NHS Apps Library in Beta Testing
NHS Apps Library: How much do we need to know to make informed digital choices?
The current version of the UK National Health Service apps library is in beta testing (for final testing with the target audience). The range of health apps included has expanded to more than 70 health apps across 11 healthcare areas.
This raises some key questions about digital health literacy:
- Is review, approval, and collation of apps by a country’s trusted health authority helpful for patients?
- How much more detail do patients and carers need to make an informed choice about an app?
- When an app is approved by a health authority, should patients see the evidence that went into that approval?
Who do patients trust the most?
We’ve always strongly believed that government health authorities should play a key role in reviewing, approving and recommending health apps and other digital tools. From a UK patient point of view, alongside patient groups, individuals still have enormous trust in the National Health Service (NHS), currently celebrating its 70th year.
So, the much-anticipated rebirth of the NHS apps library, taking a more rigorous approach to reviewing and approving apps, is very welcome.
Looking at the current beta-site how does it help patients make informed choices about apps?
Arguably, there are three key things:
- Selectivity – Out of the hundreds of thousands of health apps available, inclusion of the first 70 in the library in itself implies that the NHS accepts the app, although only one app is currently badged as ‘NHS approved’
- Snapshot – Although the current app reviews are very short, they mostly focus on the essential questions:
- Who is it suitable for?
- How do I access it?
- How does it work?
- Speedy click-through – Because the content is kept to a minimum, it’s fast for the patient to get a basic idea and easily find the click through to the app stores or app’s website. That’s where you get the detail to make a decision about whether or not to use it.
How much do patients need to know?
This is highly individual. Some people will want to know a lot of information about an app before downloading. Others will be willing to make more of a leap of faith, particularly on the small number of apps the NHS has reviewed.
For apps labelled as ‘NHS approved’, this means that the app:
“…meets NHS quality standards for clinical effectiveness, safety, usability and accessibility, and has evidence to support its use.”– NHS Apps Library (beta)
For the apps labelled as ‘Being tested in the NHS’, the library gives the following caveat:
“These digital tools meet NHS quality standards for safety, usability and accessibility and are being tested with NHS patients to see if there is sufficient evidence to provide them with the NHS stamp of approval.” – NHS Apps Library (beta)
How can patients see the evidence base?
Given that payers, patient groups and clinicians are all increasingly focused on evidence-based digital health, how can health service apps libraries make this evidence easy to find and digest?
Although approved apps in the NHS apps library will in future pass through evidence-based hurdles, currently there is no clear link to click on to see this evidence.
It’s a tricky balance. Often the evidence-base for approval can be quite scientific, clinical, technical and dense. Countries may not have the resources to analyse or summarise this data in a form that is easy for many patients to understand and use.
However, the clinical evidence is also key to doctor and nurse recommendation of an app or digital tool. It can also help patient groups to decide whether or not to recommend the app to their members.
Can countries find the budget to do this?
There is a bottom line here. Setting up a review process like that developed by the National Health Service represents a major upfront investment. That’s why most country library sites tend to be quite small- it’s still quite early days. But if digital health is to deliver the Return On Investment, efficiencies and health outcomes intended, an app library backed by the country’s health service may be a small price to pay.
Importantly, the NHS is focused on improving the quality and relevance of apps, for example through:
- One, a dedicated site for app developers to create and submit apps for the apps library
- And secondly, a set of digital assessment questions under ongoing testing to help developers assess their app’s quality from clinical evidence, through to safety, privacy and usability. Find out more here!
A shared vision
At myhealthapps.net we’ve always believed that patient groups are in the strongest position to give a collective view of what apps are most needed, and evaluating their effectiveness and quality. If the content is helpful, patients will sometimes put up with design or usability issues.
But patient group sites, or sites like myhealthapps.net, can reach only a motivated part of the population.
National and local health services own the day-to-day relationship with nearly the whole population. In many countries this is a trusted source for most people, and integrated into how they manage their health.
Arguably every country needs a high quality apps library. Although the UK National Health Service is 70 years old, it is setting out to achieve its vision for a health apps library, and the associated standards for developers:
“Our vision is for NHS.UK to host leading healthcare apps so they are accessible and trusted by the public…We are setting the quality standards that the NHS can hold all digital health and care products to, laying the foundations to build a truly transformative digital health service.”– Juliet Bauer, Director of Digital Experience at NHS England, and Rachel Murphy, Delivery Director at NHS Digital