Alison Longwill

Mar 022013

This is the content of the update email sent to members on 1 Feb - If you want to receive these and a other email from HANDI please register here

HANDI has arranged a meeting in London on 20th March for members who think they might be interested in tapping into the 75M€ European Union ICT Policy Support Programme – Themes of the latest call include: ICT for health, ageing well-being and inclusion and Digital content, open data and creativity – Both of which are relevant to many HANDI members.


I was recently introduced to LiveCode a cross platform development tool that makes it easy to develop apps. LiveCode is about to go open-source and it looks to me that it is amongst the best tools of its type. If you’re a developer or someone who thought it would be too hard to become a developer LiveCode is worth a look.


Our NE Cluster is planning a meeting to look at Social value and health apps The Public Services (Social Value) Act 2012 requires buyers of public services to consider the widest range of social benefits in procurement decisions. HANDI hope that this meeting will provide some guidance on what this means for app developers and commissioners of services. We are particularly interested in finding some NHS Commissioners in the NE to work with us if you can help or want to know more email

One of  HANDI's founder's Sarah Amani of Surrey and Borders NHS Foundation Trust has just released an app she has help develop with young service users which can help young people make informed choices about what to do to improve your mental health. The app “My Journey” is a good example of how apps can help in the mental health field and the design approach a exemplar of user centred design See:


We are working hard to build activity in our local clusters and in particular to get our new Scottish and NW Clusters off the ground – This needs people willing to take a leadership role if you can help please email me

I recently spoke at Healthcare Apps – Maximising the Impact in Liverpool - A great event with some interesting presentations these are now available online via the link below. Richard Brady’s presentation on App quality has some worrying findings and is a must read for anyone interested in app quality as is the presentation from Neil Ebenezer from the MHRA on the Medical Devices Directive. While on a more upbeat note the case studies of some successful apps are also worth looking at



Mar 012013

One of our members, Dave Kilroy recently brought a cross platform development tool LiveCode to my attention. The Edinburgh based company behind LiveCode has just raised around £500k via KickStarter which will be used to clean up and re-factor their code base and take the project Open-Source.

LiveCode provides a cross platform tool then enables anyone to create apps quickly and easily and it seems to me that it will be of interest to many HANDI members.

Dave writes:

"Some of your readers/members may remember a thing called HyperCard from long ago - it was an easy-to-learn scripting environment where users could make pretty sophisticated (for the time) software. There were various 'flavours' of the technology but the best known version shipped with Apple computers - until Steve Jobs ditched it…

" However it didn't die out and after a series of adventures was taken on and re-invented by a Scottish Company called Runtime Revolution . The language is now called LiveCode - and it's pretty good!

 "In it you can develop software on a Linux, Windows or OSX machine and deploy to Windows, Linux and OSX desktops, there is a server version running on Apache, and you can use it to create apps for Android and iOS devices. It is not a 'pretend' language and with it you can make 'proper' software.

" You can find out lots more at RunRev's website but here are a few extra links:

"The company is in the process of making LiveCode open source, and as part of this they want to do a big clean up and re factoring of their huge and ancient code base - to fund this they  put out a KickStarter project  which has recently exceed its, target £350 k"

Feb 152013

London Connect have been running a project to build a community of interest in London around patient health record access which HANDI have been happy to support.

We just be asked to include the report from the public event they held on a snowy January Saturday at the Wellcome Collection in London.

You will find the report here along with other material from the work of the community over the past few months.  It makes fascinating reading about public attitudes to and hopes for record access and digital engagement in health and is a "must read" for all interested in the area.

We are actively working with London Connect about how HANDI can help to continue to support this community of practice through our London Cluster. If you like to know more or get involved please contact

Feb 082013

HANDI are planning a series of regional workshop to be run by our growing network of regional clusters during the year commencing  April 2013.

See our events diary for those events already scheduled

We have secured funding which will allow some of these to deliver free and would like to know what subjects HANDI members would like us include in the programme.

We have three themes in mind but are open to other suggestions. These themes are:

  • Understanding the Market - Helping members of the community understand health and social care and the market opportunities for apps and digital tools
  • Business models and Finance – Raising investment and creating sustainable business models for apps for Health and Care - Practical advice for both commercial and social entrepreneurs.
  • Ensuring app quality - What are the regulatory obligations and voluntary opportunities to demonstrate app quality? How can developers meet and exceed these to differentiate their products and build market share?
  • Playing nicely together - Ensure apps play nicely with others and with the broader health and care IT ecosystem - Interoperability, orchestration and user interface design.

Our expectation that there will be more that one workshop looking in detail at specific issues under one of these themes. Our aim is to provide actionable, practical guidance for teams developing and implementing apps in Health and Care.

Please share any ideas you have as comments below and if you have not registered with us please sign up here so you get details of the events we decide to deliver

Feb 012013

Spoke at a great event today organised by Merseyside & Cheshire HIEC with support from Greater Manchester HIEC: Healthcare Apps - Maximising the Impact

Lots of food for thought. Particularly discussion about the quality of many apps (which is not good) and the need for quality assurance with an helpful presentation from MHRA.

