Apps (108)

Being nosey’s a generic human trait. There’s an app that helps. Following a successful launch in Kenya in April this year, the South African Red Cross Society (SARCS) has announced the official launch of its app, created and developed in partnership with Connectik, says an article in ITWEB Africa.

App users can see where local projects are. When they’ve found out what’s going on near them, they can volunteer, sign up to receive emergency alerts during national and local crises, make donations, register for training courses and events, and see blood donor locations. The launch of the app is the first nation-wide initiative for SARCS' new senior leadership. It’s the organisation's major stepping-stone as it seeks to digitise and improve services.

SARCS hopes the app will provide help to mobilise its resources by increasing membership, volunteer base and programme delivery. It should also improve community engagement.

As mHealth expands, choices and decisions about which apps to use and which to avoid become increasingly challenging. The American Medical Association (AMA) has adopted a set of principles in Safe, Effective mHealth Applications that can help. They may help Africa’s healthcare professionals and health systems too.

The AMA’s position’s that doctors are optimistic about eHealth and its potential medical benefits. It’s also clear that some mHealth apps and devices aren’t safe and can pose threats to patients’ health and safety. Resolving this needs more evidence to show mHealth’s accuracy, effectiveness, safety and security.

The AMA’s principles aim to encourage integration of eHealth innovations, such as mHealth apps and associated digital devices, trackers and sensors, into clinical practice. It does this by promoting coverage and payment policies based on whether mHealth apps and related devices are evidence-based, validated, interoperable and actionable. The principles are:

  1. Support establishment or continuation of valid patient-doctor relationships
  2. Have clinical evidence to support mHealth’s use to ensure safety and effectiveness
  3. Follow available evidence-based practice guidelines to ensure patient safety, healthcare quality and positive health outcomes
  4. Support healthcare delivery that’s patient-centred, promotes care coordination and facilitates team communications
  5. Support data portability and interoperability to promote care coordination of medical home and accountable care models
  6. Abide by licensure laws and medical practice laws and requirements in the state in which the patient receives services facilitated by mHealth
  7. Require doctors and other healthcare practitioners using mHealth to deliver services to be licensed where patients receive services, or as authorised by the state’s medical board
  8. Ensure delivery of services using mHealth is consistent with practice laws
  9. Ensure patient privacy and data security in compliance with laws and regulations and promote patient awareness of varying levels data privacy and security afforded by mHealth.

Given the lack of regulation of mHealth apps, regardless of whether the apps related device is encrypted, the AMA advises physicians to alert patients of the potential privacy and security risks for any mHealth apps that they prescribe or recommend, and document the patient’s understanding of such risks.

A next step is an AMA assessment of the potential liability risks to doctors is using, recommending or prescribing mHealth. Fierce Healthcare has a report highlighting an important difference between prescribing drugs and mHealth. An approved medication basically remains unchanged, but mHealth keeps changing with numerous updates, and not updating's potentially worse.

These principles offer a valuable start for Africa’s doctors and health systems to introduce effective mHealth regulation. As Africa’s mHealth expands, the need for, and value of, regulation will increase too. A lead by Africa’s medical profession will help.

Ten winners of the Innovation Awards 2016 were announced at a pan-African mobile and tech awards party in Cape Town, South Africa. This year, the awards attracted over 200 entries from 25 countries. Winners hailed from Kenya, Nigeria, South Africa, Tanzania, Uganda and Zambia.

Ask Without Shame from Uganda won the Social Impact Award. The app allows youths to access medical advices at any time about whatever emergency they’re facing, or questions they may have about sexuality. Medical experts are on hand to offer free and anonymous advice.

Young people can use the app to access accurate information on their phones about sex, HIV, STDS, body changes, contraception and pregnancy. An easy to use interface makes it possible to access information quickly. If users don’t find the information they need existing categories, they have an option to ask a direct question with guaranteed privacy. Users can also access medical experts by dialing, texting or WhatsApping +256706666001. Users can download the app from Google store by clicking here

Ask Without Shame was launched during the 1st Uganda Innovation Day on 12 December 2015. It reached 3,000 users in its first three months, and was invited as an emerging African Startup to exhibit and pitch at the biggest worldwide IT expo Ce Bit in Hanover, Germany.

