I think that the number one issue still facing our app is....

The app itself.

Although we can make the app look good in marketing aspects, I feel that our app needs a way to "hook" users.  Some aspect of our app must provide more convenience, more value, and find a way to be either number one or number two in our field. 

Right now our health promise application vs. other apps is not really bringing anything to the table that other apps are not doing right now.

One thing that I think that our app can and should do is provide a way for users AND health professionals to easily import, export, input, and update their data from other devices. 

We should also find a way for our application to meld itself into other applications, preferrably those with larger installed user bases.

By creating strategic partners we can have more stakeholders working with us to create success.  However we must be uncompromising in creating a high value product on our own that provides unique value that others cannot duplicate.

I believe that we should rather than try to be everything for everyone that we should focus on a niche and do that spectacularly.  Perhaps we can create a code to automatically interpret data and then put it into the apple healthkit database in a manner which will be intuitive, and precise. 

In one of our meeting it was mentioned that body parts are given a code.

Our strategic partners can be given this code in return for a complete comprehensive product which is greater then the sum of its parts.

Recreating in a different format code that already exists seems redundant, and if we are not doing it better then the rest of the market, then it is unlikely that our product can succeed, even with the best of marketing.

However it is not just a case of if you build it they will come.

Some ideas I had to market product is that as mentioned near the beginning of my internship we could engage in strategic alliances with insurance companies to offer discounts on premiums for people that are regularly updating their app with quality information.  Some research showing a correlation between patients that are actively involved with tracking their own health progress and lower overall health costs can provide a way for us to justify a certain amount of fund requisitioning from these groups.

Aetna Carepass is already invested in this field and looks like a decent strategic partner right off the bat, however the development of our own in-house apps which serve to perhaps even compete with their existing offerings could be problematic.  Perhaps we can work with this organization more intimitely to find out what aspects of their own applications they need help with. 

As for moves we could make to start marketing products, one thing we could do is to have a subscriber contest on our facebook page... for example what we could do is to say that people that subscribe a friend get a free entry to win an iphone 6.  However this move is not good unless we have a top tier product.

  

Trust takes time.  ESPECIALLY if you are promoting a commercial product!  We must be sure to create value everytime we interact with our clients.

Online the key to building trust within smaller niche communities is by providing high quality content.  

Since I'm coming to the POSSIBLE end of my internship on this project, I'm starting to look at how to keep this part of the project going after I leave.

If someone does not continue to produce quality content amongst the crohn's online community, then we will have to rely merely on brand recognition and reviews in the google store.  Name brand recoand our efforts will have been in large wasted.

It would be great to find if someone near to this project is either blogging or some kind of information gathered from patients is easily able to be published.  Perhaps we can even use intern blogs and promotion thereof to continue to generate content which will be found by web crawlers.  

If we do this we should make sure that all of our content meets certain minimal criteria for quality, our content should be clearly branded making it clear what our products are and what function they serve and ideally we should maintain some level of Search Engine Optimization (set metatags, intelligent titles, and so forth.)

I also believe that for as long as we can do it we should make an effort to allow users to interact in some way with each other and with us.

This type of thing should  get customers invested and help build brand loyalty.

An update on the forums

CCFA actually makes GI Buddy.  And?  No responses to the original post.  Furthermore, checking the forums it seems that there is a 4 day gap between a post placed yesterday and the previous post.  It seems that this forum does not have a good amount of traffic and contributors.


Crohn's forums which looks to be the best forum actually deleted my post due to the seemingly commercial nature of my post.  After an email exchange with one of the admins verifying the authenticity of our organization my post was retitled and reposted at this link.  My account was also changed to be given special permissions to post question of this nature which requires admin approval.  We received some feedback which I used to compile my following report.

The Healing Well forum is actually looking for a Crohn's disease moderator, and this could be a special opportunity for our lab to gain instant credibility with this subset of the population.  The link to the admin request is here.    
We received some feedback which I used to compile my following report.

Testing existing apps

GI Buddy - reviews on this app are not good... Many people complain that this app doesn't work correctly and is in actuality non functional.  For me however the app worked fine.  I do however agree that it is annoying to have to log in each time.  Also I found that the food diary had some odd entries.  For example when looking up chicken breast, there was an option to select raw chicken tenders.  (Seriously... Who's eating raw chicken tenders?)  NOTE:  This morning I tried to load GI Buddy, but it got frozen on my screen.  I did a hardware reset removing the battery and replacing it back in and the app once again would not load.  FAIL!