My presentation below and you find a full set here

And a storify that pulls the tweets from the event together

Jan 292013

HANDI has been asked by Dr Brian Fisher who is the Patient and Public Involvement Lead for the NHS Alliance if you can help to answer some questions on behalf of Bob Gann at the NHS Commissioning Board he wants to find out about as many as possible of the IT innovations that are lurking out there, smouldering on a computer and hopefully also being used. Bob knows about the large websites and those developed by the NHS itself. He wants the cutting edge stuff particularly from micro-enterprises and gifted amateur developers and is also interested in finding out what people are doing to counter digital exclusion.

I have set up a questionnaire for Brian if you involved in an product that fits the bill please take 10 minutes to complete the questionnaire here

Also if you are interested in innovation and have not yet register with HANDI please do so here

Jan 232013

HANDI wants to offer some ethical internship in 2013 and are looking for sponsors. We need dedicated resource to grow our network and develop our activities and want to do our bit to help talented young people get a foothold in the growing health and care app sector.

We want to offer a number of internships of six months and pay interns at least the minimum wage. We have plenty of interesting projects but need to be able to provide interns with a supportive environment with appropriate facilities, supervision and mentorship.

We are looking for sponsors who can offer one or more of the following:

  • Funding – £ 10k to cover a 6 month internship at the minimum wage including on-costs and expenses.
  • Office space where you can provide facilities, support and supervision. -HANDI can provide overall management and supervision, but we want some on-site support. We are flexible with regard to location, but HANDI is currently best able to provide support in the London, Newcastle, Leeds and Birmingham areas.
  • Mentorship – Help ensure HANDI and the Intern get the most out of the programme.

We have lots of potential projects but are happy to work with sponsors who have project ideas that meet their needs and also align with HANDI’s objectives. Our current projects include projects in the technical, health and care, marketing and business development domains.

We will work with sponsors to define the job descriptions and person specification for the Interns and on the selection process, but expect interns will be graduates with good degrees from a range of disciplines

If you are able to help or want to know more about being a sponsor or mentor or providing office space contact – PLEASE NOTE: Potential interns should not contact us at this stage as we are not yet in a position to process applications. Please register as a member on the HANDI website if you have not already done so. All members will be notified when applications for Interns open. You can also follow #handihealth on Twitter and monitor our web site to ensure you don’t miss our announcement which we hope to make around the end of Q1 2013.

Dec 202012

HANDI now has regional clusters established in:

  • London
  • Midlands
  • North East
  • South West
  • West Yorkshire

With formation in  progress in:

  • Scotland
  • North West
  • N Ireland

The purpose of the regional clusters is to organise whatever activities members in the regions want to do and to feed in to what HANDI does nationally. We have steering groups established for each of the clusters and these are open to anyone who want to help to join.

We have just added sections in our discussion forum for each of the clusters and the easiest way to get involved is to post your thoughts and idea to the relevant section.

Discussion Forum 


Nov 022012

One of the most frequent questions we get asked at HANDI is "How do I fund my app?"

Developing that first working prototype of an app can be a quick and therefore fairly cheap process which many individuals or small companies can easily afford, but turning this first version into a product that is sustainable and supportable and able to reach a wide audience can soon become much more expensive process and either spending you own money on this of seeking support from investors requires that app developers have a clear idea of their business model.

Government also needs to understand this. Presently there is great hope that the app community will deliver for free what the NPfIT failed to deliver for £12bn and that all the NHS has to do is encourage a few healthcare professionals to code, offer some prizes and an opportunity for glory. Sadly, much as I believe in the power of the app community and the app paradigm to transform the way we deliver health and care it's not quite this easy and the centre will have to invest in support and infrastructure if it wants the app community to thrive, but most of all it needs to understand the possible business models that exist and ensure that it doesn't unintentionally or inappropriately inhibit those that could support a vibrant app ecosystem.

So what are the business models available to app developers? Well from my discussions it would seem they are these.

Just for the hell of it – Many apps are produced by developers just because they can with no expectation of a direct or indirect commercial return.

This is the realm of the hobbyist and lots of great ideas and innovation will emerge on this basis, but this approach is rarely sustainable as the pressures of family life and the day job close in. If an apps open source someone else may pick it up but normally such apps die or switch to a more sustainable business model.

User pays – Users pay a one-off charge, takes out a subscription, pays per use or even makes a voluntary donation.

There are very few examples of commercially successful patient facing apps for which users pays. Most chargeable apps sell for well under £5, but even this small charge seems to put people off and unless an app has mass appeal the volumes achievable at this sort of price rarely generate enough revenue to be sustainable.

User pays for service including app - Here what attracts the user to pay is the service of which the app is a just a part. For the app developer the opportunity is to be paid by the service provider to create the app that supports their service or to take on the broader role of service provider. There are a number of app enabled health and care service for which there seem reasonable prospects of commercial success based on the user paying for the service.

