Service deliveryDigital Customer ServiceEnsuring the NHS mobile app doesn’t become an unwanted birthday present

Ensuring the NHS mobile app doesn't become an unwanted birthday present

Richard Whomes, director at Rocket Software, discusses the proposed NHS GP app, and what he thinks will make it a success for patients

The NHS mobile app – the “birthday present from the NHS to the British people” announced by former Health Secretary Jeremy Hunt in July, aims to provide the public with easy access, 24/7 service and control over their own healthcare. This investment demonstrates hope that mobile technology will improve efficiency in the NHS and save GPs’ time. To achieve these benefits this app has to be something the public will use, and to ensure this happens there are a few things the developers have to get right: usability, trust and positive outcomes.

The NHS smartphone app certainly sounds like something most of us would like to use: the ability to order repeat prescriptions without having to contact the GP surgery in person or over the phone; avoiding the 8AM scramble to book a doctor’s appointment; accessing your own health records whenever and wherever you need to. People are well used to mobile apps for banking, shopping, accessing information, and – possibly most consistently – fitness and health. We have come to expect usefulness, speed, reliability and security. If this new app is to succeed it needs to provide an excellent user experience from the moment it launches at the end of 2018.

Handling the data

The first challenge it faces is the amount of data the NHS generates. This needs to be processed so that people – and only authorised people – can access what they need, quickly. There is no organisation with quite the same information challenges as the NHS – highly sensitive data, multiple sites, thousands of employees, a myriad of customers (patients) and decades of records. In its report on lessons learnt after the WannaCry security breach, NHS England outlined the size of the challenge: the NHS cares for over 1 million patients every 24 hours in 236 trusts and 7,454 GP practices. In England it employs just over 1 million full-time equivalent staff (not including those working in general practice).

The data storage required could only be powered by mainframes, but with the adoption of newer technologies and the need to support digital and mobile working, there has been talk of replacing legacy systems. In 2015, NHS Scotland embarked on a ten year Mainframe Solutions Transformation Programme, with the Official Journal of the EU stating: “The current set of mainframe software solutions…are now expensive to maintain and are not efficient in supporting a modern service that is dependent on fast electronic communications and paper-lite ways of working.”

Mainframes and APIs

Many organisations across other industries have gone down this route – the mainframe is sometimes viewed as a relic, not fit for purpose in the modern world. However, thanks to Application Programming Interfaces (APIs), developers now have a gateway to crucial data and can build new mobile working applications, which allow healthcare staff – from doctors to care workers – to do away with the old-school approaches to sharing information, such as hand-delivering patient records from one department to another or sending work schedules and shift timetables via post.

APIs provide an extra layer to the infrastructure so that core systems do not have to be rewired for a new application to be integrated. This means the NHS can rely on the mainframe to store and manage all the data and use APIs to innovate to keep up with consumer demands.

Security concerns

Widespread adoption of the new app will require trust, and security is another major concern for all stakeholders with the introduction of public data access tools. Ninety per cent of NHS IT managers say that making cyber-security a priority is the only way to allow for digitisation of patient care. In response, NHS Digital is investing £20 million to create a dedicated cyber security centre where ethical ‘white-hat’ hackers will be monitoring and probing the organisation’s defences for weaknesses.

The NHS app will need to implement the same level of security deployed by banks, which have relied on APIs for decades. Banks initially used the technology for internal data transfer and more recently applied it to bring mobile banking to customers. API technology has developed accordingly to become super-easy to use on the surface, yet internally much more sophisticated; resilient to high user volumes and with sufficient security to protect privacy and financial integrity. If banks can ensure the integrity of personal and financial details, the NHS can ensure its app protects the personal and medical data of its patients.

Basic?

So, once security and speedy data access are covered, the NHS app has to provide today’s tech savvy, demanding consumers with a smooth, intuitive experience. According to the BBC, “the new service looks pretty basic and will enter a crowded market for health apps, many offering more advanced features”. However, the NHS Apps Library, currently in beta-phase, suggests the NHS knows what it is dealing with.

At the same time as the smartphone app news, NHS Digital announced that it now has 70 ‘NHS Approved’ tools in the library. The NHS is seizing an opportunity to make its mark in this crowded market and guide people towards proven tools that focus on wellness and prevention of sickness especially in areas of increasing concern such as mental health and obesity: The ‘NHS Approved’ status means there is clinical evidence that it supports clinical outcomes. With this focus on apps, NHS Digital has the tools and insight to ensure its own app is up to par.

Be patient (pun intended)

The final piece of the puzzle, where the success of the NHS app lies, is whether it will do what people want it to.

Let’s assume you and only you can refer to your medical records whenever you wish, knowing your personal details are completely secure; your prescriptions are ordered and ready at your chosen pharmacy with a click on your phone; you can see what GP appointments are available without waiting on hold for ten minutes: that sounds like the recipe for a successful app.

If the app, along with other digital technology in the NHS, works its magic and frees up GP time, everyone will benefit. But to start with, being able to book appointments online doesn’t necessarily mean that you’ll be able to get that same day appointment – maybe that’s what Jeremy Hunt meant when he said we the app will make us “expert patients”! We should not expect the new app to solve all the problems in the NHS but I’m sure we will enjoy the conveniences it promises.

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