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How can we improve the quality of Health Information Apps?

How can we improve the quality of health information apps Knut Schroeder Chief Executive

The internet has democratised health information. Informational websites, blogs and scientific papers are now only a few clicks away. At the same time, online misinformation is rife. Googling symptoms can be more confusing than it is reassuring. Moreover, myths and false beliefs picked up online keep spreading by word of mouth – as in the current COVID-19 pandemic.

People need easy access to health information they can trust, so that they can make informed decisions about their health. This includes having appropriate knowledge of common and important health conditions, knowing when it’s safe to self-care and when to seek help, and where to get support when medical help is needed. The evidence and the case for providing quality health information is compelling in terms of better health outcomes and reduced health service costs.

With health information being such a powerful ‘intervention’, healthcare providers, third sector organisations and corporates operating in the healthcare arena create and publish their own health advice. To increase their reach, an increasing number of them now make use of existing mobile technology and create mobile apps as an adjunct to more traditional means such as printed materials and web content. The aim remains the same: to educate people about health, provide support and signpost services.

Why apps? Because mobile health information apps can provide substantial benefits. Optimised for mobile phones, they can provide easy and fast access points for relevant and targeted information. They can enable people to access tailored information discreetly – anywhere and anytime, even when offline, at the touch of a screen. With a multitude of possible features and functionalities, well-designed health information apps can provide an outstanding user experience, especially when they’re easy to use. Mobile apps can also help to reach groups that have previously not engaged much with health information and increase people’s awareness of provider organisations. Finally, health information apps may enable local customisation, which can be useful for signposting local services. This can make it easy for people to find details about locally available support, all in one easily accessible place on their mobile phone.

A good example of an engaging health information app is the Red Cross ‘First Aid app’. This app provides quality information about giving first aid and enables users to learn and practice simple first aid. Up to a degree, users can learn and rehearse potentially life-saving skills at a time and place that suits them. They can watch instructional videos, take part in interactive quizzes and follow step-by-step guides – all within the comfort of their mobile phones.

Mobile health information apps are breaking the mould and have considerable potential to improve patient pathways and the delivery of care. But they have to be well-designed and engaging. In other words, they need to be user friendly and of high quality. Unfortunately, many are not.

So how can health information providers and app developers ensure that health information apps are of the best possible quality and address users’ needs? Here are three key actions for success:

  1. Involve users: Involving users at all stages of app development is crucial – from planning to marketing and promotion. This means creating content and functionality in partnership, rather than simply asking for feedback as a token gesture. Users need to be- and feel – part of the team. Their input can be invaluable. Working in partnership with users prevents developers making (the wrong) assumptions about what people really need and want. This in turn leads to better information products. As a result, apps developed with user input will be easier to use and provide a better experience than those without.
  2. Use a consistent process: Well-developed, consistent and transparent editorial processes help to ensure that health information is clear, relevant and based on robust scientific research (where this is available). Developers are advised to publish their editorial policy online for everyone to see. Their policies should include clear strategies for continuous improvement of the product and for managing feedback. The team behind the app must be suitably trained and qualified. This ensures that information is reliable, safe and medically accurate. A good team will also make the language used on the app clear, easy-to-understand and culturally sensitive, so that users are more likely to engage. The app must be easy to navigate – for example, through unambiguous ‘home’ and ‘back’ buttons and a user-friendly design. A ‘search’ option can also be very useful.
  3. External valuation: Ideally, information producers and health app developers should get their procedures reviewed and certified to help improve standards and add credibility to their projects. The UK Patient Information Forum (PIF, https://pifonline.org.uk/) provides resources and training opportunities for health information producers. PIF also assesses organisations that create health information and awards their new ‘PIF tick’ to providers that fulfil their stringent criteria. The Organisation for the review of Care and Health Applications (ORCHA) evaluates health apps with a focus on data privacy, clinical assurance and user experience. Apps passing their benchmark score are listed on their ‘app finder’ platform (https://appfinder.orcha.co.uk/search/). Finally, the NHS assesses health apps and lists those that pass their criteria on the NHS Apps Library (https://www.nhs.uk/apps-library/), where people can find apps and online tools to help them manage their health and wellbeing.

There is little doubt that mobile health information apps have great potential for reducing digital health inequalities. They can help organisations to improve the care for those who need quality information most, but who perhaps, so far, were least likely to be able to access it.

Only when we understand how important quality is for health information apps to be effective, can we appreciate the need for mobile health tools that provide a great user experience and are reliable. It can’t be emphasised enough: users need to be integrated in the entire app production process, right from the start. Co-creation is no longer an optional add-on or token buzzword, but an essential ingredient of successful app development. Every health information app should embrace it.

About the Author

Knut Schroeder is an award-winning Health Information App Producer, Founder of Expert Self Care Ltd and General Practitioner in Bristol, UK. He is Chief Executive of the UK Self Care Forum and Honorary Senior Clinical Lecturer in Primary Health Care. He also serves as an Advisor for the Patient Information Forum. He and his team have created six health information apps, two of which are listed on the NHS Apps Library. He and his team won the 2019 British Medical Association ‘Patient Information Award’ for wellbeing for the distrACT app which supports people who self-harm and may feel suicidal. To contact him, email knut.schroeder@expertselfcare.com. To find out more about his work, visit https://www.expertselfcare.com/.

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