The service continues to grow. The team plans to expand its range to reach over a million young people in East Africa.

Clinical depression leaves sufferers feeling isolated, overwhelming all aspects of their daily lives. Its impact’s worst in the Middle East and North Africa. These were the findings of study by a research team at Australia's University of Queensland and published in PLOS Medicine.

The 2013 report says eight African countries were in the highest group of over 7% prevalence for Years Lived with Disability (YLD). They’re Algeria, Botswana, Equatorial Guinea, Gabon, Libya, Rwanda, Sudan and Tunisia. Eight countries are in the next highest group, 6% to 7%; Burundi, Congo, Morocco, Somalia, Swaziland, Tanzania, Uganda and Zambia. Taken together, it’s about 30% of Africa’s countries. Five countries, fewer than 10% are in the lowest group of lower than 4%:  Burkina Faso, Guinea Bissau, Ethiopia, Nigeria and Togo.

Pfizer’s released Mood ivator in the US, an mHealth service to help motivate and encourage adults with depression. Patients can use it to track and export their mood and goal progress. Its data’s in easy-to-read charts that can be shared with doctors to inform care decisions. The app’s designed to complement patients’ treatments. Tracking mood, setting goals and establishing to support daily living are all features. It

Moodivator’s free and available for iPhones from the Apple App Store. It could help millions of Africans.

mHealth and its apps might be smart at diagnosis, but doctors are smarter. A study by a team from Harvard, Boston and Washington, in the Journal of the American Medical Association compared doctors’ diagnostic accuracy with symptom checker algorithms that people can use instead of visiting their doctors.

A cohort of 234 doctors had better results than symptom checkers by a score of 84% for the initial diagnosis compared to 51% for the apps. The overall score put the doctors ahead by about two to one for 45 clinical vignettes of hypothetical patients. About 90% of the doctors were trained in internal medicine, with 52% fellows or in residency.

A report from the US National Academies Health and Medicine Division builds on two ground breaking reports from the Institute of Medicine, To Err is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century. They found that diagnosis and diagnostic errors have been unappreciated in efforts to improve healthcare quality and safety.

The latest comparative study of doctors and apps aim to test eHealth’s potential for improvement. It doesn’t look like it. The findings are crucial for eHealth investment decisions for self-diagnosis as means of expanding healthcare access. It seems that eHealth gains for better diagnoses are elusive goals.

Why is it that lots of mobilists spend hours a day using some apps, but not much on mHealth? Could it be that mHealth isn’t good enough at its psychology? In a park recently, as in now in many other parks, lots of young people were wandering around from tree to tree, seemingly aimlessly, but playing Pokemon. Trees are good for health, but no mHealthers were in the crowd.

While technical imagination and usability are essential for app’s success, many commercial apps are relying on behaviourism, a branch of psychology from B F Skinner in the 1930s. Originating from his stimulus, response and reward using rats and boxes with mazes, levers and food, it’s taken on a new role by B J Fogg as behavioural design. Both are based on the theory that environment can shape behaviour.

An article in The Economists 1843 magazine says that designing the right box, and hey presto, behaviour’s controlled. The old, bad joke was what’s the difference between magicians and psychologists? Magicians pull rabbits out of hats, psychologists pull habits out of rats. Now, they’re putting habits into app users. Fogg found that people spent longer using computers if the computers had previously been helpful to them. The implication’s that apps can be designed using psychology so people will use them when they may not have done.

It’s Computers as Persuasive Technologies (captology), and now embedded into daily life rom Fogg’s laboratory at Stanford University’s Persuasive Technology Laboratory. This behavioural design model sets out to hack people and exploit their human instincts, quirks and frailties. The goal’s to supplement motivation and persuasion with a more effective option of making behaviour easier. When motivation’s high or behaviour’s easy, users respond to simple trigger, such as vibrating phones. Well-designed, called hot, triggers find users at exactly the time they’re ready to burst into action. They put hot triggers in the path of motivated users. 