GI Monitor- reviews on this app are much better, also I like that they have made an introductory video for their product.  It seems better supported and better developed then GI Buddy.  This product was sold to Medivo, so it's interesting that a developer saw fit to purchase an existing app rather then actually develop their own from scratch.  This reiterates my former statement that we may be able to garner value from purchasing or building strategic partnerships with other app developers to provide a high quality product to our patients/ customers.

I will continue to update with more apps as more apps are recommended.  Some apps are recommended which are not dedicated health apps such as daily diaries which some people are using to track their symptoms.  However as this is not part of an apple healthkit like ecosystem, I didn't really mess around that much with those apps.  However I did look at some of the feature sets and used this information to provide recommendations for our app.

APPS that I looked into that weren't GI related, but health related.

For diet trackers, my two favorite diet trackers are Sparkpeople and Myfitnessbuddy.  
One odd thing though is that these apps give me different calorie totals although I've logged in the same foods.  I guess that there's a certain amount of variance, but it is a little confusing.  
For fitness trackers my favorite app was JEFIT.  

My FAVORITE functionality which I found on JEFIT was the ability to sync my data with their website.  This way notes or exercise routines that I would want to develop but which would be awkward to input via a mobile device could be addressed through using my regular computer keyboard.

Also at each point where I enter data I am given the option of tracking my progress.

Also both Sparkpeople, Myfitnessbuddy, and JEFIT all save inputs and then actively use this to make data entry easier and faster.  For example JEFIT will remember how many reps, sets, and how much weight I did for my last workout and will auto fill with an input swipe system to move the numbers up or down.  So if last week I did 10 reps, and this week I did 12 reps all I have to do is swipe up a little and hit save and my numbers are in the system!  The food trackers save , "Favorite foods." which makes entering food items less repetitive.  For our app we should look to do something similar.

I also looked at 
Fitness Buddy Free  which is a program that just shows pictures of a variety of different exercises.  The  functionality of this program does not seem to bring any value that I could not get off of youtube, so I'm not a big fan of this app.
Sports Tracker is very cool for people that run.  It uses GPS and location tracking to measure how far you've run, and then allows you to share you route time and distance with your friends.  However I don't really run on the street really that much at all, so this app really isn't relevant for me.
Strong Log is a very bare bones app that just allows you to record your "Power lifts" or the 3 major compound exercise movements used in power lifting which are squat, deadift, and bench press.  It's just not enough content to keep my interest however.  and  
Gymwolf which is a fitness app like JEFIT, but just a little less better done.  

http://www.ccfacommunity.org/crohns-colitis-forum
http://www.crohnsforum.com/
http://www.healingwell.com/community/?f=17

For each of the above forum websites I created a user named:
Health Promise
The password for this account will be shared with the team.

I created a post on the board with the title and message as follows:

Subject:
Does anyone use any of the iphone or android apps to help keep track of their diet, exercise, and symptoms and treatment?

Message:
Does anyone use any of the iphone or android apps to help keep track of their diet, exercise, and symptoms and treatment?

If you have can you tell me why you liked them or didn't like them?

Also if you could let me know the name of the app and for which platform they developed the app for I would appreciate it!

Thank you!

Here are the links to the posts:

http://www.ccfacommunity.org/Post.aspx?Forum=11&Thread=11207
http://www.crohnsforum.com/showthread.php?p=803695#post803695
http://www.healingwell.com/community/default.aspx?f=17&m=3149279

crohns forums seems to show the most active users.

Some more quality posts should probably go up creating recognizable content.

More to come.

ADDED Note 8/6/2014

We've generated responses!

So I looked at the app GI Buddy and decided to give them a little further examination.

The most obvious place to start looking for feedback is the review section on the apple website where customers have rated this app.  The link is provided here.

But not that much information is available, so I went to check out GI Buddy's comments located on their google play app page.

It seems like there are a few general overall high star ratings (probably from friends, or fans) and then there are a great deal of specific criticisms where users specifically mention that many parts of the app do not function correctly.
The app developer may have rushed this product to market

This should serve as a cautionary tale, and we should be sure that when we release our app that we are always providing our customers with a high level of value, and that every interaction with our app is functional and will garner immediate value.  Creating a poor app will damage our brand, and engender less trust from potential partners.  

