March 27, 2013

Don’t Be An Apphole.

Don't be an apphole, yo.“What diabetes apps do you use?”

I am asked this question all the time, especially now that entire conferences are being geared towards mobile health, honing in on the fact that more people have mobile phones than access to toilets.  (This is true, or at least according to the fact I saw on Time.  A phone but no toilet?)  “Mobile apps to manage diabetes – isn’t it exciting?  What are the ones that you’re using?”

Last month, I spoke at the Kairos Summit in NYC about mobile health and the app-frenzy in the healthcare sphere.  I felt kind of like a tool, though, because I don’t use any mobile apps to manage my diabetes.  There are a few that I use to track other health habits (like sleep and exercise – see this post for health applications I am using that aren’t specific to diabetes), but as far as ones aimed at my pancreas?  None.  

Why?  Because I haven’t found one yet that’s useful.  Applications to log my blood sugars?  I tried that … actually, I’ve tried that several times over.  Even the savviest mobile logbook still requires me to open the app, enter the blood sugar, and save it to their system.  It doesn’t sound like a big time-constraint, but for someone who uses a glucose meter that isn’t synced up with my phone, it’s a big extra step to make every time you test.  Personally, I’d rather plug my meter into my computer and suck the results off it that way.  

And as far as food management, as it pertains to diabetes, I don’t use a carb counting application or a food diary.  The food apps I use are more along the lines of Yelp, letting me know about ambiance or price, not the grams of carbs in the main entrees.  

I think I'm a mobile curmudgeon.  Most applications that are geared towards diabetes seem useless and cumbersome to me, and I just want them to get off my lawn. (And to turn the music down and to get their hair out of their eyes.)  Every diabetes app touts itself as the newest and shiniest way of paving the road towards an A1C of 6%, but I haven’t seen one that’s better than the consistent use of my glucose meter and CGM.

You know what I’d like?  I’d love an app that:
  • Automagically sucks the results from my meter and CGM and pump and stores them as one, single document that gives me all my numbers at a glance.  And it would require nothing more than Bluetooth (or, at the very, very least, one single cord that worked with all three devices.  A magical cord.  A uni-cord [mega-hat tip to Scott and George for "unicord."])
  • Counted carbs for me by way of simply snapping a photo of the food on my plate.  (CarboGRAM instead of Instagram?)
  • Synced up with my Dexcom and texted a loved one if my blood sugar dips into hypoglycemic range
  • Stored a list of my medications and kept track of interactions, keeping me safe from taking drugs that would interact dangerously with one another
  • How about one that rewarded me for good health habits, even when my numbers aren’t cooperating?  I want big, inflatable arms to come shooting out of my phone every time I admit that I tested my blood sugar, and the arms could give me a big hug.  Even if the number is shit, I’d still be given huggy props for testing, and for reacting to that number.   Or if big, inflatable arms aren’t an option, I’d settle for a .gif of cats drinking iced coffee.  (I did find a video, though.  Go, Cuddles!)  (And in a further aside, there are apps being developed along these "reward" lines, which I think is awesome.  Positive reinforcement is at a minimum in daily diabetes, and all efforts are appreciated.)

I'd just love something that contributes to an ease of diabetes management, not something that adds to this already-daunting to do list.  It can be done.  There can be a mobile solution to all of this data management.

If you’re creating a health app for a patient population to benefit from, actually talk to them and find out what might be useful and improve their health outcomes. App developers, don’t just make an app for the sake of having an app.  Make one that’s useful, that actually fills an unmet need for the patient with diabetes (not just the unmet need of your company needing to have an app for something).  For real.  Don’t be an apphole.

March 18, 2013

App Your Face.

There's an app for that!  An app for that!  An app for thaaaaaaaat!

There being an app(lication) for everything is an infuriating concept, because so many apps are developed purely for the sake of having an app, and not because the app is filling a need, or is useful.  I've done a lot of listening, and presenting, at mobile health conferences, and listening to people talk about their bright, new shiny application can be frustrating when it's development/execution doesn't take into account the needs of people who actually use it.  (I think of the people who create apps just for the sake of having an app "appholes.")

But that's an app rant for another time.  Today, it's about apps that are useful to me, and not ones that are clearly created just so a company can check the "we have an app for ... something" box.

RunkeeperFirst one?  Runkeeper.  I have used Runkeeper for the last few months in efforts to keep tabs on my exercise efforts, and to track progress.  When it comes to the motivation to exercise, sometimes it's not enough for me to mentally high-five myself for taking the time to keep my heart healthy or my blood sugars stable.  I like seeing the miles I'm logging, and the pace I'm setting, as part of what motivates me to give exercising a go the next day.  Runkeeper lets me set goals (like "Bike 500 miles by X Date", even though I'd love to be able to specify that goal, maybe with "Bike 500 Miles and Don't Tip Over by X Date") and track my progress towards those goals. 

