I.

INTRODUCTION

The broad scope of digital health includes categories such as mobile health (mHealth), health
information technology (IT), wearable devices, telehealth and telemedicine, and personalized
medicine.[1]

From mobile medical apps and software that support the clinical decisions doctors make
every day to artificial intelligence and machine learning, digital technology has been driving a
revolution in health care. Digital health tools have the vast potential to improve our ability to
accurately diagnose and treat disease and to enhance the delivery of health care for the
individual.[2] 

Digital health technologies use computing platforms, connectivity, software, and sensors for
health care and related uses. These technologies span a wide range of uses, from
applications in general wellness to applications as a medical device. They include
technologies intended for use as a medical product, in a medical product, as companion
diagnostics, or as an adjunct to other medical products (devices, drugs, and biologics). They
may also be used to develop or study medical products.[3]

Digital tools are giving providers a more holistic view of patient health through access to data
and giving patients more control over their health. Digital health offers real opportunities to
improve medical outcomes and enhance efficiency.[4]

These technologies can empower consumers to make better-informed decisions about their
own health and provide new options for facilitating prevention, early diagnosis of life-
threatening diseases, and management of chronic conditions outside of traditional health care
settings. Providers and other stakeholders are using digital health technologies in their efforts
to: (1) Reduce inefficiencies, (2) Improve access, (3) Reduce costs, (4) Increase quality, and
(5) Make medicine more personalized for patients.[5]

 The use of technologies, such as smart phones, social networks, and internet applications, is
not only changing the way we communicate, but also providing innovative ways for us to
monitor our health and well-being and giving us greater access to information. Together, these
advancements are leading to a convergence of people, information, technology, and
connectivity to improve health care and health outcomes.[6] 

II. EVALUATIVE DISCUSSION

Nowadays we are living in an innovative world where technology has been a part of our daily
lives. From schooling, researching, and communicating, this technology makes everything
convenience for the people. Even in health services can be reached through technology such
as applications which can be used anytime. These applications, though not considered as
medication, are very helpful since it can save lives by helping young people to be well and
stay well. One of the applications/tools that has been helping many people across the world is
Anxiety Reliever (AR) which helps user to relax, overcome anxiety and stress, and fall asleep
faster. Another is the Self-help for Anxiety Management (SAM) which offers a range of self-
help methods that help users manage anxiety. 

Anxiety Reliever

The primary objective of this tool is to relax, overcome anxiety and stress and fall asleep
faster with the help of Anxiety Reliever. To Immerse the user in a relaxing, supportive and
soothing environment.[7]

This tool was launched in 2016 which was the first version they released. It has been
operating for five (5) years already.[8]

Here are some of the reviews on the application (user feedback) based on their experience
on using the application. Some were satisfied but some were quite unhappy given the fact
that it is costly since some of the audio recordings require payment to be able to download it.
Also, it can be convenient and inconvenient at the same time for the users because it is an
audio-based application.[9]

“Simon DuBoisHEALTH PRO”

Psychologist
Be aware there is a cost to use this app. I like the fact it's audio based, not text. The cost-free
components of the app like the tracker and the breathing tool can be found in other apps.

I couldn't find any information to suggest that ASMR or binaural sounds are harmful. I like the
fact the app developer appears to be a young person herself which may give some appeal to
other young users.”

“Anonymous Review”

 I liked...

There is an anxiety tracker which could be useful. It think it could be developed to be a bigger
part of the app or an app in itself.

 I didn't like...

The colours blend together a bit which makes it hard to see. The info is audio rather than
written which is inconvenient. It seems like there were ideas for 3-4 good apps that were
crammed into 1 which makes each feature not that good.

Self-help for Anxiety Management (SAM)

SAM (Self-help for Anxiety Management) is a mobile phone app that provides self-help for
anxiety management. Launched in 2013, the app has achieved over one million downloads
on the iOS and Android platform app stores.[10] It offers a range of self-help methods that
help the users manage anxiety. It has been developed by psychologists and provides 25 self-
help options on anxiety, relaxation and health. Users are encouraged to use the resources
and tools in SAM to build their own anxiety toolkit that will help them cope when they are
feeling anxious.[11]
This app helps users learn about anxiety and practice self-help techniques to manage it.
Users can keep track of their anxiety levels and the things that make it worse. The self-help
section offers a variety of tools such as breathing exercises, muscle relaxation exercises,
meditation, thought exercises, games, and tips. Users can add their favourite self-help tools to
an ‘anxiety toolkit’ for quick access. (https://www.healthnavigator.org.nz/apps/s/self-help-
anxiety-management-app/)

Reviews:

“Dr Michael Carr-GreggHEALTH PRO”

Psychologist

The app is very user friendly for general anxiety. The picture and popping exercises are very
helpful. It’s also good that the app has been developed in collaboration with a research team
from UWE, Bristol. It helps clients to understand what causes their anxiety, monitors their
anxious thoughts and behaviour over time, and manages their anxiety through self-help
exercises and private reflection. However, there is no diary function, no cloud moderation, and
no help for panic attacks. It’s a very good app, but I can’t find any peer review studies on
RCT’s which is disappointing.”