A recurring theme that comes up amongst complaints with gastro related apps is that users often encounter difficulties working with  food diary applications.  (I don't think that our app even has a food diary tracker)  Primarily issues complained about seem to come mainly from the cause that  apps do not have specific food choices available or in useable masurements that the consumers can easily use.
It seems like too much work to do this part of the app well.  I think it's probably better to just license or join in on a strategic partnership with an already existing app.
Here is a list of the top 5 best food and nutrition tracking tools according to lifehacker.com


It seems that MYFitnessPal has a strong presence in the market as well as one of the largest food databases.  Also they have a large installed userbase, so if we can offer a highly technical installed user base  a chance to user our app, well this seems like it could work well.

Aetna Carepass or Apple Healthkit?

Well from an enterprise solutions it looks like the school's servers are not Apple based, so we are unlikely to see any benefit from using Apple generated data  in an Apple native environment.

Aetna's Carepass you can tell that the management is real serious about getting the app out and getting it right... BUT

Yikes!  The reviews about aetna's carepass are not good!

I will just copy over some words that jump out.

One user wants there to be a better privacy feature setting.  It' easy to add a screen lock feature where patients can decide to lock out the phone after a certain time, or close down the app after a certain amount of inactivity.
There was a complaint about how the app doesn't scale down well for mobile app usage, and there were several complaints about the clunkiness of the interface and how the app required multiple logins.

This complaint was prophetic for when I tried to present the app during my meeting with the rest of the team this turned out to be an issue.  

Also the reason for  using an interface to deal with the stand alone apps is apparent from me after doing research on this topic, but the benefit for the hassle is never made to the user, and no real value for using the app is made to the user.  I'd be shocked if really anybody was using this app with regularity at all.

The product is less then the sum of the parts!
Aetna Carepass needs some real work!

My latest assignment

is to create an identity amongst crohn's disease community blogs and so forth so as to build trust and communication with the IROQ brand.

http://www.ccfacommunity.org/crohns-colitis-forum
http://www.crohnsforum.com/
http://www.healingwell.com/community/?f=17
these are some forums that I will be attending to this weekl.


As for the "face" of our current app, I was thinking perhaps the app could wiggle it's smile or wink occassionally to just further let the user see the "face" in the app.  The first thing he eye sees is motion, so adding a component of some motion could make the app more attractive.

http://www.cs.cmu.edu/~rahuls/pub/cvpr2010-food-rahuls.pdf



Additional apps for reading

But we can't judge just based off of these reviews for anumber of reasons.
Apple would be a direct competitorin this space, so to trust reviews on their site just isn't the best idea.  Also as this is a relatively new field and space what are the alternatives?  While the criticisms may be informative, even justified 
http://www.healthleadersmedia.com/page-1/TEC-293967/Seeking-Patient-Engagement-Payer-Curates-Mobile-Apps
http://mobihealthnews.com/15324/why-aetna-acquired-itriage-app-maker-healthagen/#comments
http://mobihealthnews.com/25909/mobile-health-ceos-look-back-on-acquisitions-forward-to-new-features/
http://en.wikipedia.org/wiki/Aetna
http://www.emrandehrnews.com/tag/www-carepass-com/

https://developer.carepass.com/blog

According to an article by ebizmba.com data from July 14th generated via Alexa  (an internet crawler that measures web traffic) claims that The top 15 most popular social media websites are:

1. Facebook with 900 million monthly users
2. Twitter with 310 million monthly users
3. Linked In with 255 million monthly users
4. Pintrest with 250 million monthly users
5. Google Plus with 120 million monthly users
6. Tumblr with 110 million monthly users
7. Instagram with 100 million monthly users
8. VKwith 80 million monthly users
9. Flickr with 65 million monthly users
10. Myspace with 42 million monthly users
11. Meetup with 40 million monthly users
12. Tagged with 38 million monthly users
13. Ask.fm with 37 million monthly users
14. MeetMe  with 15.5 million monthly users
15. Classmates with 15 million monthly users

According to this article published on mashable from October 28, 2013, almost 2/3rds of a year ago, Facebook had about 100 million less individual visitors.  
And visiting Alexa's website we can see that 

the amount of web traffic visiting classmates.com is actually on a decline.