NHS/care provider pays An NHS organisation or care provider pays for apps that are made available free to appropriate  service users. Here the payer sees value to itself in making an app available and meets the cost of doing so.

There are a number of potential variations on this model. The payer may fund a developer to create an app which they then own (or open source) or they may buy licences, subscriptions or pay-per-use to enable an app to be provided free to users  with the developer bearing the commercial risk and opportunity.

This approach can create sustainable business models where the value of app to the payer is sufficient. Given the potential of many apps to substantially reduce payers costs and improve quality of service this approach should work in many cases.

However, the app developer faces two challenges. Making the business case to the potential payer and finding a route through the procurement jungle, both of which can be challenge for a typical small and innovative  app developer and an area where Government could help.

Non-commercial sponsorship. Many self-help and charitable organisation have paid for the provision of apps and services that are made available free of charge to the community that they serve – Organisations concerned with specific patients groups or conditions may well fund the development of apps or buy licences or subscriptions to provide apps free to those in their communities.

Commercial sponsorship – A commercial organisation sponsors an app in the hope of a direct or indirect commercial return. There is significant interest from pharmaceutical and other healthcare companies in sponsoring apps which relate to a clinical area in which they have an interest or draw users into services they offer.  There are a number of potential variations on this model which include funding development of an app they then own, paying for licences or subscriptions for an app to be available free to a target audience they define or pay-per-use (possibly linked to "click-throughs" to a service they offer. Commercial sponsorship is likely to be an attractive business model for many app developers.

Advertising – Apps are made available free to user but carry advertising. This approach is used by a number of health web sites and apps. Typical this approach uses services like Google Adsense or PlacePlay which provide advertisements relevant to the apps target users and shares revenue with the app developer. This is low effort for the developer but means they have little control of the advertisements that appear.  Targeted advertising has been one of the most successful business model for many web sites and the same is likely to be true for popular health apps, particular those that can attract user valuable to advertisers.

There is some understandable concern about some of the more commercial business models which could results in apps with a commercial bias towards particular products and services and  in apps not being so easily available to those in the groups that might benefit most from them as either they won't be able to afford the app or associated service or because they are not attractive to commercial sponsor and advertisers. However, Government need to decide if it wants to support commercial models for the delivery of health and care apps or fund them from the public purse.

However, beyond all this lies the challenge for the app community to demonstrate that apps bring value in terms of reduced cost and improved quality in the healthcare system. I'm firmly convinced that with the right support and infrastructure that apps can do exactly this and it then  becomes simply a matter of designing business models which enable those who get value from apps to pay for them, which in the context of a publicly funded health and care system is predominantly the tax-payer.

Oct 182012

HANDI have been asked by the Dept of Health to comment on plans for a NHS “App Store” and put some specific question to our community. The following few paragraphs provide some background and context for these questions to which you will find a link below.

It has been proposed that the NHS might develop an “App Store” for patient facing health and care apps.

The closed nature of the apple commercial model means that it is not possible to provide an App Store for apple IOS apps and as it is not currently acceptable to exclude this platform, in practice, it is likely that what can be delivered is an “App Directory” pointing to the relevant App Store.

The purpose of the store is:

  • To make it easier for UK citizens to find appropriate health and care apps – Particularly apps that can help people manage long term conditions – By “appropriate” We think what is meant is of good quality, consistent with way health and care is delivered in the UK (England) localised for uk use (i.e. no US date formats, drug names or units likely to confuse UK users)
  • To provide a degree of quality assurance probably with a mixture of light-touch certification similar to web certification (like HON and The Information Standard Plus crowd-sourced ratings and user reviews
  • To help app developers promote their apps

In the context of this proposal some thought has been given to defining the types of apps (or maybe functions of apps) and it is suggested that there are three broad classes of apps/functions.

  • Informational – An app provides general information in any media format which does not provide personalised advice (although it may be tailored to a particular class of user).
  • Monitoring – An app collects information from people related to their health and care and experiences of services (eg personal monitoring - such as monitoring your own weight, exercise and BP, including data collected by near-patient devices and  patient-reported measures of outcome, experience, feedback etc.)
  • Decision Support – An app which provides personalised guidance based on information it has about a specific individual (eg data entered by them, provided by near-patient devices or obtained via record access) to which it applies some form of automated reasoning (from a simple calculation, a decision support algorithm or some more complex heuristic). These are the types of apps most likely to fall in the scope of the Medical Devices Directive requiring registration with MHRA
  • Transactional – An app enables a user to carry out a heath and care related transaction. (book and appointment , request a prescription, have a virtual consultation etc.)

It is possible that initially an NHS App store will not deal with all of these types of apps

The Dept of Health are keen to establish if there is the HANDI community perceive value in the creation of such an NHS App Store and if we do  any advice or comments we may have to make it as useful as possible.

You will find the questions for completion at