Urgent NICE consultation: a great opportunity (UK)

This is a plea for any reader interested in the future success of medical apps in the UK to take a few minutes over Christmas to respond to a consultation request from the National Institute for Health & Care Excellence (NICE), which this editor has just been made aware of. The triennial consultation on the role of NICE opened in early December and closes on 2nd January – a very short time-frame as it covers the Christmas period!

Details are here. There is a form to download so it is not a challenging task to respond.

Many readers will be aware of this editor’s campaign following extensive research, to widen the remit of NICE to include reviewing the efficacy of medical apps. This is so that doctors can confidently recommend and indeed prescribe (NICE approved) medical apps without fear of liability, in the same way that they currently do for drugs. In addition, when discussing treatments with patients, doctors can then compare the efficacy of apps and of drugs for those conditions – such as depression, anxiety and pain relief – where apps can likely do the job better, at lower cost, with no side-effects. At a stroke this would reduce the cost of drugs to the NHS and take the UK to the forefront of the mobile health revolution.

If you can spare the time over Christmas you would give one person a very Happy Christmas; many thanks in anticipation.

The NICE way to a long and healthy life

The National Institute for Health & Care Excellence (NICE) has produced truly excellent draft guidance entitled Dementia, disability and frailty in later life – mid-life approaches to prevention.

As pointed out by David Oliver’s Kings Fund blog, which alerted this Editor to the NICE document, what is particularly exciting about these guidelines are “the principles and linking themes behind them, and the fact that, instead of just advising clinicians, the guidelines include direct advice to the government on health and wider social policy”.

Put another way, this document represents a holistic approach to coordinating the principal health drivers for a long and healthy old age: a major step to helping people achieve the vision of looking forward to old age. The table on page 15 of the draft emphasises just how wide (more…)

mHealth: too much to blog, too little time

As always the question is where to start? Perhaps with the FT headline ‘Powerhouse’ UK leads Europe app development, says research, a piece by Daniel Thomas on some research sponsored by Google & Tech City UK. A full version of the report is here. Key findings are that the UK:

  • Has become the largest tech hub in Europe for app development;
  • Received a third of revenues generated from mobile software in Europe last year;
  • Is the base for almost a fifth of European developers of smartphone applications;
  • is believed to be the world’s second most important tech hub after the US;
  • Has about 8,000 companies involved in app development, employing close to 400,000 people.

Apparently almost half of app developers and designers in the UK generate most of their income from apps, although a fifth generate no income from apps at all but rather see them as a hobby.

Staying with the FT, Prof Mike Short has kindly also pointed this editor to another article entitled (more…)

Healthcare Apps 2014 – a few impressions

This event was held on April 28th-30th in Victoria in London. It was organised by Pharma IQ and clearly had a strong pharma focus (including the charge which at £1995 for industry attendees clearly discriminated in favour of those with big-pharma sized budgets). It was also held just a few days after the significantly lower-priced Royal Society of Medicine event, and in the middle of a London Tube strike, all of which doubtless contributed to the relatively modest attendance (26 paid). I am most grateful to the organisers for kindly inviting me as one of speaker Alex Wyke’s guests.

As mentioned in an earlier post, there was a similarity with the RSM agenda, so I won’t repeat comments made by the same speaker before. The first up was the 3G Doctor, David Doherty, who gave another of his excellent presentations, although the sound engineer sadly made some of it inaudible. After a review of how we had got to where we are, he suggested that the Internet is about to become a device-dominated network. He drew a parallel between (more…)

Playing games, using apps, promoting wellbeing – RSM event summary (UK)

This is a brief summary of the main points made at an event on medical apps held at the Royal Society of Medicine on 10th April 2014.

First up was Prof Mike Kelly, Director of the Centre of Public Health at NICE who spoke about how apps could change behaviour. He described what he called “system 1”, the rational reflective system that he associated with Apollo, and “system” 2 the impulsive automatic system that he associated with Dionysus. System 1 is most often targeted by behaviour change, however most people find thinking hard so spend most of their time in system 2 mode, so it is  much more effective to “nudge” the automatic system 2, if you can.

Humans are relational creatures, not billiard balls, so (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…)