App-assisted Behaviour Activation in Healthcare: Part One
30 Aug, 2018

Digital health apps offer new technologies to help a growing and aging population self-manage increasingly complex conditions and comorbidities. Patients demand empowerment to enable them to manage their treatment more independently. Such developments, from the very straightforward to more indepth solutions, can result in lower treatment costs to the patient and the NHS.

This series of blog posts will focus on behavioural activation and the way that the adoption of digital health applications can assist with such an approach to treatment. We will consider:

  • the rise of app-reliant health support – how Healthcare Professionals manage and navigate through the apps available, clinician prescribed VS patient choice
  • how developers build apps that conform to standards
  • the difference between informing and changing – striking the balance between giving accurate and useful information
  • providing the means to help patients change behaviours based on ‘The States of Change’ model

The first part in the series will focus on the increasing number of apps available on the market and how HCP’s are dealing with this.

Conforming To the New Norm

Smartphones allow the industry to create apps that are an extension of patient treatments, outside of the doctor’s surgery. They’re designed to push the right information to the right person at the right time.

App developers must conform to health app criteria as outlined by gov.uk. There must be evidence that the apps improves outcomes for patients and users, provides value for money, meets user needs, and is stable and simple to use.

“All apps must be clinically safe: this means that they they’re safe for people to use – not just for healthcare professionals and patients but everyone involved in creation, testing and approval of the apps.”

Apps must capture and handle data sensitively, legally and securely, and usability and accessibility must be considered to mean the app is inclusive of those with disabilities or those with a limited technical knowledge.

Should Healthcare Providers Prescribe Apps or Let Patients choose? Or both?

On the other side of the coin is the recommendation and administration of such apps from HCP’s. The NHS released the NHS Apps Library last year, accessible to the public to help them make informed choices about the apps they choose. This is the one of the early stages of patient empowerment during treatment as the notion of choice stimulates positive behaviour activation.

HCP’s can refer to the Apps Library to help provide better informed recommendations, as each app has been quality standardised and is compliant according to the NHS.

Some apps are labelled, NHS Approved meaning those select few meet NHS quality standards for clinical effectiveness, safety, usability and accessibility and are backed by strong evidence supporting improvement of patient outcomes

Digital Health Today

However with over 165000 health apps currently in circulation in app stores it’s equally as easy for a patient to “self-diagnose” which can of course present many dangers.

Some HCP’s remain reluctant to adopt their use in clinical practice

NCBI Mobile Devices and Apps for Health Care Professionals: Uses and Benefits

The vast majority of digital health apps available from app stores aren’t certified by the NHS, therefore they’re without the thorough understanding of risks and benefits. A patient might discover an app that they’re confident will assist with their treatment. The purpose of an app is to provide quality and safety with accurate information and guidance to the end user in order to improve patient outcomes, but unlike medication such treatments aren’t scientifically measured, so if it’s not approved by the NHS, it’s generally at the HCP’s discretion whether to approve its use for their patient, which can be problematic.

Disruptive. In a Good Way

Mobile Health – AKA “mHealth”- has notable benefits globally, especially in developing areas of the world. Countries such as Africa are emerging with “ a great deal of innovation, because the need for low-cost solutions for pressing health issues has generated much experimentation and research that is likely to play a role in more advanced economies in the coming years

Gigaom

The distribution of a physical pill as part of a patient’s treatment, despite rigorous scientific testing, can still never assist with certainty in improving patient outcomes. As the world becomes immune to antibiotics it seems practical and imperative that another solution be brought to the doctor’s office. Unlike traditional medication, mobile apps have greater potential to assist with behaviour activation, as it encourages the patient to educate themselves by becoming actively engaged with a non-invasive treatment method.

Interoperability

In a previous blog post we discussed interoperability in healthcare and why electronic data such as EHR’s need communication improvements in order to function more effectively. We also discussed the NHS at 70 and the ways in which digital can be adopted into the wider healthcare sector to ensure another successful 70 years of the National Health Service.

“Interoperability is the extent to which systems and devices can exchange and interpret shared data. In healthcare, effective interoperability occurs when IT and software systems exchange shared data to create information that can be used to assist clinicians and other medical professions with patient care.”

Digital health apps have the potential to improve interoperability, as longer as there’s focus on training efforts, and apps that need to communicate with clinical systems must be compliant with the relevant technical standards.

At Bitjam we’ve recently developed an app called BeAble, with Combined Healthcare that bridges the gap between one-to-one appointments and discharge, enabling mental health patients to effectively manage their aftercare without the need for more appointments. The app is in phase two of testing, and each user has been given adequate training to use and administer it to the patient. Find out more here.

Next week we’ll be following up with a discussion about the difference between informing and changing patient outcomes, providing the means to help patients change behaviours based on The Transtheoretical model.

In the meantime if you want to discuss any of the matters surrounding patient empowerment, behaviour activation and digital health applications drop us an email for a chat.