Myspace.com is also suffering from a decline in membership.  Does this mean that social media is undergoing a period of consolidation?

Looking for relationships in the data.
Pintrest graphs for Instagram and Pintrest are showing increased levels of visitors, and they both have very similar content creation mechanisms.  They are mainly driven by pictures which are very quick and easy ways to create content to share.  
However Flickr is showing decreased # of visitors and is also driven by photo based content.

So once again we see that in this subset that the top sites are gaining visitors while the bottom sites are losing visitors. 

Since the power of a social network is in the installed user base it makes sense that as a social network loses popularity that it would result in a snowball effect as users seeking a better and more dynamic content experience would flock to a more popular social networking site.

A major difference between this general data when applying it to our situation.

Although a particular social networking platform may be right for the general public it is possible that a niche audience such as those seeking help with Crohn's disease might tend towards a social network that does not conform to that of the general population due to demographic differences, a large installed user database and quality of information on one social network vs. another etc.  Any attempts to use social networking would probably ideally use a multi tiered approach utilizing several different social networking platforms at the same time.

Any time that a multi platform campaign is launched it is important to create a consistent experience and message for visitors.  So it is important to make clear what the goals and mission of the campaign is for right away.  The message should be intuitive, and simple enough to be clearly expressed so as to engage the visitor before they click away to another website.

In building a user base to consume web content it has been clearly established that content is king.  In fact this idea was espoused in a famous document by Bill Gates in 1996 which can be read in full here. I have chosen exerpts and made them red along that I think are most relevant and placed them below along with my own comments in blue.

Content Is King – Bill Gates (1/3/1996)
Content is where I expect much of the real money will be made on the Internet, just as it was in broadcasting.

If people are to be expected to put up with turning on a computer to read a screen, they must be rewarded with deep and extremely up-to-date information that they can explore at will. They need to have audio, and possibly video. They need an opportunity for personal involvement that goes far beyond that offered through the letters-to-the-editor pages of print magazines.


High quality content is key here.  Half assing it won't work.  Our competition is global in nature, and  this is a race.  We must provide our users with the content they want as fast as possible in a format that is quick and easy for them to understand.

For example, the Internet is already revolutionizing the exchange of specialized scientific information. Printed scientific journals tend to have small circulations, making them high-priced. University libraries are a big part of the market. It’s been an awkward, slow, expensive way to distribute information to a specialized audience, but there hasn’t been an alternative.

Actually the internet was in it's infancy used by academia to speed up the process of research and accessing documents.  But now with the masses driving web traffic we should decide if we want to cater to everyone or to a specific niche, and do it better than anyone else.  The consolidation of the market shows that there will be clear winners and losers.

Now some researchers are beginning to use the Internet to publish scientific findings. The practice challenges the future of some venerable printed journals.

Some reluctance on the part of advertisers may be justified, because many Internet users are less-than-thrilled about seeing advertising. One reason is that many advertisers use big images that take a long time to download across a telephone dial-up connection. A magazine ad takes up space too, but a reader can flip a printed page rapidly.

Advertising particularly when providing medical information is controversial.  Undoubtedly questions will come up as to whether our coverage or recommendations have been influenced by relationships with advertisers.  However meeting organizational costs is also critical.  Who will pay for all of this?  Will it be insurers?  The government?  Or will we enter a free market economy?  Under Obamacare it seems as if the answer is government, but there is also quite a controversy in giving the government access to all of it's citizens health data.  The citizens will decide what is to be done here, but there is much good that can come of this project, so perhaps we should decide how we can best serve patients interests and create advocacy and educational groups to ensure the success of this project's bigger goals which are more efficient processing of patient paperwork, and better tracking and more accurate patient data for health professionals.

Those who succeed will propel the Internet forward as a marketplace of ideas, experiences, and products-a marketplace of content.


The internet has the power to revolutionize the human condition at a level that perhaps rivals the wheel.  It's an incredibly exciting time, and the opportunity to shape the usage of this incredibly powerful tool is really a blessing.


