An overview of the 'My Journey' Youth Mental Health App including background to developing the app, research for mobile health and next steps.

1. My Journey
Mobile App
Evidence for Healthcare Mobile Apps
Sarah Amani
Youth Mental Health Lead
Surrey & Borders Partnership NHS Foundation Trust

2. Overview
1. Background
2. Mobile Health App Ecosystem
3. An App a day keeps the doctor away?
4. Evidence for Mobile Health Apps
5. Next Steps

3. Released: 1998
CPU: 233 MHz
RAM: 32 MB (512 MB max)
Storage: 4 GB (+ optical drive)
Display: 38.1 cm Millions of colours
Dimensions: 40.1 x 38.6 x 44.7 cm
Weight: 17.3 kgs
Released: 2007
CPU: 412 MHz
RAM: 128 MB
Storage: 4 GB (8 GB max)
Display: 8.9 cm Millions of colours
Dimensions: 11.4 x 6.1 x 1.2 cm
Weight: 135 g
This was ‘portable’...
<10 years...
The Digital Revolution

4. http://www.flickr.com/photos/43533334@N07/5153726732
Your mobile phone has
all of NASA in 1969.
more computing power than

5. UK
Smartphone penetration is 52%...
31
2
Who uses smartphones?

6. http://www.flickr.com/photos/oimax/3800475934
Public space
distractions
limited attention
mobile usage can be this...
glanceable?
simple?
tedious input
personal
onehand
How do they use smartphones?

7. “
http://www.flickr.com/photos/armaggeusa/3176297283
The most profound technologies are those
that disappear. They weave themselves
into the fabric of everyday life until they are
indistinguishable from it…. Mark Weiser

8. work
learning
navigation
discovery
With a button or two!
creativity
video
a big screen...
web browser
+
application
layer
+
APIs
camera
communication
play
sharing
Enabling users to choose
music their own experience
chat
Health

9. 17,000+ Health Apps

11. http://www.flickr.com/photos/diloz/5023417436
MY Journey
Mobile App

12. Crowdsourcing

13. The Design Process

14. P
Phase 1 – February 2012

15. Phase 2- September 2012

16. Ce n’est pas un phone
times have
changed
Intuitive
Responsive Usable
Helpful
My Journey
Personal
Customizable
Motivational
Testing 1-2-3

17. Iteration

18. Modifications

19. Researching mHealth
ClaimClaim
HypothesisHypothesis Literature Search
of Hypothesis
Literature Search
of Hypothesis
Reconsider
Solution
Reconsider
Solution
Validate
claim
through
analysis of
existing
research
Validate
claim
through
analysis of
existing
research
Conduct
Primary
Research
Conduct
Primary
Research
ObservationalObservational
Interventiona
l
Interventiona
l
Checklist:
•Appropriate subject selection
•Sufficient Sample Size
•Suitable Controls
•Outcomes aligned to hypothesis
Checklist:
•Appropriate subject selection
•Sufficient Sample Size
•Suitable Controls
•Outcomes aligned to hypothesis
No evidence to
Support hypothesis

20. Types of Evidence
Expert
Opinion
Expert
Opinion
Case
Studies &
Pilots
Case
Studies &
Pilots
Multi
Time
Series
trial
Multi
Time
Series
trial
Multi Centre
Trials
Multi Centre
Trials
Non-
Randomized
Control Trial
Non-
Randomized
Control Trial
Randomized
Control Trial
Randomized
Control Trial
Referenceability
Effort Needed to Produce Evidence
Observational
Interventional
Low
High
High

21. Adoption
New
Health
App
New
Health
App
Successful
Adoption
Successful
Adoption
Technical
Questions
Regarding
safety &
Reliability
Economic
Hurdles e.g.
cost-
effectiveness
Patient/End-
User
Preferences
Clinical
Effectiveness
Healthcare
System Impact
e.g. access,
impact on
service use &
hospitalization
1 2 3 4 5

22. Advantages & Disadvantages
Interventional (RCT) Observational
Applicability Controlled
Environment
Real World
Patient Population Narrowly Defined General
Controls All all times Variable
Likelihood of Bias Low High
Resource
Requirement
High Low

23. The Hypothesis
Mobile health apps are effective adjuncts for
improving adherence and reducing hospitalizations
which reduces healthcare expenditure
Mobile health apps are effective adjuncts for
improving adherence and reducing hospitalizations
which reduces healthcare expenditure

24. Key Issues for Investigation

25. Authors: Caroline Free, Gemma Phillips, Louise Watson,
Leandro Galli, Lambert Felix, Phil Edwards, Vikram Patel and
Andy Haines.

26. • 42 trials
• 11 showed statistically significant benefits in
communication between clinicians & people who use
services
• One study showed less accurate diagnosis through
mobile technology photos than gold standard
mHealth Meta Analysis
Conclusions
The results for health care provider support interventions on diagnosis
and management outcomes are generally consistent with modest
benefits. Trials using mobile technology-based photos reported reductions
in correct diagnoses when compared to the gold standard. SMS
appointment reminders have modest benefits and may be appropriate for
implementation. High quality trials measuring clinical outcomes are
needed.

27. Survey of 20 young people aged 14-25 who used the app
The Best Feature About the app is…

28. Survey of 20 young people aged 14-25 who used the app
What will you use the app for?

29. Service Users
My Journey
Mobile App
Self Rated Measures
+
Activity Trackers
Secure Data Base
Electronic Health
Record
EIIP Team
Care Coordinator
+ MDT
Mobile Internet
+
N3 Network
Next Steps

30. From: Vorst, Bernard [mailto:Bernard.Vorst@viha.ca] Sent: 25 March 2013 20:00To:
ComplaintsSubject: Sarah Amani
- not actually a complaint, but could find no other e-mail address!
Hello,
We are the team at the Child, Youth, and Family Mental Health Services of the Vancouver
Island Health Authority in Saanich, British Columbia, Canada (it’s a mouthful – I know).
Our manager, Elaine Halsall, is very interested in the My Journey App project being
coordinated by Sarah Amani of NHS South East. Unfortunately, we are unable to find on-
line any contact information for Sarah; would it be possible to please pass this message on
to either Sarah herself or somebody else well-informed around the project? We are very
excited about what this type of tool could do for our service and would like to learn more
about it.
Many thanks,
Ben Vorst
Child, Youth, and Family Mental Health Services – Vancouver Island Health Authority
Possibilities

31. Thank You
Any Questions?
Twitter: @S_Amani