Lycra-clad Tom Denwood, Executive Director at the Health and Social Care Information Centre and BCS Health Vice Chair (Policy and Strategy), examines the cycling, the health and wellbeing apps phenomenon.

Whether it’s thanks to Wiggo and his sideburns for winning the Tour de France and Olympic Time Trial in 2012, the successes of Team GB in the Velodrome, Chris Froome’s Tour de France win in 2013, London’s Boris Bikes, or just a convenient and healthy form of transport, cycling appears to have slipped into the national consciousness. Many say it’s the new golf.

For both professional cyclists and MAMILs (Middle Aged Men in Lycra, in case you didn’t know) alike, there is a social app called Strava that’s taking the nation by storm. Founded in 2009, and headquartered in downtown San Francisco, it lets athletes all over the world experience social fitness - sharing, comparing and competing with each other’s personal fitness data via mobile and online apps.

A powerful training tool that allows users to record routes, examine performances and track milestones, Strava makes fitness a social experience, providing motivation and camaraderie even if you’re exercising alone. All you need to do is register online, and either download the smartphone app, or upload data onto it from a GPS device.

Michal Kwiatkowski, the current World Road Race champion, won the famous Amstel Gold Race held in Holland on 19 April 2015. He posted his race on Strava for all to see. You can go online and see it took him 6hr 32minutes to ride the 259km, he burnt 8,686KJ, climbed 3,669m, and had an estimated average power output of 369 watts. He also hit a maximum speed of 83.5km per hour - a truly spectacular performance.

For the amateur cyclists, part of the thrill of Strava is being able to create and log routes (known as ‘sections’) - anything from a 312km lap of Majorca, to a 30 metre sprint in Maidenhead. All riders who then cycle that section (evidenced by GPS data), have their time registered against it, and entered into a league table.

Those who go fastest, become the coveted King of the Mountain (KoM) or Queen of the Mountain (QoM). More KoM/QoMs mean greater credibility, and a chance to get kudos and comments posted from those who follow you.

Michal Kwiatkowski achieved 94 KoMs from the Tour of Britain last year, including taking a mere 3mins 59s up Ditchling Beacon (the 0.9mil, 9.4 per cent average gradient) near Brighton - the feared hill from the London to Brighton charity bike ride. Try to beat it (if you dare).

If you are part of a cycling club you can register a team and track your club mates on leader-boards. And it’s not just a UK cycling community, Strava CEO Mark Gainey last year announced it had gained £12m of private equity investment to grow its increasingly global user base.

It is always developing new functionality, whether it’s an app for the Apple Watch, Achievement Awards, the ability to relive your 2014 cycling year with a Strava Story video for 2015, and challenges such as riding 500km between Christmas and New Year.

Strava tries to convert members to use its premium service, that allows access to ‘more ways to stay motivated, train effectively, and have fun’ such as training plans, goals, personal heat-maps to visualise the ground you’ve covered, high-intensity/low volume training videos deviously crafted by The Sufferfest, and more.

It also has its disadvantages, as Scottish Liberal Democrat leader Willie Rennie recently found to his peril. After forgetting to switch his app off after a ride, and getting in his car, he was then recorded driving at over 80mph down the M90, Britain’s most northern motorway.

Of course Strava isn’t the only app aimed at cyclists - there’s also Wahoo Fitness, Map My Ride and Cyclemeter, and a similar range for other apps for other sports.

Health and well-being apps agenda

Strava would be categorised as health and wellbeing apps by UK health experts. In November 2014 new plans to improve health outcomes and the quality of patient care through digital technology and innovation were unveiled by national health and social care organisations.

Established by the Department of Health and chaired by NHS England’s National Director for Patients and Information, Tim Kelsey, the National Information Board set out a vision for how technology should work harder and better for patients and citizens by 2020, for not only when patients are ill, but to prevent illness via improved health and well-being.

The plans also include NHS kite-marks for trusted smartphone apps, which will help patients access services and take more control of their health and wellbeing from 2015.

Whatever the colour of government post general election, technology will play a vital role in helping contribute to the £22 billion in efficiency savings needed to sustain the NHS, as set out in the NHS Five Year Forward View. The consensus around the National Information Board vision should also ensure the proposals survive the test of time.

At the same time as these policy developments, smartphone adoption rates are high and increasing with 62 per cent (2014) of UK adults using a smartphone - an increase from 54 per cent in 2012. NHS Choices, the largest health information website in Europe, receives 60 per cent of its traffic from tablets and smartphones.

Having a computer in your pocket (or wrist) is significant - providing the capability to monitor status, activity, habits and to interact (e.g. blood pressure monitoring and fitness tracking either directly through the smartphone or by linking to other devices, such as wearables and biometric sensors).

In response to the market opportunity there has been rapid innovation of apps in healthcare with the number of apps available reaching in excess of 100,000 in the Apple Apps store alone. Growth in health-related apps is exponential. Health and wellbeing apps are by far the biggest category with only a fractional number of apps relating to personal health records, managing long-term conditions or medical interventions.

With the market dominated by two platforms - Apple / iOS (28 per cent) and Google / Android (60 per cent) and recently there has been a considerable and more serious move into the health market with Apple releasing HealthKit, a new tool for developers.

HealthKit enables the integration of health and fitness data stored on the mobile device with third-party ‘apps’ (e.g. GP system vendor EMIS uses HealthKit to link citizens smartphones to a cloud-based personal health record that can be viewed by a GP at the point of care).

These market conditions create massive opportunities for the UK to change the way in which care is delivered. However, with these opportunities there are significant challenges and risks. The health apps market is largely unregulated.

As the barriers to developing and releasing certain apps to market are so low, the number of apps becoming available is accelerating and their average quality is poor in many cases - bringing significant risk to patient safety.

Moreover, there is a lack of evidence to support their effectiveness and efficacy. For example, an academic review in 2013 shows a comparison of the evidence vs. popularity of 47 smoking cessation apps. The most concerning finding was that the most popular apps were the least effective.

James Butterworth, a graduate of the recent BCS Healthtech Startup School, has developed the app Trackmeo, an app designed for people with or at risk of cardiovascular disease such as hypertension (high blood pressure), coronary heart disease, cerebrovascular disease (stroke), peripheral artery disease, rheumatic heart disease, congenital heart disease and heart failure.

TrackMeo helps users to monitor key factors related to cardiovascular health such as symptom log, medication, blood pressure, weight, activity and sleep tracking and integration with various Fitbit devices. It aggregates the data entered by the user with that collected from wearable fitness devices and wireless monitors.

This data allows patients and their healthcare professionals to make collaborative treatment plans based on lifestyle data, thus helping people with cardiovascular problems to live longer, more empowered and healthier lives.

So the more MAMILS we can have using Strava to get fit, and the more effective cycling and health-related focus, the better the long-term care, and less pressure on the NHS.

About the author

Tom Denwood is the Executive Director at the Health and Social Care Information Centre, the data and technology partner of the health and care system and BCS Health Vice Chair, Policy and Strategy. Many thanks to and