The challenge for mHealth developers’s to design hot triggers instead of just mundane triggers to appeal to users’ emotions in their computer transactions. This isn’t new. Fogg’s theory dates back a long time before social media invaded the world. Nir Eyal’s added to it since. His book Hooked, he sees hot triggers as internal factors, not internal as Fogg does, so apps succeed when they meet people’s basic emotional needs and unthinking choices before users are consciously aware of them.  Tristan Harris, a former Google employee after Google bought his start-up and his app Apture, calls this “Whoever designs the menu controls the choices.”

Africa’s health systems can benefit by assessing their mHealth apps for effective hot triggers and technical prowess to ensure they’ll maximise benefits. For such a significant investment, it’s essential they‘re effective. They also should ensure that hot triggers are ethical, not just medically, but constitutionally. Borrowing from magic, the hot trigger Genie’s already out of the bottle. Africa’s health systems need to make sure it work well for everybody.

Fitness apps and wearables have been flooding the market. There’s a fitness app to track just about anything these days. From how many steps you take, your heart rate and your eating and sleeping patterns. If you can imagine it, there is almost surely an app for it.

While the popularity of fitness apps continues, there may be a change coming. A survey by Silicon Valley Bank shows that clinically-focuses health apps and devices are more likely to be more popular this year than consumer-focused products. Innovators and investors are more interested in the switch too, an article in HealthcareITNews says.

Of the 122 executives and investors in health-tech companies interviewed, 45% said clinically-driven health programmes will have grow most. Only 8% selected mobile health apps and 7% named wearables. The report says “Investment trends in digital health are shifting from consumer wellness applications to clinically driven solutions that drive better health outcomes at lower costs. This next wave focuses on encouraging consumers and patients to change health-related behaviors, underscoring the greater opportunities for companies with solutions that create value for payers, providers, employers and consumers.” 

About 55% of all digital health investments since 2011 have been in companies providing consumer-facing tools. Investors have recently preferred clinically-focused startups, seeking tools designed to affect patient behavior and generating better health outcomes and cost savings.

In 2015, 60 early-stage funding deals in clinical enablement, totaled US$600 million. In 2016, there will be more than 70 deals, up by more than 16%, amounting to more than US$850 million, up more than 40%. The average deal value’s increased from about US$10 million to over US$ 12 million. Consumer deals for fitness and wellness are heading in the opposite direction, There were 45 deals valued at US$550 million in 2015 compared to there will be 10 deals at less than $20 million in 2016. The change’s a drop in deals of about 80% and average deal values down by from about US$12 million to about US$2 million.

Disease management and remote monitoring companies are shifting to specific disease to help patients and providers manage conditions better. Instead of providing general solutions,  “Now the focus is on digital solutions for disease management. Going forward, clinically proven software and hardware will be integrated to drive better health outcomes and cost savings.”

These are encouraging healthcare development. Its potential benefits are considerable, although often in eHealth, potential benefits are seldom realised fully. Hopefully, this trend will make it way to African countries soon and add to its mHealth ambitions.

Two of Apple’s ambitions are to provide a safe experience for users to access apps, and create a great opportunity for all developers to succeed. It’s updated its App Store Review Guidelines to support these goals. They could improve health users’ attitude to app security, so increase mHealth use, an important goal for Africa’s health systems.

