Methodology

Two main factors dictate whether a health app is featured on myhealthapps.net (MHA):

1. The health app has been nominated as a favourite by patient/disability/carer/family/consumer groups, or by empowered consumers (eg consumer advocates, active members/bloggers of moderated consumer health forums).

Patient groups and empowered consumers identify favourite apps to MHA in a number of ways:

  • Via regular PatientView surveys of patient groups, disability groups, carer/family/friends' groups.

  • Patient groups and empowered consumers alert PatientView to online discussion forums on websites on which health apps are discussed and reviewed.

  • Patient groups inform PatientView that the group itself has produced or co-produced an app.

  • Developers contact PatientView about a health app they have created. PatientView then seeks reviews of the app from patient groups and empowered consumers. An app so reviewed may then be published on MHA.

  • Patient groups submit apps for inclusion directly via the website. PatientView then confirms the review and other information (see below) before uploading details to the site.

  • If a health app is approved on the NHS Health Apps Library, PatientView seeks reviews of it from patient groups and empowered consumers. An app so reviewed may be published on MHA.

2. The app developer is transparent about the nature of the app. Background checks carried out by PatientView include the following:

  • Pricing (plus hidden pricing; prices of upgrades).

  • The authenticity of the patient group/empowered consumer submitting an app for MHA. Online submissions have to be accompanied by an e-mail address, link, and the organisation’s name.

  • The contact details, and the geographic location, of the app developer. These must be readily available in the public domain.

  • Information on the funder/s of the app (not necessarily always the same as the app developer). This, too, must be available in the public domain.

  • Information on any medical advisers involved in the making of the app (again, these might not always be the same as the developer). This must be available in the public domain.

Over time, we try to obtain more than one nomination/review from different patient/consumer groups for each health app. Negative comment is included if provided. The levels of usage of the app among the members of the patient group nominating the app is obtained (when available). Even when the group providing the nomination prefers to remain anonymous, PatientView retains an unpublished record of the group’s details, to ensure sources are authentic.

We are now working with our partners and other stakeholders on drafting user-defined guidelines for health apps, seeking input from:

  • Patient groups familiar with apps.

  • Patients with chronic diseases familiar with apps.

  • Commissioners of apps that have been recommended by patient groups.

  • App developers who have been recommended by patient groups.

  • Health professionals (mostly UK - so far via DHACA (Digital Health and Care Alliance) on its working group to look at guidelines for medical apps.

  • Producers of app guidelines (eg British Standards Institution, UK’s National Information Board).

  • Via workshops and stakeholder meetings organised by PatientView (eg in conjunction with Health 2.0 and TICBioMed, the UK’s Knowledge Transfer Network).

  • Involvement with professionals groups looking at health apps eg Royal Society of Medicine

App classification

There are many ways to classify apps, but from the perspective of how people use health apps, and their perception of risk, we have sorted the apps on myhealthapps.net into three classes (note that some apps may fall into more than one class):

Disability — health apps that enable people to cope with daily living and provide support to people with any type of disability, including physical, mental and sensory impairment. For example, text-to-speech apps that help people who have speaking difficulties or limited verbal abilities, to augment their communication skills.

Health, wellness and care in the community are health apps that allow us to manage our health and healthcare without the necessity for medical assistance, and which do not result in clinical decision-making by the user, or require input from a health professional. These apps include the bulk of lifestyle health apps (diet, exercise, stopping smoking etc), many informational apps, and those that enable people to gain support from carers, family, or friends. Also included here are simple pill reminders, since in the normal course of events people cannot consult on a daily basis their doctors or pharmacists when to take their medication. (Although these latter reminders do need to follow clinical recommendations, and as such users should assure themselves that the app has been produced with medical advice.)

Apps not included in this class are ones that provide information to help people decide whether they should go and visit their doctor, which are classified as medical apps—in that the person is making a medical decision based on the information received. Also not included are most of the health apps that support glucose monitoring in diabetes (unless they provide diet or nutritional advice), since the results generated by these apps do result in a clinical decision being made by the patient as to whether they should take their diabetes medication.

Medical apps. These are health apps that lead to any sort of clinical decision-making, diagnosis or treatment. Health apps that work alongside medical devices are included in this class as well.

Generally speaking, medical apps will pose more safety risks to the public and patients because they involve clinical decision-making processes (though for some patients, say with renal disease, the food they eat can mean the difference between life and death).

The above definitions hold no legal context but are drawn up as a result of the research already undertaken by myhealthapps with users and other stakeholders. They represent the users’ perspective only, for example the patients and carers who use health apps.

However, we expect these definitions to evolve with time.

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