I had an idea to do coverage on perhaps the top 10 health related social media companies, or the top 10 health related apps and their accompanying businesses as well.  An interesting side note supporting the idea of consolidation is that some of these companies are actually  being swept into each other, for example I believe that Pintrest now has some affiliation with Google, and also Alexa now has some affiliation with Amazon.  The period of consolidation is far from over and restructuring and reorganization of apps and their creators seems like it will be the norm for the forseeable future.

I was referred to examine the following related technologies by Dr. Atreja.  


Qualcommlife
(click on the word above to visit their site)

I wasn't quite clear on exactly what they did from their site, so I watched a video on youtube where their CEO talks about his organization and project.

It seems that QualcommLife is focused on making it easier for 3rd party hardware developers to make it so that their devices can communicate wirelessly with primary devices such as perhaps ipads used to collect data, or perhaps even updating directly to online servers.

Aetna's Carepass
(click on the word above to visit their site)
Aetna is primarily a health insurance company, but it seems like they are getting in on this too.  This puts them in a unique position because they already have access to a good amount of information from their own health care subscribers.

This reminds me of a story told to me by a friend who vehemently argued that Vonage would fail.  Vonage was and still is a voice over IP telephone service that achieved a good amount of press and recognition around 2001, after which their stock price and subscriber base dropped.  My friend argued that no business could succed when they did not control their own infrastructure.  

Vonage can provide low price calls between different callers, however all of these users need high speed internet connection.  Sure enough every single high speed internet provider aggressively has continued to sell phone package deals which use voice over IP.  Furthermore the advent of free VOIP phone services like Skype have created a lot of problems for Vonage, and they definitely had a period of struggle.  However it seems that they have found a niche where they can offer superior value, namely international calling and also they've used their name brand recognition to create apps that while still using other's networks, have been, when combined with their core business model of VoIP telephony, enough to help Vonage bounce back from bankruptcy.  (Now their website focuses on selling to small businesses.)
Sources I used to make the claims made in the above paragraph were made after reading Vonage's wikipedia entry and a review of their product placed on PCMAG.com.

So while it seems that owning one's own infrastructure isn't a death knell, it seems that the way to succeed in a business venture where one does not control the infrastructure is to focus on providing superior value in a niche.

Aetna will theoretically have an advantage in their installed user base, but their product line does not as of yet seem to have enough to differentiate from the other products I have had opportunity to review, or the proposed products that are to be released including Apple's Healthkit, Google's Fit, or Samsung's already active health/fitness tracker.

Here's an article by Forbes that supports Apple's Healthkit over their competitors.  (it mainly focuses on privacy issues and how Apple is doing a better job of protecting patients privacy.  However this is completely odd because the article itself admits that Apple hasn't even revealed how they will use the information.  In fact this following article from Tech Advisor  titled  Why Apple's HealthKit isn't good for your health makes the exact opposite claim.
The only thing clear here, is that no one's really sure exactly how ANY of these organization will use the data that they collect.

Microsoft's Healthvault

Probably the best option that I've seen as of yet that addresses the possibilities of what this technology can and should do is found at Microsoft's Healthvault site..  The site has a list of devices that their software already works with, and also have a list of apps that their system works with.  However they are missing the elephant in the room, WebMD who apparently may be working exclusively with Apple's Healthkit.  (This is not certain though and I'll have to research this further.)
Out of all the sites I've visted I like the presentation of this organization the best.  However I have yet to see implementation of any of this.  I'll try to sign up next week and examine this more in depth.

Applying these lessons to our own work

So as I start to investigate deeper into the possibilities... I realize that the relationship of these programs to our gastroenterology unit and specifically tracking of Crohn's disease leads to it's own set of unique problems.  What device has the most relevance to Crohn's disease care?

How about the camera pill?  The following is a video of the camera pill technology at work.
The Role of Capsule Endoscopy in the Diagnosis and Management of Patients with Crohn's Disease

Perhaps these pictures can be examined using detection of certain light wavelengths or patterns that can generate auto diagnosis.  The pictures and or video can be stored in the patient's database (hopefully the patient database will be large enough to handle a large number of high resolution photos)

Also the app can lead to better tracking of how medications have impact on disease aka # of ulcers, etc.