Both tools/applications are helpful in a way that it improves the mental health and well-being
of the users especially of the young people. An independently peer-reviewed study that
explores how young Australians engage with ReachOut and how the service has impacted
their mental health, A Measurable Impact presents the findings of a longitudinal study that
surveyed approximately 2000 ReachOut users aged 16–25 over a three-month period. The
study showed: (1) an improvement in mental health, including a significant reduction in
symptoms of depression, anxiety and stress, (2) reduced suicide risk, (3) an increase in help-
seeking behaviour, (4) 90–95 per cent of participants rated their overall experience of
ReachOut as ‘good’ or ‘excellent’, (5) 82 per cent of participants agreed that ReachOut is
relevant, (6) 87.7 per cent of participants said it was available and accessible.[1]
ReachOut helped users by improving their understanding of their own experiences of mental
health and wellbeing, as well as the experiences of others. It also provided practical strategies
and tools to support their mental health, connected them with others, and made them feel
more positive about themselves.[2]

A second longitudinal study – the Check-In Study – was launched in late 2019 to explore in
greater detail the mental health impact of our service for the young people who use it.[3]

We’re following a cohort of over 300 young people for a period of three months and checking
in with them weekly to learn about their lived experience of mental health issues and their use
of ReachOut, to see how their wellbeing is tracking over time. We’re collecting their onsite
browsing data, so that we can connect their use of ReachOut with their mental health
outcomes and better understand what works, and for whom. The study was co-designed with
young people and academics from the University of Western Sydney, the Australian National
University and the University of Sydney.[4]

Privacy Policy

Both tools ensure that the data of the users will not be transferred to an organization or a
country that moment it collects the Personal Information / Data of the user. Upon registering
to use the tools, it requires Personal Information such as the name, username, passwords
(encrypted), and e-mail address. Further information might be needed for the delivery of
additional product and services.[5] For example, in Anxiety Reliever app, some audio should
be purchased before the user can fully use it. By purchasing, the user is required to input
additional personal information to push through with the payment. Same with Self-help for
Anxiety Management, it also collects personal information when the user creates an account
on the application, voluntarily makes contributions or statements on the application, or when
the user emails or contacts the application provider. [6]

For AR, its primary goal in collecting personal information is to provide the best service
possible through its services. The majority of information that is collected about you is for the
purpose of verifying contact information, delivering requested information and responding to
your inquiries.

Legal/Regulatory

Ethical Considerations are accumulation of values and principles that address questions of
what is good or bad in human affairs. Ethics searches for reasons for acting or refraining from
acting; for approving or not approving conduct; for believing or denying something about
virtuous or vicious conduct or good or evil rules.

(Australian Law Reform Commission and Australian Health Ethics Committee, Protection of
Human Genetic Information, IP 26 (2001), ALRC, Sydney, 106.)

The language in which ethics is expressed includes two distinct types of statements. Ethics
contains statement about what is good or bad, what ought or ought not be done and the
grounds for those assertions. For instance, researchers ought, ethically, to seek consent from
people to use their genetic information in research because doing so respects their autonomy
and freedom to choose. Or, on the other hand, researchers should be free to use coded
genetic information in research without consent because that will enable more information to
be used and better research to be conducted. As a result, all members of society, including
those whose information is used, will benefit. These statements are often called normative
statements—they are statements about how, and why, people should behave.

In connection with the tools/applications in this study, it goes to show that both Anxiety
Reliever and Self-help for Anxiety Management follow the ethical principles in the Australian
concept. The applications only collect information that is general such as the name, email
address and/or password of the user. By this, the user consented to give their information to
make use of the applications. The only time they may be allowed to use the information of the
user is when there has been a merger or sell off of the company in which case, the
information of the users shall be transferred to the buyer company or corporation. Also, as
permitted by the laws of Australia.
[1] ReachOut.com. Our Impact. https://about.au.reachout.com/our-impact last accessed,
October 17, 2021.
[2] Id.

[3] Id.

[4] Id.

[5] Anxiety Reliever. Privacy Policy, https://anxietyrelieverapp.com/privacy last accessed         

October 17, 2021.

[6] SAM

[1] U.S. Food and Drug Administration. September 22, 2020. What is Digital Health.
https://www.fda.gov/medical-devices/digital-health-center-excellence/what-digital-health last accessed,
October 17, 2021.

[2] Id.

[3] Id.

[4] Id.

[5] U.S. Food and Drug Administration. September 22, 2020. What is Digital Health.

https://www.fda.gov/medical-devices/digital-health-center-excellence/what-digital-health last accessed,

October 17, 2021.
[6] Id.

[7] ReachOut.com. Anxiety Reliever. https://au.reachout.com/tools-and-apps/anxiety-reliever last

accessed, October 17, 2021.

[8] ReachOut.com. Anxiety Reliever. https://au.reachout.com/tools-and-apps/anxiety-reliever last

accessed, October 17, 2021.

[9] Id.

[10] ReachOut.com. Anxiety Reliever. https://au.reachout.com/tools-and-apps/anxiety-reliever last

accessed, October 17, 2021.

[11] Id.