Presentation to HC2013 on the My Journey Mobile Health App.

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

3. The Digital Revolution
This was ‘portable’...
<10 years...
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

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

5. Who uses smartphones?
UK
2
1
3
Smartphone penetration is 52%...

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

7. “
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
http://www.flickr.com/photos/armaggeusa/3176297283

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

9. 17,000+ Health Apps

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

12. Crowdsourcing

13. The Design Process

14. Phase 1 – February 2012
P

15. Phase 2- September 2012

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

17. Iteration

18. Modifications

19. Researching mHealth
Claim
Claim
Literature Search
Literature Search
of Hypothesis
of Hypothesis
Hypothesis
Hypothesis
Conduct
Conduct
Primary
Primary
Research
Research
No evidence to
Support hypothesis
Reconsider
Reconsider
Solution
Solution
Validate
Validate
claim
claim
through
through
analysis of
analysis of
existing
existing
research
research
Observational
Observational
Interventiona
Interventiona
ll
Checklist:
Checklist:
••Appropriatesubject selection
Appropriate subject selection
••SufficientSample Size
Sufficient Sample Size
••SuitableControls
Suitable Controls
••Outcomesaligned to hypothesis
Outcomes aligned to hypothesis

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

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

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

23. The Hypothesis
Mobile health apps are effective adjuncts for
Mobile health apps are effective adjuncts for
improving adherence and reducing hospitalizations
improving adherence and reducing hospitalizations
which reduces healthcare expenditure
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. mHealth Meta Analysis
• 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
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. The Best Feature About the app is…
Survey of 20 young people aged 14-25 who used the app

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

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

30. Possibilities
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 online 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

31. Thank You
Any Questions?
Twitter: @S_Amani