I'm also thinking that perhaps we can use google glass/ and or phone cameras to capture pictures of the food we eat and use algorithms perhaps to estimate the volume and then predict quantity of food eaten.  I'm thinking that if two pictures are taken from slightly different angles an algorithm can predict the volume of the image.  This would make things like food diaries easier to track.  Also wearables even just a wrist band may be able to detect the clenching of core muscles used in the Valsalva maneuver associated with bowel movements.  (However it is possible that flatulence or even certain core exercises may trigger false positives.)

I spoke recently to a friend named Slav who is interning in Mt. Sinai's Genomics lab, and apparently Harvard Medical School has a genomics program where they track certain patients who's genome have been identified.  Data such as medications they are taking are apparently tracked and since Crohn's disease has a genetic correlation perhaps we can look at testing our app with such a population.

This weekend I went to Emblem Health's event at Astoria Park and it gave me an idea.  I've done events in the past, the largest probably being my free concert in Union Square Park.  Couldn't we do something similar to promote our App and our work?  
I could look into getting permits at the park, or perhaps there is a lecture hall, series of rooms, or some such we can use to achieve goals of promotion, outreach, and marketing!
This can bolster strategic alliances, and also just sounds like a lot of fun!

On a similar line we should raise awareness of our app by promoting it to press outlets
PC mag has an article titled the 25 best fitness apps.

Worth a look over not just to promote our apps to this outlet, but also to understand how apps are rated.

I'll install the apps that are available for android.

I met with some people from the team to discuss some of the particulars that I mentioned in my last blog post.
First off, although Apple is apparently providing a centralized space for developers to talk to each other, they are not really providing a set infrastructure for the data to be set to "talk" to each other.

While some tools are being provided, such as tools that can convert metric units into english, so for example someone's height can be given in inches or centimeters using Apple's tools, apparently there is no set rules or conventions for any fields.

My concern is that this could just lead to a big giant mess of data that is inefficient and will lead to programming redundancy in labor.

For example let us suppose that patient data is stored in the following spreadsheet

The A column could represent the patient's first name, the B column could represent the patients last name C could represent the birth date, D could represent their age, E could represent their height and so on.

I believed that this new system of integrating health records would mean that information would now exist in one central easy to access spreadsheet.  However this does not seem to be the case.

After speaking with Misael it is apparently the case that each app will be collecting their own data, and then programmers will have to tie in data from other apps via either data mining of some sort using search queries, or through paid access done through apple or google servers.

This does not seem efficient.  Furthermore access to the database can cause different input errors as for example 5'0" may read as 5 feet 0 inches by one program, but 50 inches by another program.  When we're talking about health the results can be disasterous!  Even deadly!

I think it would be a great thing if programmers could get together and agree on some kind of unified coding scheme and database standards.  This would also save a lot of redundancy as in terms of staff work as code would not have to be developed to mine for information but could just be programmed to go to a certain location in the database for info.  Operational server side costs of time and electrical energy would also be saved as additional search operations running acrost the whole database  could be avoided.  As time goes on the amount of data will surely just grow and grow and grow, and it is important to build an efficient and expandable system to address these issues.

I'm excited that I've just started seeing a computer programmer, whom I'll call, "L" and our discussions on this topic should be pretty lively.  We've already discussed the need for such a project, so it's interesting to continue discussion on this topic with a professional in the field of computing.  She probably has much more experience with database management.

The coolest thing is that we are one of the pioneers in this field and have a chance to really set the bar and determine the standards in this newly developing field!

BUT returning to the original point of this post, I was exploring this topic originally to compare the feature set of Apple Healthkit vs. Google Fit.  It seems that there is no limit to the number of fields that a programmer can utilize to interact with Healthkit.  

It's generally agreed between people that I speak to that these apps will be speaking to each other and that developers are already planning on building cross platform.  Due to the sensitivity of patient data, the data will have to be stored on secured servers, and the cost of maintaining this security is supposed to be a hugely profitable field.  

Honestly I'm a big fan of open source in it's spirit and execution, and I'd love to see this problem addressed with as little cost as possible for the end users.  While I understand the need for proprietary databases to keep venture capital around to fund these projects, I'd really like to find a way to make things more efficient and to bring costs down.

REVIEWING THE APP


On the initial screen I see the face.

The nose is HUGE.  aesthetically a large nose is comical... clown like.  Perhaps a smaller pie chart with a larger 2 of 4 completed underneath?