I like seeing the totals climb.  Makes me feel like I'm doing something productive.  And, conversely, when I was healing from my tendonitis injury, I used the Runkeeper app to log low long it took me to recover, and to log what exercises irritated my ankle more or less.  Adding some of my friends from the DOC has helped, too, because there are folks on there who motivate me to keep moving, purely because I see that they also got their exercise on that day. So this app is useful, to me at least, because it motivates me to get off my arse.

Sleep CycleSecond one?  Sleep Cycle.  I blame the use of this one on one of my coast-to-coast traveling friends, who told me that he sleeps better and wakes up more refreshed using the Sleep Cycle alarm.  Every time I try to explain what this app does, I stumble through my attempts.  "It wakes you up when you're, like, mostly almost awake. When you're sleeping lightest?  It grabs you then."  The description offered by the site is a bit more streamlined:  "A bio-alarm that analyzes your sleep patterns and wakes you when you are in the lightest sleep phase."

i set this app when I go to bed at night, tuck the phone up at the top of our bed, and it wakes me up within 30 minutes of my set alarm time, using tones that are gentle (instead of the jarring ENT ENT ENT noise [not the trees in LOTR /digression]).  About 75% of the time, the alarm is fine and I have noticed that, while traveling, waking up without being jolted from bed is a helpful bonus, particularly when I'm out of my own time zone.  However, the app hasn't figured out that those moments when it thinks I'm in "deep sleep" are actually times when I'm sitting up and treating a low blood sugar or out of bed consoling a nightmare-roused toddlerbird.  But it does track the hours I've slept and the assessed quality of that sleep, and that's helpful when I feel completely drained and then see that I've only slept 10 hours in two days. 

This week, I'll be checking out the Training Peaks app and the one for FitBit.  I still haven't found a diabetes-specific application that I'd use every day, but health and fitness apps speak to diabetes health overall, so these two technically count, right? 

What apps do you actually find useful in your day-to-day quest for health?  Are there ones you love?  Ones you loathe?  Ones that bring you flowers and trim your split ends?  Bring it.

February 18, 2013

Guest Post: The Effect.

I've seen mentions of this service in different parts of the DOC (like over at Scott's blog house, and Kim's, and then over at the New York Times).  I've done some research on their company, and for people who don't mind having the location services, etc. turned on for their phones, it's an interesting way of collecting data to provide insight on health habits (although for me, I'm not so much about sharing every data point of my day).  So when Peter (the account manager for contacted me to see if he could help spread the word about this data-driven service, I was happy to help. Mostly because after talking to Peter and telling him that I didn't want to post a "call for participants!" but instead wanted to share some of their more altruistic company mission-type stuff, he was happy to oblige. 

Here's a little bit about who the people behind are, what their mission is, and how you can get involved, if you want!

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Ginger, E I E I O

Kerri, thanks for letting us speak to your readers!  I wanted to start by explaining why we describe ourselves as “a small startup on a big (data) mission.”  As a company, and as individuals, we are all committed to changing the healthcare system and improving patient experiences.

Each of us has our own personal story of interacting with the healthcare system, and a reason for dedicating ourselves to this cause.  For our co-founders Anmol and Karan, even though they grew up halfway around the world from each other, it was the shared experience of seeing the impact of poor health information and decisions on their families and communities.  They would later meet at MIT, where Anmol, a PhD in computer science, had developed expertise in modeling human behavior patterns, and Karan, a MBA, had a deep knowledge of the health care system.

The two connected over their shared interest in helping people make the connection between actions and health outcomes.  What began as a “Daily Data” app turned into a platform for helping people living with chronic conditions by providing a check engine light for their loves ones.  An early version of the app, focused on helping people living with diabetes learn about and share how their behavior affected their health, and won Sanofi US’s 2011 Data Design Diabetes Innovation Challenge!

As a follow up to the Innovation Challenge, we have partnered with Sanofi US to provide a limited number of opportunities to use our app to people with type 2 diabetes.  It’s free, secure, and is an innovative way to keep track of how you’re doing, because it focuses on overall well-being.  The app collects active data, from mood surveys you fill out, and passive data, based on how you use your phone. The more behavior data we collect, the more accurate our map for type 2 diabetes becomes. This means that your participation doesn’t just improve care for you. It contributes to science and improves care for other people like you.

So how does it actually work? Our platform uses the sensors already in your smartphone to collect general data around your movement and communication patterns — with minimum effort from you.  All we ask of participants is to answer a few questions every few days to supplement the data being collected from your smartphone sensors.  

For the first two or three months, we’ll focus on collecting data and learning how your condition affects your behavior.  Once we have your behavior baseline, we’ll start delivering personalized health insights and allow you to better connect with your care team by alerting them when something seems out of place.

Those interested can learn more about and/or sign up to get started!  

If you have any further questions you can also reach the team by emailing 

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Questions for the team?  Leave them in the comments or email their team!

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