Can J Diabetes 39 (2015) 192e193
Contents lists available at ScienceDirect
Canadian Journal of Diabetes journal homepage: www.canadianjournalofdiabetes.com
Innovations in Diabetes Care
How Can Diabetes Applications Be Better? Kerri Sparling BA *
There’s an application (app) for everything, and diabetes is no exception. But do diabetes apps actually make life with diabetes better and easier? Apps are not new. According to Pew Internet Life, 58% of adults have smartphones, and 1 in 5 smartphone owners have downloaded an app aimed specifically at managing or tracking health-related data (1). Diabetes is not new, either, with 387 million affected worldwide (2). Health apps should serve a previously unmet need or make a diabetes task simpler to accomplish. In short, it should be useful. So how do we make an application that’s useful? A patientdpreferably, many patientsdshould be part of the development process from inception to production. The development and execution of an app must take into account the needs of the people who will actually use it. For example, a blood sugar logbook app that requires uploading cables and does not sync with existing software may create more frustrations than it solves. Utilizing the perspectives of and feedback from people with diabetes is crucial to the successful development of a useful app. What makes a useful app? Focusing on the needs and wants of the diabetes community can lead to incredible innovation. An example of a useful app is the mySugr Companion (3), a blood sugar logbook app developed by a team of patients with type 1 diabetes in Vienna, Austria. The logbook application functions properly, but something as simple as an open field-notes line gives patients the opportunity to add any information manually that they deem relevant or important in relation to their blood glucose values. This is useful because app developers cannot yet make a drop-down menu long enough to cover all the differing variables that may influence blood sugar control. The opportunity to personalize a data entry may improve usability and adherence. Another application that addresses the common frustration of estimating nutritional information is the Figwee (4) app. Figwee provides visual representations of portion sizes, with the accompanying nutritional information by way of a searchable database of common foods. For example, by searching for spaghetti, a plate of spaghetti pops up, and the user can manipulate a slide bar to shrink or enlarge the serving size, offering realistic carbohydrate count estimates for people with diabetes, thus helping make estimates more precise. Positive reinforcement for users is also a currently underserved desire. Diabetes is a data-driven disease with patients at the centre of their own management, and oftentimes blood glucose results are not
* Address for Correspondence: Kerri Sparling, BA, 5600 Post Road, Unit 228, East Greenwich, Rhode Island 02818, USA. E-mail address: [email protected] 1499-2671/$ e see front matter Ó 2015 Canadian Diabetes Association http://dx.doi.org/10.1016/j.jcjd.2015.04.009
viewed simply as data points but instead can be viewed as emotional responses (i.e. guilt). The opportunity to offer digital “high fives” for patients as a reward for interacting with an application might make the difference between app adherence and app drop-off (5). Apps should serve to streamline, not clog up. Part of the app challenge is to eliminate tasks for a person with diabetes, which they do not always do; instead, they may add extra steps. Logbook apps can be useful, but the proprietary nature of glucose meter software and the lack of integration between diabetes devices and smartphones make data transmission clunky and inconvenient. Creating an app that requires manual entry or doesn’t allow for automatic upload can be more prohibitive than productive. The best app is one that will be used and will improve peoples’ lives. The diabetes app wish list isn’t long, but common themes concerning access and interoperability come up again and again in online community discussions. “Can I also ask that my data (including drugs and doses, emergency contacts, age, etc.) be stored on an open platform, accessible by me via a password.and shareable with any medical professional when it’s needed? And able to integrate with their system(s) when needed? And able to be accessed by my phone, when needed in an emergency? These are simple things. Whoever solves them all first will win. Please, somebody win,” wrote diabetes blogger Stephen S (6). Sometimes apps are developed out of the need to tackle diabetes management from an entirely new vantage point. The Open Artificial Pancreas System (#OpenAPS) is an open and transparent effort to make safe and effective basic artificial pancreas-system technology widely available so as to more quickly improve and save as many lives as possible and reduce the burdens of type 1 diabetes (7). The creation of this system takes app development to a whole new level by attempting to streamline blood sugar control instead of simply tracking it. App development and diabetes technology in general are hot topics, but simply having an app for an app’s sake isn’t in the best interests of patients or developers. Keeping patients’ needs and perspectives at the centre of development discussions and implementations can help to produce a new wave of outcome-improving and behaviour-changing digital tools. References 1. Fox S, Duggan M. Tracking for health. Pew Research Center, Washington, District of Colombia. http://www.pewinternet.org/2013/01/28/main-report-8/. Accessed November 7, 2014. 2. International Diabetes Federation: Diabetes Facts and Figures. http://www.idf. org/worlddiabetesday/toolkit/gp/facts-figures. Accessed November 7, 2014. 3. mySugr. http://mysugr.com/companion/. Accessed November 7, 2014.
K. Sparling / Can J Diabetes 39 (2015) 192e193 4. Figwee. http://figwee.com/. Accessed November 7, 2014. 5. Smartphone medication adherence apps: Potential benefits to patients and providers. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919626/. Accessed November 7, 2014.
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6. Stephen S. Six Until Me: My diabetes app wish list. http://sixuntilme.com/wp/ 2014/03/25/diabetes-app-wishlist/#comment-11337. Accessed November 7, 2014. 7. OpenAPS. http://openaps.org/. Accessed April 13, 2015.
