App endorsement: 50% chance of success
The new NHS endorsement model for healthcare apps has a 50% chance of success, according to the project’s leaders.
Public Health England's deputy director, digital, Diarmaid Crean, who was speaking at the EHI Live 2015 event in Birmingham, said the challenge of developing a model to replace the recently closed NHS Apps Library is “considerable”.
“We have always said to ourselves as we are going through this process that there is a 50% chance we won't pull this off; because it's so complicated.”
Some of the challenges highlighted by Crean include the need to encourage innovation and not just to design a process that attempts to address big healthcare problems – such as diabetes or obesity.
“If we devise a process that only looks at apps of that nature, we will miss innovations that come from the left field,” said Crean, referencing Twitter and Facebook as examples of non-healthcare apps that have a major impact in healthcare.
He added that that, at the same time, apps must demonstrate their quality and that both clinicians and GPs need to be able to trust apps that carry an NHS recommendation.
Crean is positive though, suggesting that his team has “cracked it” with the proposed model.
This includes a four step process of endorsement, ranging from self-assessment by app developers to an independent evaluation of an app by an official body for a small number of apps that have demonstrated a high level of quality and potential.
The development of a new endorsement model for healthcare apps is one of the workstreams set up by the National Information Board to implement the ‘Personalised Health and Care 2020’ framework for NHS IT launched a year ago.
The project is led by Public Health England and the National Institute for Health and Care Excellence and is intended to design a process to replace the NHS Apps Library, which closed last month amid controversy about the quality and security of apps it recommended.
Crean explained: “The apps library, once hit by volume, they had to drop the bar for the approval process to such a low standard they were actually allowing many apps onto the apps library that didn't get a very thorough appraisal.”
The new model is hoped to address these issues by providing a more robust framework for recommendation that includes some form of crowd sourcing and an assessment of an app's effectiveness.
“This is about trying to move the bar up another level but not allow it to become onerous to the system as well.”
Crean said that once an app is recommended in the new model, they will likely be promoted in other NHS services, such as NHS Choices, when relevant.
This is already seen on a minor scale on some mental health pages on NHS Choices, where there are recommendations for tools in an NHS mental health app library, which was set up earlier this year.
There are pilots planned for this month and next month to test an endorsement model for diabetes.
The plan is to have full feasibility on what the end-to-end process for an accredited app will look like by the end of March 2016, although this is dependent on whether the project receives funding as part of the government spending review later this month.
The issue of cost also applies to who will pay for the app, with Mark Salmon, programme director at NICE, commenting that this debate is “ongoing”.
Other issues that Public Heath England and NICE are considering as part of the project include how to work with Apple and Google to get them to create a space for recommended healthcare apps in their own stores; which might also have financial implications.
