Apps present a fantastic opportunity to provide us with valuable health information which can help us not only improve the quality of our healthcare, but also help us to live healthier lives. The market is awash with apps, though, and we have no facility to see whether what is being downloaded will actually improve our health or if our personal data will be stored safely.
As of 2015, it was estimated that 93% of health and care professionals believed that apps could improve patients’ health, and 80% were already using smartphones and medical apps. Furthermore, it was estimated that 71% of the UK’s population owned a smartphone, 75% used smartphones or tablets to search for health information online, and over 90% would use mobile-health services to engage with healthcare professionals. But with over 300,000 health and care apps on the market to choose from, the white noise of choice can be deafening.
West Lancashire CCG have partnered up with ORCHA (the Organisation for the Review of Care and Health Applications) to provide our dedicated site for residents across West Lancashire to solve just those problems.
ORCHA carry out independent and impartial reviews of health and care related apps, and you’ll see that the resultant information is clearly presented for us throughout this website. We can be reassured that any apps shown on this site have undergone a rigorous review process, and can feel confident as we choose the best app for us.
By bringing this information to our fingertips, it’s now possible to identify and compare the best apps for our needs – and to ensure that we, and our friends and families, can get access to quality assured apps that meet a standard that clinicians across West Lancashire are comfortable with.
The ORCHA Review process is the most advanced review mechanism for health and care Apps available anywhere. It is the only truly comprehensive assessment of the Apps that are available on the two primary App stores ‘health, wellbeing/fitness and medical’ categories.
Our review looks at a range of elements of an Apps offer rather than just focussing on one aspect or area and it is entirely objective and based on a robust examination of quantifiable evidence and data. Some aspects of the review are automated which provides an initial filter and information gathering function. The rest of the review is undertaken by our highly trained review team. The expert input comes from our review development team, who collectively have designed and continue to refine the structure and content of the review to reflect best practice, guidance and emerging regulation.
There are a huge array of different types of health and care Apps available with an equally wide array of functionality and sophistication. At ORCHA we believe that just because an App offers more functionality it doesn’t mean it is automatically better than a functionally simple App. Apps that for example simply provide information and guidance – similar to health ‘leaflets’ – can be very useful in certain circumstances and this isn’t impacted by their relative functional simplicity.
Apps in this area are also focused on a wide array of areas. Some are clearly health focused and within that are often targeting specific conditions or diseases, others however are more general and many are actually focused on wellbeing rather than health. A focus on wellbeing would include areas such as exercise and fitness and diet and these Apps are really important and offer really valuable support in the maintenance or improvement of overall wellbeing which is crucial for overall health.
The Orcha Levels are as follows:
|Level 0 - Simple Wellbeing||These apps are designed to support general wellbeing and have limited feature sets and don’t collect any data. Because they are not health focussed and do not collect data we only assess their compliance in the User Experience domain.|
|Level 1 - Advanced Wellbeing||These apps are focussed on general wellbeing but they can collect data and they are likely to have a number of more advanced features. Because they are not health focussed we only assess their compliance in the Data and Security and User Experience domains|
|Level 2 - General Health||These apps are focussed on general health. They may collect data and they may have a number of more advanced features. Where they collect data we assess their data use policies and compliance with relevant standards. Because they are health focussed we also assess their compliance in the Clinical Effectiveness as well as the User Experience domains.|
|Level 3 - Condition Management||These apps can be focussed on general health or supporting specific health conditions. They may collect data and they may have a number of more advanced features. Where they collect data we assess their data use policies and compliance with relevant standards. Because they are health focussed we also assess their compliance in the Clinical Effectiveness as well as the User Experience domains.|
|Level 4 - Regulated||These Apps can be focussed on general health or specific conditions and contain advanced and complex features that are subject to formal regulation. Where they collect data we assess their data use policies and compliance with relevant standards. Because they are health focussed we also assess their compliance in the Clinical Effectiveness as well as the User Experience domains.|
To help users find the right App for their or their patients/clients needs, we try and identify as many Functions and Features that an App has to offer. These are displayed in summary form on our search result 'ribbons' and in more detail in the relevant App Cards. Users are able to filter searches according to the Functions and Features they wish to see. Some of the Functions and Features also inform what areas we will investigate in the subsequent detailed Review Areas, for example Data Collection and Sharing.
We look at an Apps compliance with standards, guidance and best practice in three distinct areas. These are Data and Security, Clinical Effectiveness and User Experience. Each of these Review Areas has been designed by relevant experts and consists of a series of objective (Yes/No) questions which should be capable of being answered by our Reviewers from information in the App, on the relevant App Store or on a supporting website. If our Reviewers cannot find evidence to support an answer from these sources they will assume that the App is not compliant with or capable of satisfying the relevant requirement.
There are often cases where an App is in fact capable of satisfying particular requirements but that this is not made clear in any obvious publicly available place. In these circumstances Users are left with uncertainty as to the real position and our view is that in this circumstance they should proceed with caution.
The results of this analysis results in an overall ORCHA score which is built up from the answers to each of the questions in the three Review Domains. Some questions earn positive points and some earn negative points. The ORCHA Score aims to deliver a meritocratic evaluation with all Apps being treated equally and fairly irrespective of their current popularity or the financial position of their Developers.
Any score below 65% would indicate that an App has some issues that users should investigate further prior to using this App. Scores below 45% indicate that an App has considerable issues or challenges and in its current form is potentially unhelpful or unsafe.
The final stage of the process is Developer notification and publication stage. When the review is complete, we send a notification to the relevant developer/publisher giving them an opportunity to preview the Review ahead of its publication. This gives them an opportunity to highlight any obvious errors or issues before we release the Review onto all our platforms. Once the notification period has expired, we publish the Review on all our platforms.
All our reviews will remain valid until a new version of the App is produced. If a new version is not produced within 18 months of the current version, we mark the relating to the App as 'Out of Date' and the ORCHA App Score will start to degrade at the rate of 5% per month.
If the Developer implements a new version of this App we will automatically detect this via the relevant App Stores and we will mark the current review as being related to an old version of the App on all our platforms. The new version of your App will go back into the queue for a Re-Review and we will in time undertake this.