By Eve Macharia, Specialist Registrar and clinical researcher in Paediatric Surgery, Institute of Child Health.
Eve is the project lead on the TARDIS team, where she coordinated the development of an app for the study of gastro-esophageal reflux (GOR) in children. The app, called TARDIS:GOR, is currently undergoing beta testing at Great Ormond Street Hospital for Children. We asked Eve to pass on her top tips on developing apps for the healthcare sector.
1. Identify a Key Opinion Leader
If you develop and app for heart disease, find a heart disease specialist to work. Beta testing using online focus groups or dedicated app testing services is expensive. A doctor with a patient list populated by your target audience would be an invaluable ally. They could run your beta test as a clinical trial and endorse the app to their patients and colleagues.
2. Embed the app in research
Healthcare research is, by its very nature, a long and laborious process in which the funding if front-loaded and impact assessment is measured with delay. For the app developer, this has sustainability benefits. An app project embedded within a well-costed research project may have years of iterative development and testing with a captive population of research participants as users. Furthermore, embedding the project in an academic department of repute may allow the developer to broker industry partnerships and scale up the initial project.
3. Review publications
In healthcare research, if an event has not been reported on Medline, it hasn’t happened. Journal articles are the currency of the medical and academic world. They open the keys to the ethical approval kingdom. They are the secret code to the funding vault. Understanding the publish or perish imperative is key in the process of establishing common ground.
Journal articles are remarkably verbose when compared to the succinct communications that drive technology communications (who thought we could summarise our thoughts into 140 characters?). Most academic papers read like a 1980s IBM manual. Papers on apps inevitably begin with an attempt to define the smartphone without plagiarising some other publication. However, positioning the project in academic terms will demonstrate the app developer’s ability and willingness to understand the healthcare ecosystem.
4. Go down to the clinic, get into the theatre
To really understand what is being measured and how the information will be used, the app developer should embed themselves in the clinicians world and understand the utility of the knowledge. A tool that accurately collects information from the patient that the clinician needs to take crucial decisions, is far more useful than a tool gathering extraneous data. One wonders how many of the developers who created middling-to-poor sleep screening apps actually spent time in a sleep study lab?
5. Ethical approval and data security
Data security is the app developer’s trump card. Researchers and healthcare workers have an ingrained fear of contravening data protection rules. Within the NHS environment, these rules are more stringent in their application than their writ. Demonstrating data security is essential to gaining ethical approval for any research project involving patient data. Researchers going through protracted National Research and Ethics applications will value expert guidance. App developers able to offer this knowledge may have a foot in the door and perhaps even a place at the table.