ORCHA is the world’s leading health app evaluation and advisor organisation. In this interview, Chief Executive, Liz Ashall-Payne, tells us how ORCHA is driving safety improvements across the globe, empowering patients and highlights the danger of a poorly designed health app.
Questions & Answers
Can you tell us a little bit about yourself?
After my early years as a speech and language therapist, I’ve led a range of transformation projects across the NHS, including more recently across the digital health agenda.
Within the digital space, I saw that 93% of health professionals think digital health is one of the major weapons to enhance NHS services.
But I also saw three big problems. Firstly, finding the right app. With over 365,000 in app stores, how can you find the great ones in such a crowded space? Secondly, trusting an app. How do you know if an app is safe to use and won’t mistreat your data? Thirdly, integrating it into care. How can apps work along other services you use?
That’s why I formed ORCHA.
How long have you been in post?
I founded ORCHA almost four years ago, and we’ve seen huge growth. ORCHA now support 25% of the NHS and national health bodies across Europe, the Middle East and Africa.
Can you tell us more about what you do and the purpose of your role?
ORCHA transformed the way in which health apps are reviewed. We test more apps than anyone, which helps us to cover more conditions and be on top of new releases of apps. We’ve reviewed almost 6,000 apps to date. We’re home to the world’s only library that lets you find and compare health apps against a range of criteria including effectiveness, usability and security. This helps professionals and patients to find or recommend apps with confidence.
To drive uptake of health apps and target specific communities, we provide locally branded and tailored microsites. Our tools enable health professionals to recommend, which is proven to increase take-up and increase self-management of conditions.
Our mission is to make digital health happen. But this brings challenges. Introducing apps into healthcare pathways requires significant change and so requires education, a shift in attitude and behaviour.
Talk us through a typical day
I don’t have a typical day, which is one of the things I love about my role. One week I may be meeting health ministries across a number of different countries, discussing how they can introduce health app accreditation. The next I could be sat with patient groups, discussing their needs or patient safety, or meeting with app developers discussing upcoming security standards and legislation.
What do you think are the most effective ways to engage staff in patient safety?
The most effective way to engage is by explaining why patient safety is important. Understanding the impact or consequences for a patient, brings to life the importance. Our team doesn’t meet with patients often, but everyday whilst evaluating apps, they see the safety implications of poor design or security.
For example, there is an app that’s intended to help in suicide prevention, but because of its poor design, it can be used as a source of ideas for people thinking about suicide. This really brings to home the importance of patient safety.
How should patient safety leaders be engaging with patients?
Our service was designed with patient safety at its heart. Our tools help health professionals ensure that patients only use health apps that are safe.
Leaders should set out to ask if something is safe for patients, before considering any additional performance characteristics. Sometimes in the digital world, people start out looking at features for patients, leaving the safety considerations ‘til later on. We’re here to ensure all aspects aren’t forgotten.
What three words best describe a culture that promotes patient safety?
Ownership. Learning. Trust.
As an organisation, you need to take ownership for safety, try to learn from problems that occur and trust your processes.
What are the three main barriers to patient safety?
- Not talking: The biggest barrier to safety is not talking when things go wrong.
- Blame: Not talking often occurs within a culture of blame. It is important to recognise that things can and do go wrong, allowing people to fail, but then learning from this.
- Poor processes: Failings often come about through poor process development, and so an organisation should regularly appraise and test these with a patient centric approach.
What do you think needs to stop, start and continue when it comes to patient safety?
Stop: When it comes to patient safety it’s important to stop keeping quiet, be it about failings or improvement ideas.
Start: Organisations should start being open when incidents happen, learning from them.
Continue: The proactive Safer Clinical Systems programme from the Health Foundation should continue!
Can you share an example or anecdote about how your work has had a positive impact on patient safety?
We’ve tested almost 6,000 health apps to date, using a platform that looks at 260 criteria. This revealed that almost 85% of health apps in app stores do not meet quality standards.
We help health professionals to spot and avoid apps with low scores, and our app libraries help professionals to find and recommend the best apps to their patients.
What are you passionate about?
Since training to be a speech and language therapist I have always been passionate about helping people to be healthy and safe. Working in digital health lets me do this at scale.
If you could jump to 2050, in an ideal world, what would healthcare look like?
In time, hopefully before 2050, I see us moving to a proactive, integrated approach to people’s health. We will live in a world where patients will be prescribed a combination of drugs, digital tools and social solutions to meet their needs. Not just drugs in isolation.
Another big change I anticipate is that data from apps will be aggregated. There will be a move from the silos we see today, to an ecosystem of data. This will enable clinicians to access one picture, pulling information such as blood glucose, exercise and diet, from a variety of apps into one dashboard. This extends the personalised, integrated, whole life proposition that apps will offer.
Can you tell us about a woman who has inspired you when it comes to patient safety?
In my role I meet so many women who’ve pioneered apps that address real patient safety issues. One such woman is Asma Khal, who is behind health app HaMpton. This innovative smartphone app helps pregnant women to monitor their high blood pressure at home. It alerts women if they need to attend the hospital, and it also links with a hospital computer system where the data can be monitored by clinicians in real time. HaMpton empowers women to be involved in their own care, reduces the number of hospital visits, and has achieved excellent patient and staff satisfaction.
What advice do you have for young females who are just starting out in their careers, whether in the healthcare industry or otherwise?
Find something that you are passionate about and then be true to yourself.
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