Its guidelines are in five clear sections: safety, performance, business, design and legal. There’s also good advice on an app development, including:

  1. Test apps for crashes and bugs
  2. Ensure that all app information and metadata is complete and accurate
  3. Update contact in case App Review needs to reach you
  4. Provide an active demo account and login information, plus any other hardware or resources that might be needed to review an app, such as a sample Make sure you:
  5. Test your app for crashes and bugs
  6. Ensure that all app information and metadata is complete and accurate
  7. Update your contact information in case App Review needs to reach you
  8. Provide an active demo account and login information, plus any other hardware or resources that might be needed to review your app such as a (e.g. a sample Quick Response (QR) code, a 2D barcode used on mobile phones
  9. Enable backend services so they’re live and accessible during review
  10. Include detailed explanations of non-obvious features and Internet Access Providers (IAP) in the App Review notes, including appropriate supporting documentation
  11. If an app’s not accessible app because it’s geo-locked or otherwise restricted, provide a link to a video of the functionality
  12. Check whether your app follows guidance in other documentation, such as:
  • Development Guidelines
  • Design Guidelines
  • Brand and Marketing Guidelines.

Backups are a bit boring but vital. To ensure they’re as efficient as possible, Apple Store says to store app data according to the following guidelines:

  1. Only documents and other data that is user-generated, or that cannot otherwise be recreated by your application, should be stored in the /Documents directory and will be automatically backed up by iCloud
  2. Data that can be downloaded again or regenerated should be stored in the /Library/Caches directory. Examples of files you should put in the Caches directory include database cache files and downloadable content, such as that used by magazine, newspaper, and map applications
  3. Data that is used only temporarily should be stored in the /tmp directory. Although these files are not backed up to iCloud, remember to delete those files when you are done with them so that they do not continue to consume space on the user’s device
  4. Use the "do not back up" attribute for specifying files that should remain on device, even in low storage situations. Use this attribute with data that can be recreated but needs to persist even in low storage situations for proper functioning of your app or because customers expect it to be available during offline use. This attribute works on marked files regardless of what directory they are in, including the Documents directory. These files will not be purged and will not be included in the user's iCloud or iTunes backup. Because these files do use on-device storage space, your app is responsible for monitoring and purging these files periodically.

For Africa’s health systems, it should now be easier to assess mHealth initiatives by applying Apple Store’s guidelines in full. The resulting rigour should support mHealth expansion.

St. Joseph’s Children’s Hospital in Florida has a new tool for their young patients to deal with the stress and scariness of being in a hospital. UnMonsters, an app game has been released just for the hospital's pediatric patients says an article in Mobihealthnews.

UnMonsters, which has been developed by the hospital and interactive design firm Haneke Design, features different types of monsters that patients must find and capture. UnMonsters is a combination of distraction and exposure. The game is set in the hospital, with animated versions of places like the x-ray room, lab and waiting room."To our knowledge, this is the first hospital-based game app in the country," Kim Marlatt, director of marketing for St. Joseph's Children's Hospital said in a statement.

The game is not just about the monsters. Players are also offered health education information. Each round features a simple health-related question, such as how much of a certain healthy food kids should eat per day. The whole idea is to get kids more comfortable with being at the hospital, by having them focus on monsters instead of doctors and making the hospital seem like any other place.

"Sometimes, the best way to conquer our fear is to view things in a different way," St. Joseph's Children's Hospital President Kimberly Guy said in a statement. "We hope that UnMonsters will give kids and parents a new way of looking at going to the hospital, because when we understand the things that scare us, the monsters don't seem so bad after all."

In Sanskrit, myArogya means my Health. It’s also Arogya World’s mHealth app to help with India’s chronic disease prevention, including diabetes and its complications such as heart disease, stroke, and kidney disease. Cigna Foundation provided substantial support for myArogya. Other partners are Click Medix, the Madras Diabetes Research Foundation (MDRF), Quest Diagnostics and Emory University.

It’s available on Android and iOS phones. The app’s content includes disease awareness and prevention, food and activity trackers, a smoking cessation programme, healthy recipe videos, nutritional icons for India. Extra trackers are planned newer versions. myArogya aims to help people make healthy lifestyle choices. 

myArogya builds off of an earlier program, m Diabetes,, which helped about 150,000 people lead healthier lives. As the incidence of chronic and non-communicable disease rises across Africa, myArogya offers a valuable example of an mHealth programme for Africa’s health systems.