Thousands of people with Parkinson’s will be able to better manage their symptoms thanks to a revolutionary apps and devices library launched by Parkinson’s UK and Our Mobile Health. ​

In a first of its kind, ‘Tried and Tested’ offers technological solutions for managing Parkinson’s symptoms, including speech problems, drooling and freezing.
 
So far six apps and devices have been approved for the library, and more will follow.
 
Each app and device first goes through a rigorous independent review process used by Our Mobile Health to identify trustworthy digital health tools, before going into ‘real-life testing’ by people living with Parkinson’s, a condition that affects 145,000 people in the UK. ​ 

Our Mobile Health sourced the apps from developers and reviewed them against their rigorous quality assurance process, which identifies the ‘best of the best’ apps by reviewing them against ten key attribute areas.  An independent panel of expert reviewers looks at apps across a range of areas including patient safety, data security and indicators of effectiveness. Only apps which meet the high standards required are put forward to the charity for real-life testing. 
 Julie Bretland, Chief Executive of Our Mobile Health, said: “It is fantastic that digital health is being embraced in this way, to help those living with and managing lifelong conditions to be able to identify and embrace digital health interventions which they can have confidence in using.
 “We are proud to have been able to work so closely with Parkinson's UK on this new initiative. Using our rigorous independent health app review process we have been able to help identify potentially suitable health apps, thoroughly review them and identify those which can then be taken forward.
 “The user testing and feedback from those living with Parkinson's has been invaluable as it has helped to further improve the quality of apps and digital health solutions targeted at those living with Parkinson's.”
 All the tools featured in the library are designed to help people with Parkinson’s with everyday life. Parkinson’s can affect the voice – leaving some people barely audible - so the library features an app that records volume, pitch and speed of speech, with the results easily shareable with health professionals.

The library also features an app called Swallow Prompt to help prevent drooling, something many people with Parkinson’s can face due to difficulties with swallowing.
 
People can now also try recommended and reviewed apps to help them get some rest, as difficulty sleeping is a common problem for many living with Parkinson’s.
 
‘Tried and Tested’ is being spearheaded at Parkinson’s UK by Emma Lawton who was diagnosed with Parkinson’s at 29. With her determined attitude to living well with Parkinson’s, Emma is always looking for new solutions and technology to help her live life to the full including taking part in the BBC’s Big Life Fix where technology experts invented a device that enabled her to draw again for the first time in years.
 
Emma, Project Lead for Apps and Devices at Parkinson’s UK, said: “Parkinson’s symptoms can make everyday tasks like getting dressed or making a cup of tea feel impossible, and that’s where technology has a massive role to play.

“Parkinson’s UK’s helpline was increasingly being asked whether apps and devices, that people had seen or heard about, could help with their symptoms.
“We wanted to provide consistent advice on this area with real conviction, as Parkinson’s UK should have a strong voice in this rapidly growing area. That’s why we created the library, to help provide the right advice and guide people to apps and devices that are safe and effective to use.”
The charity and Our Mobile Health now plan to grow the library, both by reviewing existing apps and devices but also by encouraging new designs from developers.
Julie Dodd, Director of Digital Transformation and Communication at Parkinson’s UK added: “With more than 40 symptoms of Parkinson’s and no new treatments for more than 50 years, there are still gaps in Parkinson’s treatment that we know technology can help us to address.
“Ultimately we want to see people being referred to the library alongside their medication. And we hope that other charities will follow, to create a network of libraries that can benefit people living with many different conditions.
“We are incredibly excited about the potential of technology to transform the lives of people living with long-term conditions like Parkinson’s and we are committed to leading the way to make this happen.”


If you have an app or device that you think would be suitable for this new library, please contact Our Mobile Health to discuss: e-mail Matt.Wilkinson@ourmobilehealth.com

Follow us on Twitter: @OurMobileHealth

Read Our Mobile Health founder Julie Bretland’s perspective on what needs to be done to make digital health a part of our health ecosystem in the current issue of New Statesman’s Spotlight on Health. 

​Israel is leading the way in digital health integration. 100% of the Israeli population has access to their full personal health records online via their smartphone; they can schedule appointments, renew prescriptions, and even have an online visit to their physician.
 
Yossi talks of his unique window on this changing landscape: “I continue to practice medicine, not just because people and the art of diagnosing and healing are my personal and moral passion, but also because it presents me with the opportunity to experience, in first-hand, the needs and gaps for patients, clinicians, and organisations. That gives me a unique perspective when it comes to translating those needs into solutions which aim to combine technologies and human experiences.”
 