Now I'll cover each individual application piece from the top to the bottom... left to right.

QUALITY OF LIFE

The first box labeled Quality of Life (3 months) is confusing because I see 5 circles although it says three months.  If the line between two circles represents a month then there is either an extra month or the data is being divided in some unintuitive way.  If data is being mapped to 5 measurements taken over 3 months, then this is just confusing.

When I open up the Quality of Life box I see a graph with many lines all over the place.  I find the graph confusing and if I was really sick I would feel anxious.

Here are the issues that I felt were of the most concern:
1.  On the graph I see a lot of vertical lines.  This means that on a given date my quality of life was at once good and bad.  I'd rather just see a single line that I could understand.  I'd rather have simplified information that I can understand, then a wealth of information that is confusing.
2.  The graph is filled with specific dates.  Rather then labeling each individual date it would be good to choose a less cluttered view.
3.  Quite a few questions (out of the 10 questions given questions 1, 5, 8, and 10) are, "state of mind" questions.  Or questions that ask a patient to identify their mood.  However psychology studies show that when someone is currently feeling happy or sad it can affect their ability to accurately access their overall mood over a previous time period.  On the other hand I liked questions 2,3,4,6,7, and 9 because I felt that these questions were much more specific and able to answered in a more accurate way.

I was unable to get the following questions to correctly record a response.  1,2,6,9,10.

After finishing the questions I received a score of 35 which is, "Fair."  I was then prompted that if my score was 50 or above or increased by 5 or more that I should notify my health provider.
I think it would be a good thing for the health provider to be automatically notified.  I'm not sure if this is able to be done due to patient privacy rights, but if this is the case then I feel like we should inform the patient of this phenomenon so that they are not thinking that the program is forcing them into an unnecessary sequence of actions.  Also once patients realize that by modifying the answers to their "state of mind" questions can alter their final score, they may start to answer questions in a way not to achieve the goals of the application but to achieve a desired score.

On the Symptoms screen which is the "Left eye" of the application, there is a sequence of questions that are to be answered.  The frequency of BM's is obviously bowel movements, but should be clarified as this abbreviation may not be readily apparent for users.

The Checklist of Care once again arbitrarily seems to mention 3 months.  This is good because it's a quarter, but it would be nice to be able to visit past quarters.

Also the answer choices of Unmet, met, N/a, and Don't know aren't very clear.  Measuring bone density doesn't seem like something that will happen very often and filling out n/a as the first choice again and again seems like it will lead towards patients eventually just skipping the whole section.  It also seems inappropriate to constantly prod the patient for something that happens like a YEARLY colonoscopy, or to address HPV if they are innoculated.  If certain things have been addressed, then these pieces should be disabled (yet the patient should still see that they are getting credit for these activities and see that it is positively impacting their score)

Getting down to the smile section of the health promise application once again we have a (3 months) informational prompt which seems redundant.
I know we are going off the idea of a gas gauge which is easy to read, however the red is scary.  I'm assuming that less hospital and ER visits is good, so we could perhaps label the gauge with a *good* on the red side and a *bad* on the green side if this is what that means to make things crystal clear.  If "bad" is something we are trying to avoid (because do we really want to tell patients that they are "bad?") then we could say more visits (better) or less visits (needs attention.)  I would include the better and needs attention pieces just to make things very clear as to which side is good or bad.

In the app part that opens when they click on this button the patient is asked to make calls such as whether or not their hospital visit was related to their Crohn's disease.  Is the patient qualified to make this decision?  I'm also thinking that it would be nice if the patient could store photos of their hospital documentation and doctor's notes at this point.  Perhaps we can add this functionality.

Also I noticed that there is a spelling mistake in the "Have you recently experienced" part of the app.  In the Hospitalized section the word "Admitted" is misspelled as "Adimitted" and the word "Released date" is grammatically incorrect and should be switched out to the word, "Release date"

MEETING ANOTHER MEMBER OF THE TEAM and VIDEO MEETING UPDATE

I did not know this but Sameer who is our advisor is a graduate of Hunter College!  Our lineup is very heavy with Hunter College students.  I find this pretty cool.  During our meeting we discussed some of the upcoming instructional videos that would be made for users.  This means instructional videos and an explanatory video.  I had some ideas about pitching the product which members of the team found helpful and I look forward to contributing towards this part of the project with my sales experience.  At this meeting I got to meet Flo, and work with Pascal in a more professional setting as we got to wrap our heads around some actual production work.  Thank goodness!  I can't wait to start producing some real product!
We've got a target production date of July 20 something... I'd like to make sure that I'm finished contributing whatever I need for the product by the 20th to give Pascal time to piece whatever he needs together.  I'll ask him as the project progresses if he needs an extra hand.

