Safe, Effective, and Efficient Deployment of Digital Health – Lessons from ORCHA

In this episode of Friends of Project Healthcare

Host Eric Thrailkill and Project Healthcare colleagues, Jeremy Raley and Lauren Hatcher, are joined by Liz Ashall-Payne, the co-founder and CEO of ORCHA (the Organization for the Review of Health and Care Apps), to discuss the assessment and distribution of safe digital health technology and how providers, patients, and the economy at large, can all benefit when digital health technologies are regulated and distributed appropriately.

Over 86 million Americans use health or fitness apps, but only 20% of those meet quality standards. ORCHA is attempting to fix this through assessing health apps, setting safety standards, and creating digital health formularies that can be used by payers, providers and patients.

Liz Ashall-Payne began her career as a trained speech and language therapist, though she quickly grew frustrated with how few lives she could improve over a short amount of time. 

“I felt frustrated because I’d only seen six patients, but I knew that there was a waiting list of hundreds, if not thousands, of people who needed access to my narrow established knowledge and skill,” she shared. “So that immediately took me on this journey of wanting to do things differently to help more people.”

For almost 20 years after, Liz led some of the UK’s National Health Service (NHS) transformation programs, helping to unlock the power of digital health across the UK and Europe. During that time, Liz watched technology creep into the healthcare system, but once again found herself frustrated by the reach it had. She dove headfirst into researching solutions to merge the gap between access to healthcare and technology.

“I met all these amazing companies that nobody had ever heard of and nobody was using, and ultimately got frustrated with the missed opportunity that it presented,” Liz described. “And I thought somebody would have cracked how we connect people to great digital health technologies, that nobody had. And so that became the problem that I got obsessed with.”

In 2015, Liz co-founded ORCHA, which has grown exponentially since, now providing digital health assessment and distribution services in twelve countries and in the UK to organizations in 70% of NHS regions.

ORCHA’s mission is similar to a drug prescription program. “When we prescribe a drug, it’s gone through a licensing process. Would-be prescribers are trained, and they then have access to a formulary,” Liz explained, “which means that a drug is prescribed and then governance is established, risk is managed. And I thought that’s what we need for digital health.”

The difference between a drug and a technology, of course, is that technology keeps changing. So ORCHA is designed to provide an ongoing evaluation, which is proactive every time that technology updates and changes. They assess gaps and how to fix it, whether the app is reaching the right consumer and asking the right questions.

That assessment process is a benefit to both the patient and the product developer. “Because we are continuously reassessing the technology, if a future fault is found, you can do a recall. So your professional liability is protected,” Liz said. “It also allows for reimbursement flow at scale because the system knows it doesn’t matter if one or 1 million prescriptions happen, the system knows. And so whoever’s paying for that technology, we can do the reimbursement through the flow.”

The result means less duplicated effort so healthcare systems can focus on distribution, activation, reimbursement and workforce development to really embrace the technologies.

“New technologies are emerging, but technologies that were established are falling off the market because they’ve not been able to stay viable because that reimbursement flow isn’t always there,” Liz explained. “And as healthcare systems globally, we need to really think about that carefully because if the technology dies whilst it’s waiting to become viable, then we miss the opportunity to have the patient impact, but also to grow the economy to have more jobs.”

Liz argues that while digital health is a global challenge, it’s also a global opportunity. “My passion of wanting to help people doesn’t start and finish with the UK,” she shared. “What’s interesting about the United States is here in the States, you are the highest users of digital health technologies as consumers. Now that’s great, but what we also know from our research is that only 20% of those technologies being used are safe and effective. So you have a bigger missed opportunity.” 

According to Liz, that means nearly 80% of patients are downloading and using unsafe technologies, which can greatly impact on their health. 

“If we can just close that first opportunity gap and then really drive adoption of the right technology for the right person at the right point in their pathway through our healthcare systems, then the impact is just tremendous. And our opportunity to help is massive.”

This conversation was captured at the 2023 ViVE Conference in Nashville. Stay tuned for more exciting interviews from the event.

About Liz Ashall-Payne:

Liz Ashall Payne is co-founder and CEO of ORCHA, the world’s leading provider of digital health accreditation and distribution services. A trained Speech and Language Therapist, for almost 20 years Liz led NHS transformation programmes, helping to unlock the power of digital across the UK and Europe. 

Liz was appointed an NHS England NIA fellow, is a coach for the NHS England Clinical Entrepreneur program and is Vice Chair at the Tech UK Health and Social Care Council.

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