Learn why we need to assess digital health products, such as apps, before you can recommend them to patients and people who use your services. Discover an easy way to make recommendations and track what you recommend.

Expert: Liz Ashall-Payne, CEO, ORCHA Health Ltd

Welcome to Foundation Module two. My name's Liz and I'm the chief exec here at ORCHA. And this foundation module is all about how and why we need to have a mechanism and a system for recommending digital health technologies to our patients or clients. Now, sometimes the word prescription can feel a little bit uncomfortable, but I'm going to explain why we're using that word.

If you do feel a bit uncomfortable with the word prescription, use the word recommendation. That's absolutely fine. And the first question you might have is, well, why is it important that we have a system or a process for recommend or prescribing digital health technologies? Well, when we're prescribing or recommending anything to our patients or clients, it's really important that we think carefully about not only what we're recommending, but how we're recommending.

And it's really important for two key reasons. One is patient safety, and the second is all about governance and managing risk. So before I get into how and why we need to prescribe or recommend digital health therapies and technologies, I just wanted to take a step back and think about what do we mean by patient safety? And I'm just going to use the definition by the World Health Organization.

And they say that patient safety is the absence of preventable harm to a patient during the process of health care and the reduction of the risk of unnecessary harm associated with health care to an acceptable minimum. And the key things here that we need to think about is the fact that what we're saying is we must support patient safety by reducing risk of unnecessary harm and making sure that we prevent harm.

And the only way to do that is to have a clear system and process in the recommendation or prescription of any intervention that we make to our patients or clients. Now, why is this
important? Well, again, I'm going to take a step back and a step away from digital health. And I'm just going to briefly talk about the prescription of drugs to patients.

Now, we have a very truly a process in how we prescribe drugs to our patients and how we receive those drugs as patients. So the first step on this journey is a patient feels unwell or has a health need. So they have a consultation. They go and see their doctor or that prescribing nurse or that prescribing therapist, and they have a consultation.

And what happens during that consultation is that we as healthcare professionals will listen and work out what the symptoms are and what the need is from a health perspective. We can then go to a repository of drugs, in the UK it's called the British National Formulary. In other countries they also have different national drug formularies and we can go to the national drug formulary and find a drug that has gone through all the relevant clinical trials and has been placed in there so that we, as the prescribing health care professional, can trust that that drug is safe.

What happens then is we then have a mechanism for prescribing that drug to our patient, and that's either through an e-prescription or through a paper prescription. And that piece of paper or e-prescription is really important because it's that piece of paper or e-prescription that the pharmacist will then use to deploy that drug to the patient, and then the patient can go and collect that drug from the pharmacy.

The pharmacist is then able to answer questions about that drug and make sure that we as patients use it. And obviously, the end point of all this is that the patient's health is improved. Now, during that process, there are key steps that minimize the risk and help ensure that patient safety is established along that process. The first is the critical point of having a national repository or a national formulary for the drug choice.

That's really important. Any drug that gets into a national formulary has gone through all the quality checks and clinical trials that are required, and we as prescribing professionals now know which drugs are safe to prescribe. The next step that minimises risk is the actual prescription process. So if I, for example, said to a patient, go to the pharmacist and buy X, Y, Z drug, you may then go and ask for the wrong drug.

And therefore the risk is established, so the point of the prescription is to make sure that the patient actually goes and collects the right drug. The next point of minimising risk is the fact that the pharmacist at point of giving that drug over to a patient is now able to advise the patient on any questions they have. And because ongoing clinical trials are happening for drugs, if a future problem is found with a drug in the UK, for example, NICE can do a recall through the prescribers to make sure that anybody who's on that drug is told of a new risk and that drug can be withdrawn should it need to happen. And that process and system has been established to minimise the risk associated with prescribing drugs.

The reason I wanted to explain to you that process and system of prescribing drugs will become apparent in the next module when I start talking about how we recommend or prescribe digital health technologies.