwithstanding the previous post, I get the impression that the balance between the two is evening up.

There is a stark contrast between these numbers (over 19,000 for Apple, just over 8,000 on Google Play) and the small number of medical apps approved by the FDA (just over 100 according to a comment on the report) and on the NHS Choices health apps library.  Even making a very generous allowance for clinician-focused apps, this still emphasises the importance of the work underway just now on ordering the market to give users greater confidence in the safety and efficacy of what they download.