Decision‐support tools via mobile devices to improve quality of care in primary healthcare settings.

Decision‐support tools via mobile devices to improve quality of care in primary healthcare settings.
Cochrane Database of Systematic Reviews 27 July 2021, Issue 7. Art. No.: CD012944. DOI: 10.1002/14651858.CD012944.pub2.

• A systematic review identified 8 RCTs (none from UK) of examining the effect of decision‐support tools on mobile phones on primary health care, but the evidence is not clear about the effects of these tools on patients' and clients' behaviour and on their health.

The Data Divide

The Data Divide
Ada Lovelace Institute 25 March 2021

• Public attitudes to tackling social and health inequalities in the COVID-19 pandemic and beyond.
• Findings of a telephone-based, nationally representative survey of 2,023 UK British adults, to explore public attitudes towards a range of technologies deployed during the COVID-19 pandemic for health outcomes, including mental and physical-health apps, symptom-tracking apps, digital contact-tracing apps and vaccine passports.

Digital Technology Assessment Criteria (DTAC)

Digital Technology Assessment Criteria (DTAC) for Health and Social Care (DTAC)
NHSX 22 February 2021

• Following a period of consultation NHSX has unveiled a new simpler and faster assessment process to help give staff, patients and the public confidence that the digital health tools they use meet NHS standards. The simple new guidance brings together legislation and best practice in five areas. Tools will receive a pass or fail in four categories - clinical safety, data protection, technical security and interoperability - and a score on usability and accessibility.

Digital Technology Assessment Criteria

Digital Technology Assessment Criteria for health and social care
NHS England October 2020

• The Digital Technology Assessment Criteria for health and social care, beta (DTAC) forms a baseline assessment criteria that validates the suitability and function of digital health technologies for use by the NHS, social care staff or directly by citizens. It replaces the existing Digital Assessment Questionnaire (DAQ) and Digital Assessment Portal (DAP).
• It will be supported by the Guide to Good Practice for Digital and Data-Driven Health Technologies, which will be published in October by the NHS AI Lab.DTAC focuses on detailing the specific requirements that must be evidenced before digital health technologies can be used directly by patients or procured safely by commissioners and the wider health and care system. The five core areas are clinical safety, data protection, technical assurance, interoperability, and usability and accessibility.
• See the roadmap to assessing new apps and products and blog
• DTAC v1 is due to be published in January 2021.

mHealth 2030

mHealth 2030 Report
ORCHA 24 August 2020

• Whilst there has been an explosion within the fitness industry and uptake for GP online services have seen fast growth, mHealth is not yet part of the fabric of the NHS, nor is it widely adopted amongst those who could perhaps benefit the most. We ask worldwide leaders from across mHealth: what will the next decade bring? What will apps deliver by 2030? What will be the biggest barriers faced by the industry? And what do governments need to do to contribute?

Confidence in a crisis? Building public trust in a contact tracing app

Confidence in a crisis? Building public trust in a contact tracing app
Ada Lovelace Institute August 2020

• Outcome of a rapid online discussion convened by Ada Lovelace Institute, Traverse, Involve and Bang the Table with 28 members of the public – the ‘Lockdown Debate’ – to explore attitudes to the use of COVID-19 related technologies for transitioning out of lockdown. The cohort was asked:
• ‘Under what circumstances do citizens think that technological solutions like the COVID-19 contact tracing app are appropriate?’ The four resulting themes:

1. Provide the public with a transparent evidence base.
2. Offer independent assessment and review of the technology.
3. Clarify boundaries on data use, rights and responsibilities.
4. Proactively address the needs of, and risks relating to, vulnerable groups.

• The report presents a checklist for the Government, policymakers and tech developers to support design and delivery of COVID-19 technologies with public legitimacy built in.

Ehealth and mobile apps in the NHS

Ehealth and mobile apps in the NHS
HEE Learning Hub, 21 July 2020 [Registration required]

• This resource details how mobile phone applications are currently being used as an "e-health" solution to supporting healthcare delivery within the NHS. The potential opportunities and barriers to wide-scale use within the NHS are explored, as well as potential Healthcare Science. A summary of the apps catalogued within the NHS App Library is given, alongside suggestions of alternative ways they could be used to manage the COVID-19 crisis. The barriers to integrating e-health solutions to NHS pathways are explored, as well as potential solutions for successful adoption.
• Also available as a pdf here.

Procuring health and care apps through the Dynamic Purchasing System

Procuring health and care apps through the Dynamic Purchasing System
ORCHA 16 July 2020

• NHS London Procurement Partnership (NHS LPP) is offering support to procure safe, secure apps through its Health and Social Care Apps Dynamic Purchasing System (DPS). Developed in partnership with ORCHA, NHS LPP’s DPS allows NHS organisations to rapidly procure quality assured digital health solutions at scale.

Engaging Children and Young People in Digital Mental Health Interventions: Systematic Review

Engaging Children and Young People in Digital Mental Health Interventions: Systematic Review of Modes of Delivery, Facilitators, and Barriers
J Med Internet Res 2020;22(6):e16317 DOI: 10.2196/16317

• This study identified 6 modes of delivery used in CYP digital mental health interventions (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. 
• The literature highlighted that CYP prefer digital health interventions with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders.

