Health apps - helpful or harmful?
ORCHA's mission to make us savvier consumers
Want to sort out your insomnia, monitor your diabetes or track your period? Well, there’s an app for that. As soon as Apple and Android’s app stores opened in 2008, using a smartphone to assess, monitor and inform us about our health became a major focus for developers. But here’s the problem - how do you work out whether these apps are any good?
“Five million people download a health app every single day,” says Liz Ashall-Payne. “Now, most people then go on and delete it within 24 hours. Why? Because they pick the wrong technology for them and they didn't know how to find the right one.”
That’s why she started ORCHA, the Organisation for the Review of Care and Health apps, with a mission to tell us - and our doctors - how to sort the wheat from the chaff when we’re presented with dozens of similar apps all claiming they have the answer to our health issues.
Liz began her career as a clinician, a speech therapist determined to make healthcare more efficient and increasingly convinced that digital technology was the answer. But when she switched into NHS management she was frustrated that her fellow healthcare professionals were not embracing technology. “It comes back to they didn't even know these technologies existed, and they don't know where to find them. They don't know which ones they can trust.”
ORCHA tests 500 different apps every month, then presents healthcare professionals with what Ashall-Payne describes as bespoke digital health formularies, menus of apps for particular tasks such as preventing type 2 diabetes.
The bad news is that most of the apps tested turn out to be of poor quality. One recent example - a survey of 25 period trackers found that 24 of them shared data with a third party. With fears in the United States that sensitive data from these apps could be shared with law enforcement after the overturning of the Roe v Wade abortion ruling, privacy has become a hot topic. Some women have said all such apps should be shunned but Liz Ashall-Payne disagrees:“What we need to do is be clear about which period trackers are safe, and data secure, clinically valid, and let's just get those technologies out there.”
Mental health has been another area flooded with new apps - ORCHA reckons there are around 22,000 of them. There is a spectrum ranging from mindfulness and meditation apps right through to those claiming to offer help with conditions such as OCD or schizophrenia. I suggested to Liz that some of the mindfulness apps might be a bit flaky - is listening to whalesong really going to help me sleep?
But she said ORCHA’s research showed that the real problem was at the serious end of the spectrum where just 5% of apps dealing with severe mental health issues were of good quality: “Obviously the risk associated with something like a whalesong technology is far less than, say, a suicide prevention technology.”
It sounded to me as though doctors would be wise to tell patients to steer clear of health apps altogether. But Liz said that would be counterproductive - there was some evidence that people with mental health issues were finding that apps could at least keep their condition stable while they waited for an appointment with a doctor.
Picking up her phone she told me: “The reality is people are already using these technologies. And so what's happening in clinic is patients are walking in saying I'm using that health app. That's quite scary if you're a clinician, because you've not been trained in this space.”
So her message is that whether we like it or not, the smartphone revolution is sweeping through healthcare. That means both doctors and patients need to become better informed about health apps and which are helpful rather than harmful.
Rory - any app that claims an intended purpose of treating, diagnosing, improving or monitoring a specific disease or condition is a medical device, and as such need regulatory clearance to be allowed on market, i.e. a UKCA mark or CE mark. Being externally audited and approved sorts the wheat from the chaff, as you say. Additionally there are numerous ISO standards for all aspects of medical devices, from cyber security to usability that are mandatory. The MHRA have a public database anyone can use to check if an app is regulatory approved, and only regulatory approved medical devices can be prescribed.
The paid for app, « My pain diary 2 » is very customisable and is an invaluable tool for chronic illness patients, whatever the cause as it can track when you take « as needed » medication, appointments and you can also track pain levels and suspected triggers. It will even help you to compile a *.pdf report for your GP or consultant, recording the preceding 3 months for their records.