Through his experience leading the digital transformation of Israel’s largest health organisation, Yossi learned that digital health can’t be deployed as if it was a standalone technology solution. For it to be adopted it must be warmly embraced by the different stakeholders and interact with the existing healthcare infrastructure and solutions. Yossi explains his experience with mHealth apps:
 
“Healthcare is a challenging environment – very traditional, virtually immune to change, and overwhelmed by regulatory, legal and ethical complexities. Medical teams are an essential component in the adoption of mHealth solutions. If your physician sees the mHealth solution as one that enables him to provide better, more personalised and more efficient care, you will also look at it as a medical device rather than as a nice-to-have app. The internalisation of the value of mHealth solutions by the medical team personnel and their will to convey this value to their patients is crucial.”
 
That insight was what led Yossi and his team to the concept of prescribed apps.
 
Apps as prescribed clinical interventions
 
Today, physicians in Israel routinely prescribe apps for a range of purposes, including for chronic disease management such as diabetes prevention and Inflammatory Bowel Disease, ADHD, and medication adherence. Research has shown that using apps as health interventions does deliver measurable improved clinical outcomes. Yossi refers to prescribed apps as “pills composed of digital molecules”. That integration of health apps into practice didn’t happen overnight. Yossi talks about some of the barriers they had to overcome:
 
“Physicians are used to practicing medicine in a certain way, so in-order for app prescription to become part of their routine practice, they need to be educated on the value, the supporting evidence, the way to convey it to their patients, and the right way of using these “digital pills” so to maximise their potential benefits. In our organisation, we built a dedicated team which was responsible for managing the change associated with the adoption of mHealth solutions by the medical teams. We developed methodologies and processes aimed at engaging physicians, nurses and other medical team members, explaining to them the vision and making them curious and excited about how significantly these solutions can contribute to the quality of medicine they provide. Our approach appealed to their logical heads but also their hearts. That was key to drive a change in their beliefs about health apps as clinical interventions.”
 
“Alongside practical challenges like reimbursement; fear, suspicion, reluctance to change are all barriers. These physicians are not used to thinking about apps as medical interventions and the path to changing this is a journey rather than a one-off seminar. Even for the ones who are more inclined to change and who are more tech-savvy, app prescription requires a change in state-of-mind, training and practicing. It’s like learning and adopting a totally new treatment protocol after being used to a certain way of doing things for years. For change to happen you need to embed these new interventions into the existing workflow. You need to reduce the logistical hurdles while also addressing the emotional ones.”
 
There are also hurdles to be overcome on the patients’ side. Most patients are still not used to interventions that aren’t drugs. Yossi’s experience was the more the physician was engaged, the better they would emphasise the app as a bespoke clinical intervention to the patient. The doctor-patient relationship is the key to patients adopting mHealth solutions. 

​Evidence base for health apps
 
There is a growing body of literature about the clinical efficacy and health economic returns of digital health interventions. Individual studies support specific interventions but also hint towards a "class effect" that suggests when health apps are designed and deployed in the right way they can be very effective in improving outcomes, empowering the patient-physician relationship and reducing costs. Still, methods for assessing and evaluating mHealth solutions are in their early days, and advancements are required on all fronts –  including clinical outcomes, user experience, privacy, security, economic models.  
 
“Differentiating the truly digital therapeutic apps from ones that are not properly evaluated is crucial,” says Yossi. 

​The future of healthcare
 
We asked Yossi to share his perspective on how healthcare is changing: “We are about to experience one of the most remarkable changes in the history of modern healthcare. New mobile technologies, consumer trends, reimbursement models are converging to fundamentally change the industry, and address the challenge of delivering improved outcomes in a cost-effective way. The reimagining of healthcare is already underway and it will continue to accelerate. People will get more involved in their health, more engaged, healthcare will become more participatory and more personalised. The pace of change will increase as more millennials start to become “consumers” of healthcare. This is already happening, and this wave of change will grow whether we lead it or whether we physicians and the other healthcare stakeholders will be forced into it. I believe it is always better to lead because it allows you to influence the change and navigate the journey versus being carried away by hyped trends.”
 
“Digital health and the promise it brings to patient centricity and healthcare personalisation is just beginning. What we are seeing now is the tip of the iceberg. I feel really privileged to be part of this evolution of healthcare. My driving force and life mission is to expand this promise on a global scale, making my humble contribution to a healthier humanity. In order for this evolution to succeed, this requires a collaborative effort – with governments, health professionals, regulatory systems, tech innovators and consumers joining hands.”