Guest Column | July 15, 2022

3 Lessons Learned Designing Our Digital Health App

By Richard Pearce, chief operating officer, Theragen


Digital technology can revolutionize patient care — and could save the healthcare industry $3 trillion by 2030. But to reap the benefits, the industry needs digital health solutions that people will actually use.

That means medtech companies can’t guess at their users’ needs when designing digital solutions. Instead, they must research users (usually patients and practitioners), understand their pain points, and use that insight to drive every stage of product development. When users lead the way, digital health companies can optimize their solutions for usability and adoption.

As VP of R&D at Theragen, I’ve seen this user-first philosophy in practice. We partnered with TXI, a product innovation firm, to research, design, and develop a mobile companion app for our spine fusion stimulator to improve post-surgery protocol adherence and, ultimately, recovery outcomes. I’ll share three lessons we learned in the process.

Lesson 1: Focus On Patients And Healthcare Providers

Our spine fusion bone growth stimulator offers surgery patients post-op therapy to improve outcomes. To maximize the benefits, patients need to wear the stimulator continuously — typically for six to nine months (or per their doctor’s instruction). But adherence can fall off over that long period, negatively impacting the product’s effectiveness.

At Theragen, we knew our product worked — if patients used it. Based on device data and preliminary user interviews, our integrated team determined that a companion app could motivate patients to stick to a monthslong treatment. To empower our users, we needed a user-centric design approach that accounted for both user groups: patients and healthcare providers.

We couldn’t make assumptions. Instead, we interviewed surgery patients and spine surgeons to fully understand their needs. In our user research, we found that patients are typically:

  • Between 40 and 85 years old. This age group has a wide range of health needs and tech proficiencies.
  • Experiencing post-surgery back pain. They need a way to track pain levels.
  • Feeling lost between follow-up visits. They could benefit from clear recovery instructions.
  • Unsure about their recovery progress. A progress-tracking feature could help them see their recovery path over time.

We had to design an app that patients (including the ones we interviewed) wanted to use. That meant creating a friendly user experience (UX). We wanted all ages and all tech levels to have access to this app, which meant a streamlined setup process and user interface.

In practice, that looks like:

  • Guided app installation and setup. Our sales reps walk patients through this process in person.
  • Step-by-step pain diary entries. The app prompts patients to enter their pain level, add a comment, and choose an activity that was causing pain.
  • Plain-language text. We avoid medical jargon to simplify complex concepts.
  • A tech support line. On-demand in-app assistance helps limit frustration and sustains adherence. Plus, local reps can help as needed.

Our user research provided unique insights into healthcare providers’ needs, too. Providers know that motivated patients show strong adherence to post-op protocol and therapy. Strong adherence leads to successful recovery outcomes. What they need is a way to both track adherence and keep patients motivated.

Throughout the app design process, we balanced the needs of the two groups and created a bridge between them. The result: an app designed for usability, adoption, and effortless data entry from the start.

Lesson 2: Track More Than One Type Of Patient Data

Immediately after surgery, patients and providers are in regular contact. But around the three-week mark, that contact becomes less frequent, with follow-up visits spaced out by weeks, and then by months.

Our user research found that between visits, patients need a way to measure and remember their recovery progress. Providers benefit by seeing real data rather than relying on patient recall, which means they can better gauge adherence between visits.

We applied these insights to our app, which tracks several types of data for patients and providers to reference:

  1. Device usage: The device monitors this continuously.
  2. Relative activity levels: Our spine fusion stimulator includes an accelerometer, patented data handling approaches, and proprietary algorithms to show trends in activity over time – a key part of recovery.
  3. Pain levels: The app includes a pain diary so patients can track pain levels throughout the recovery process, reducing the need to rely on memory when meeting with their prescribing physician.
  4. Activity types: The types of activities being carried out by the patient are logged.
  5. Patient journal entries: Open commenting allows patients to document and remember events that could impact recovery, such as experiencing a fall or illness unrelated to surgery.

With data tracking, patients and providers can see correlations among activity level, activity type, pain, and progress over time — a bigger-picture path to recovery that was previously unavailable. This enables a more informed patient-provider bridge of collaborative care.

Day to day, patients might experience less pain the more they walk — or more pain the less they move. And if patients wear their stimulator every day, they can use the companion app to log pain levels and see how their behavior affects their recovery.

Seeing those data-driven links motivates and empowers patients to stick to the recovery plan. It also helps providers identify anomalies, like when a fully adherent patient isn’t seeing results.

Lesson 3: Enable Data Visualization

It’s one thing to track data in a digital health app. But when patients and providers can see that data, they’ll more easily notice trends.

Our system enables that with two modes of data visualization:

  1. Simple graphs: Patients can see visual representations of device usage, activity types, and activity levels. They can also track how these factors correlate to pain levels over days, weeks, and months.
  2. One-sheet charts: Customizable, patient-specific reports enable providers to review compliance, correlations, and trends. 

In-app data visualizations spark vital conversations between patients and providers. For example: A physician asked a patient whether they’d been following their care instructions, including the note about avoiding BLT. The patient said yes. But when the physician pulled a patient activity report, they noticed a massive spike that indicated strenuous movement.

The physician asked what had caused the spike. The patient replied, “Oh, yeah, that was the day I had to cut down that tree in the yard.” The disconnect? The patient didn’t understand that avoiding BLT meant avoiding “bending, lifting, or twisting” — not bacon, lettuce, and tomato sandwiches.

Without visualized data, this kind of conversation likely wouldn’t have happened. As a result, the patient would have continued to bend, lift, and twist, impacting their overall recovery outcome. When digital health apps enable data visualization, they help patients and providers make critical insights to shape their care trajectory.

User-First Design Drives Strong Patient Outcomes

User-first design works — and there’s proof. While adherence in the sort of closely controlled clinical studies used for FDA approval is rarely matched in the real world post launch, our preliminary data shows that adherence has been maintained for our spine fusion stimulator.

Strong adherence doesn’t just mean a successful product. It means better patient outcomes. Take spine fusion stimulators, for example: adherence can improve the chances of successful spine fusion by around 30 percent.

Easy-to-use products empower patients to participate in their recovery. When digital health companies optimize their products for usability and adoption, they can make a real difference in their lives.

About The Author:

Richard Pearce is the chief operating officer and VP of research and development at Theragen, a wearable medical device company that developed a non-invasive stimulator to increase spine fusion surgery success rates.