Retiring Health Apps, Does it Have to be This Way?
As an Englishman I’ve always liked the Polish saying which translates as `to leave in the English way’. Roughly, it means that we sneak out without anyone noticing. The same seems to be true of nearly all health apps at the end of their life… a retiring app. One moment they are working, and on the stores, the next, they are defunct and gone. The myhealthapps team gets emails most months from people frustrated that apps are no longer supported or are impossible to find.
Does it have to be this way?
Firstly, most apps fail, and all, will in time, be withdrawn. There’s no incentive for most app developers to invest in warning that an app is about to become unavailable, or not be supported.
Secondly, if the app is not set up for push notifications, or the user has blocked these, there may not be an overt way to alert individual users.
Thirdly, if the developer has no contact information for the user, there’s no way of reaching out.
What should happen?
Following on, this blog was triggered by an example of good practice in withdrawing an app. It related to an app that gathers all the treatment guidelines for the UK health body National Institute for Health and Care Excellence (NICE). When pressing `Update’ for a batch of apps, the update description was very clear:
“The NICE Guidance app is being withdrawn from use. It will no longer be available to download from December and any downloaded apps will no longer be updated from 31st 2018”
– NICE app update notification.
Moreover, when you open the app, there is a prominent notice on the main screen informing you of the app’s closure.
They even have a whole page on their website explaining why they are removing the app, including this quote:
“We have worked hard in recent years to make the NICE website optimised for mobile devices and we are continuously improving the system to ensure users will be able to access the information at all times…. It therefore makes sense to focus attention on the website rather than the app.”
– NICE Evidence Resources Director, Alexia Tonnel
What does pharma do?
Medical/Legal/Regulatory departments are very powerful within pharmaceutical companies. When a pharma app can potentially cause harm, it will be pulled quickly. One major company discovered that their app was miscalculating a key value. This was pulled the app from the Apple and Google stores. Additionally, they wrote to doctors informing them of the problem and asked them to delete the app from their devices.
Does this really matter?
It depends on what you use the retiring app for. For example, some health apps encourage users to use the app as place to store medical records, track symptoms over time, and so on. We’ve had users complain that suddenly all that has gone. At least with a bit of warning, you would be able to retrieve your data and save it in another way.
Where is the emergency exit?
Furthermore, in BSI (British Standards Institution) and DHACA (Digital Health and Care Alliance) research projects, we’ve raised an issue. The issue of not only of what happens when an app reaches the end of its life, but what happens if it needs to be withdrawn because it is doing harm? How can it be withdrawn quickly? There are many channels to report dangerous effects from prescription drugs, yet with apps it is much more fragmented. In theory app stores can remove dangerous apps quickly, just as they would with apps proven to be malware or law-breaking, but in practice how fast can it be?
Finally, for once I’m not going to `leave in the English way’. So, I’ll say goodbye.
View the NICE explanation on retiring their app at…
Download the British Standards Institution’s PAS 277 Health and Wellness apps: Quality criteria across the lifecycle. Code of practice at…