Contents lists available at ScienceDirect
Canadian Journal of Diabetes journal homepage: www.canadianjournalofdiabetes.com
Innovations in Diabetes Care
How Can Diabetes Applications Be Better? Kerri Sparling BA *
There’s an application (app) for everything, and diabetes is no exception. But do diabetes apps actually make life with diabetes better and easier? Apps are not new. According to Pew Internet Life, 58% of adults have smartphones, and 1 in 5 smartphone owners have downloaded an app aimed specifically at managing or tracking health-related data (1). Diabetes is not new, either, with 387 million affected worldwide (2). Health apps should serve a previously unmet need or make a diabetes task simpler to accomplish. In short, it should be useful. So how do we make an application that’s useful? A patientdpreferably, many patientsdshould be part of the development process from inception to production. The development and execution of an app must take into account the needs of the people who will actually use it. For example, a blood sugar logbook app that requires uploading cables and does not sync with existing software may create more frustrations than it solves. Utilizing the perspectives of and feedback from people with diabetes is crucial to the successful development of a useful app. What makes a useful app? Focusing on the needs and wants of the diabetes community can lead to incredible innovation. An example of a useful app is the mySugr Companion (3), a blood sugar logbook app developed by a team of patients with type 1 diabetes in Vienna, Austria. The logbook application functions properly, but something as simple as an open field-notes line gives patients the opportunity to add any information manually that they deem relevant or important in relation to their blood glucose values. This is useful because app developers cannot yet make a drop-down menu long enough to cover all the differing variables that may influence blood sugar control. The opportunity to personalize a data entry may improve usability and adherence. Another application that addresses the common frustration of estimating nutritional information is the Figwee (4) app. Figwee provides visual representations of portion sizes, with the accompanying nutritional information by way of a searchable database of common foods. For example, by searching for spaghetti, a plate of spaghetti pops up, and the user can manipulate a slide bar to shrink or enlarge the serving size, offering realistic carbohydrate count estimates for people with diabetes, thus helping make estimates more precise. Positive reinforcement for users is also a currently underserved desire. Diabetes is a data-driven disease with patients at the centre of their own management, and oftentimes blood glucose results are not
* Address for Correspondence: Kerri Sparling, BA, 5600 Post Road, Unit 228, East Greenwich, Rhode Island 02818, USA. E-mail address: [email protected] 1499-2671/$ e see front matter Ó 2015 Canadian Diabetes Association http://dx.doi.org/10.1016/j.jcjd.2015.04.009
viewed simply as data points but instead can be viewed as emotional responses (i.e. guilt). The opportunity to offer digital “high fives” for patients as a reward for interacting with an application might make the difference between app adherence and app drop-off (5). Apps should serve to streamline, not clog up. Part of the app challenge is to eliminate tasks for a person with diabetes, which they do not always do; instead, they may add extra steps. Logbook apps can be useful, but the proprietary nature of glucose meter software and the lack of integration between diabetes devices and smartphones make data transmission clunky and inconvenient. Creating an app that requires manual entry or doesn’t allow for automatic upload can be more prohibitive than productive. The best app is one that will be used and will improve peoples’ lives. The diabetes app wish list isn’t long, but common themes concerning access and interoperability come up again and again in online community discussions. “Can I also ask that my data (including drugs and doses, emergency contacts, age, etc.) be stored on an open platform, accessible by me via a password.and shareable with any medical professional when it’s needed? And able to integrate with their system(s) when needed? And able to be accessed by my phone, when needed in an emergency? These are simple things. Whoever solves them all first will win. Please, somebody win,” wrote diabetes blogger Stephen S (6). Sometimes apps are developed out of the need to tackle diabetes management from an entirely new vantage point. The Open Artificial Pancreas System (#OpenAPS) is an open and transparent effort to make safe and effective basic artificial pancreas-system technology widely available so as to more quickly improve and save as many lives as possible and reduce the burdens of type 1 diabetes (7). The creation of this system takes app development to a whole new level by attempting to streamline blood sugar control instead of simply tracking it. App development and diabetes technology in general are hot topics, but simply having an app for an app’s sake isn’t in the best interests of patients or developers. Keeping patients’ needs and perspectives at the centre of development discussions and implementations can help to produce a new wave of outcome-improving and behaviour-changing digital tools. References 1. Fox S, Duggan M. Tracking for health. Pew Research Center, Washington, District of Colombia. http://www.pewinternet.org/2013/01/28/main-report-8/. Accessed November 7, 2014. 2. International Diabetes Federation: Diabetes Facts and Figures. http://www.idf. org/worlddiabetesday/toolkit/gp/facts-figures. Accessed November 7, 2014. 3. mySugr. http://mysugr.com/companion/. Accessed November 7, 2014.
K. Sparling / Can J Diabetes 39 (2015) 192e193 4. Figwee. http://figwee.com/. Accessed November 7, 2014. 5. Smartphone medication adherence apps: Potential benefits to patients and providers. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919626/. Accessed November 7, 2014.
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6. Stephen S. Six Until Me: My diabetes app wish list. http://sixuntilme.com/wp/ 2014/03/25/diabetes-app-wishlist/#comment-11337. Accessed November 7, 2014. 7. OpenAPS. http://openaps.org/. Accessed April 13, 2015.
