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 Rolls Royce’s telemetry-enabled service approach for jet engine provision and how LTCs like diabetes might best be managed.

He went on to describe the importance of mobile technology to clinicians, suggesting that there will be a date beyond which they will not be allowed to practice without owning one. For training, the difference in performance is already emerging: he pointed people to the UC Irvine study that showed that their students scored 23% higher when they used apps to study with.

As he did at the RSM, Julian Hitchcock, from Lawford Davies Denoon gave another truly brilliant summary of the UK and US regulatory position. Every time I hear his talk I learn more – on this occasion it was recognition of jusat how complicated the regulatory position is, with the great number of considerations in addition to MDD/IVDA, data privacy and consumer protection.

Unfortunately I had to duck out for the presentations by David Grainger, Senior Medical Device Specialist from the MHRA and another RSM speaker, Indi Singh, Head of Enterprise Architecture at NHS England.

Jim Dawton, Lead specialist – Design, at the Technology Strategy Board, did a great job of convincing us that money spent on a well designed app is money well spent.

Alex Wyke of PatientView gave a similarly excellent presentation to the one she gave at the RSM on the myhealthapps site that rates health apps on customer feedback.

What I had hoped to be the highlight of the event, Baku Patel, Senior Advisor at the FDA in the US, turned out to be a phone call from him which somehow lost much when compared with a presentation in person, especially as in the forty minutes he principally confined himself to the basics of FDA regulation that have been so well described by Julian Hitchcock as (a small) part of his regulation presentations anyway.

The second day began with an interesting talk by Alexia Tonnel, Director of Evidence Resources at NICE, who spoke about NICE’s use of apps to deliver NICE guidance and the BNF. Of special interest to those present was the willingness to allow NICE content to be used by other organisations in their apps, obviously on an appropriate basis; many business cards were exchanged.

This was followed  by Peter Dannenfelser, Director of Pharmaceutical Marketing at Janssen Pharmaceuticals (Johnson & Johnson’s pharma arm) who told us about strategic approaches to developing an HCP (ie clinician-facing) app. He explained that, compared with tablets, smartphones are used by clinicians typically at the point-of-care for quick hits so the apps need to be simple to use. He suggested that good principles for app creation are: meet user needs: be beautiful but practical; speediness; your app is yr brand; and finally update, update, update. He gave appropriate good and bad examples ot make his points.

Next up was Rowan Pritchard-Jones, who offered a slightly different angle to that in his RSM presentation. A particular point I had missed in previous presentations is that not only does the Mersey Burns app give much more accurate fluid infusion calculation, it also saves emergency doctors some ten minutes of the ‘Golden Hour’ to do the 19 separate calculations. He is also on a mission to get patients to feel comfortable with doctors using technology – as he said: “I want patients to see doctors approaching their beds using smartphones & not worry”. Rowan told this editor in conversation he now has CE certification for another app, Mersey Micro, which doubtless we’ll get to hear about very soon.

Andy Smith, Global Mobile & Emerging Channels Manager, Digital, in BUPA gave an interesting presentation on the Ground Miles app, aimed at getting people worldwide to exercise more ot reduce the risk of heart attack and stroke. A great initiative by BUPA, with a well designed and marketed app!

Imran Rafi, Chair of Clinical Innovation & Research at the RCGP gave an excellent presentation on data protection and risk management issues associated with apps. A particular challenge he mentioned that had not occurred to me before was the information governance aspects of releasing information on PHRs from other sources, eg Benefits. In TTA we have commented on the RCGP’s 2022 Vision documents that almost failed to recognise forecast technological progress at all. Imran is now working hard to change that, so more power to his elbow.

That was followed by Sharon Cooper, CTO of the BMJ who gave us a fascinating insight into how the BMJ uses user input to design their apps – the series of pictures from sketch to completed screen design were particularly impressive. She showed a particularly interesting infographic of use of smartphones by doctors which is well worth a look. She explained that the four critical aspects of decision support for clinicians are: computer based generation of decision support; provision of recommendation rather than just an assessment; provision of decision support at time and location of decision making; and automatic provision of decision support as part of clinician workflow.

What this editor took away from the event is that, to misquote L P Hartley, pharma is a foreign country; they do things differently there. For example, most of the tea-break, and round-table, discussions with pharma delegates focused on how apps could be used to promote or support product sales, or improve the effectiveness of products when sold (thus presumably encouraging more sales). Others had come along from their companies for inspiration, having been given app-related responsibilities, and told to find an appropriate role for them. This is very different to the clear patient outcome-focused world this editor is used to.

In this context, it is perhaps just worth referring readers to the mobihealthnews in depth item on pharma’s digital health opportunities which, though just released, already has an active disagreement underway in the comments. The two key aspects they highlight are the lack of trust patients (presumably US) have in pharma, and the industry’s strong risk adversity.



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