ABSTRACT

COVID-19 App Library

COVID-19 App Library
ORCHA (Organisation for the Review of Care and Health Apps)

• App evaluation company ORCHA has launched a COVID-19 formulary to signpost healthcare professionals and consumers to clinically validated apps. ORCHA has verified the accuracy, security and risk associated with the apps before adding them to the library. They include some to which NHS staff have been given free access during the pandemic (see here.)

Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic

Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic
Journal of Medical Ethics 04 May 2020. doi: 10.1136/medethics-2020-106314

• A discussion of the ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic from The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK

Effectiveness of Mobile Applications on Medication Adherence in Adults with Chronic Diseases

Effectiveness of Mobile Applications on Medication Adherence in Adults with Chronic Diseases: A Systematic Review and Meta-Analysis
Journal of Managed Care & Specialty Pharmacy April 2020;26(4):550-61. DOI 10.18553/jmcp.2020.26.4.550

• A systematic review of the literature identified 14 studies which measured the effect of mobile apps on medication adherence in adults with chronic diseases involving 1,785 participants. The meta-analysis showed that the use of mobile apps was associated with a significant improvement in patient adherence to medication (Cohen’s d=0.40, 95% CI=0.27-0.52; P<0.001), but the studies were of low level of evidence and short intervention duration.

How we are assessing COVID-19 apps

How we are assessing COVID-19 apps [blog]
NHS Digital 17 April 2020

• NHSX is working with NHS Digital to fast-track and evaluate apps (and similar technologies) that support our response to COVID-19, using the existing Digital Assessment Questionnaire (DAQ), within the Digital Assessment Portal (DAP). 

Home-based albumin screening in primary care

Tackling the £1.5bn a year cost of chronic kidney disease
HSJ 20 March 2020

• A urine test that patients can do at home using a smartphone app and a simple urinalysis kit has the potential to prevent chronic kidney disease, saving lives and money. GP super-partnership Modality Partnership, working with Healthy.io and inhealthcare, has shown that home-based albumin screening in primary care is a cost-effective way to increase uptake and improve early detection.

Mobile and Web-Based Apps That Support Self-Management and Transition in Young People With Chronic Illness: Systematic Review

Mobile and Web-Based Apps That Support Self-Management and Transition in Young People With Chronic Illness: Systematic Review
J Med Internet Res 2019;21(11):e13579

• This study aimed to evaluate the utility and effectiveness of mobile and Web-based health apps that support self-management and transition in young people with chronic physical health illnesses. 
• A systematic review identified 6 studies (n=336) but was unable to provide evidence for effectiveness of this approach. It does provide insights into future study design, with reference to the development, evaluation, and efficacy of apps tailored for adolescents with chronic illnesses.

Perceptions and experiences of targeted digital communication

Clients’ perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis
Cochrane Systematic Review 14 October 2019 https://doi.org/10.1002/14651858.CD013447

• This qualitative evidence synthesis (35 studies) explores clients' views and experiences of being communicated with by the health system through their mobile phone. The synthesis looked at communication about pregnancy, newborn, and child health, sexual health, and family planning.

See also:
Qualitative evidence synthesis informing our understanding of people's perceptions and experiences of targeted digital communication
Cochrane Editorial 23 October 2019 https://doi.org/10.1002/14651858.ED000141

Mental health apps - MaST

Special Report: patient-facing apps to support mental health interventions
Digital Health October 2019

• This report describes the Management and Supervision Tool (MaST), developed by Otsuka Health Solutions for Mersey Care Foundation Trust. MaST analyses data from the electronic patient record and uses an algorithm to determine how likely a patient is to use crisis services in the next 28 days. MaST overlays existing electronic health record and business information tools, extracting data overnight from the EPR and so presenting an up-to-date assessment each day. Launched in April there has been an increase in teams that are discharging people back to GP who are using MaST, and a reduction in the re-referrals.

Mobile phone text messaging and app‐based interventions for smoking cessation

Mobile phone text messaging and app‐based interventions for smoking cessation

Cochrane Systematic Review: 22 October 2019 https://doi.org/10.1002/14651858.CD006611.pub5

• Based on 26 RCTs the synthesis found that text messaging programmes may be effective in supporting people to quit, increasing quit rates by 50% to 60%. This was the case when they were compared to minimal support or were tested as an addition to other forms of stop‐smoking support. There was not enough evidence to determine the effect of smartphone apps.

The role of medical smartphone apps in clinical decision-support: A literature review.

The role of medical smartphone apps in clinical decision-support: A literature review.

Artif Intell Med. 2019 Sep;100:101707. doi: 10.1016/j.artmed.2019.101707. Epub 2019 Aug 21. PMID: 31607347.

• This review explores the evidence base that exists to validate and evaluate the use of medical decision-support apps.

Safety concerns with consumer-facing mobile health applications and their consequences: a scoping review

Safety concerns with consumer-facing mobile health applications and their consequences: a scoping review
Journal of the American Medical Informatics Association, ocz175, 10 October 2019 https://doi.org/10.1093/jamia/ocz175
In 74 identified studies about health apps 80 safety concerns were identified. Sixty seven concerns related to the quality of information presented including incorrect or incomplete information, variation in content, and incorrect or inappropriate response to consumer needs. The authors suggest that mandatory reporting of safety concerns is needed to improve outcomes.

Abstract