When googling apple health kit vs Google fit we come up with the following results. 

It's much of the same information, with articles such as:

In Google Fit vs. Apple HealthKit, Fitness Apps Stay Neutral on Mashable or Smackdown: Google Fit vs. HealthKit on Get Real Health. 

These articles just relaying that these well known hardware/software companies are now entering the health field information space and setting up for a competition.

What's not really apparent is any differences in feature set, storage capacity, variable labelling or so forth. 

Google Fit's release is months away, and no technical information is available on this product yet.
I'm now on Google Fit's interested developer mailing list where you can sign up to get information when it becomes available which you can do by visiting Google Fit's developer site.

Later on I will go down to the office and try to mess around with the apple healthkit app itself, but from my current understanding of the application, the onus is really on the developer to call up information from other apps, and to make sure that apps store their data in such a way that is easily accessible and useable by other apps.  Apple's dedicated healthkit website does not give a lot of back end information on how such data will be handled.  I'm guessing I'll need to start messing with the application creation kit to start seeing how this data is stored and labeled.  I also am interested to see what analytic tracking tools for data are available.

Apparently Samsung has already entered the market in this field.  Even though it carries the name Health, it really seems more of a fitness tracker.  Available functions are Exercise, Food Diary, Sleep, Pedometer, and Heart Rate.  You can see these features at their website which is linked here.

Apple's website suggests that they will also be tracking for Diagnostics, Lab Results, Medications, and Vitals.

Stay tuned for part 2, where I will address more of these issues in depth after consultation with some team members.

On a side note I've already tried to recruit all my friends on facebook to like the Mt. Sinai App Lab facebook page, and now instead of like 5 likes we are up to 12.  I tried to upload a picture to the page, but apparently it is only accepting video.  I guess I'll do that later.

I've  interacted with  the following sites writing reviews, subscribing, and liking where appropriate.

• http://sinaiapplab.com/
  
• https://twitter.com/SinaiAppLab
  
• https://www.facebook.com/SinaiAppLab
  

Unfortunately my linkedin isn't up to date, but one of these days I'll get to it!

https://www.linkedin.com/company/sinai-app-lab

I encourage you to do the same!

Social media, the most common examples that are used I'd say are Facebook, and Twitter have really caught on.  Social media used to be all the rage amongst advertisers as while people do put a certain amount of trust in commercials, they put much more trust in the recommendations and testimonials of their friends.

There is a trope about the six degrees of separation that exist between anyone in the world. (link provided to wikipedia article)  But social media can close this gap faster and easier.

Social media is a tool, just like a hammer, or a wrench.  Used properly it can achieve amazing things, but it can also cause damage, or just sit unused.  As a means of communication it provides an easier way for groups of people, or social networks to interact in a way that is documentable.  It also allows users to easily exchange not just text, but pictures, videos and so forth.  But the true power is in finding others that are potential partners and stakeholders in your projects and knocking down obstacles to communication.

While I will be recruiting people from my own social networks.  (I've created social network groups at my past school to provide student to student assistance in all premedical classes with most groups having over 900 members.)  I've found that there quantity alone does not build successful campaigns.  Rather it is building quality relationships with people that are invested in shared outcomes that create meaningful and committed discussion that can develop into action.

I plan to increase communication with groups that already have expressed interest in our project such as renewing and providing content of interest to people who have already subscribed to our project via twitter.

I also plan on finding other organizations and individuals that are working on projects that are very similar to what we are working on and building a shared communal forum for us to discuss our work on development in a way that is both efficient and yet open.  

But before I outreach to any of these groups I will wait for advisement from my team leaders, Jason Rogers and Ashish Atreja so I may be sure not to recover any ground that has been covered in previous interactions with the groups and individuals because each interaction with these groups should bring significant value to both parties.

I will update the results of any such discussion to this blog for future reference.