This is What Happens When Mel Develops an App

What can Mel teach us about developing a medical app?

It’s Thanksgiving Day and I find myself lost in a supermarket searching the isles for eye drops. The desert is drying out my eyes and making them itch so I hitched a ride to Albertsons with my sister-in-law who is picking up some last minute groceries for our holiday meal.

I can’t find the eye drops anywhere. Not in the beauty section, not in the pharmacy section. Everything is closed. The store is deserted.

I can’t find anyone to ask except for a balding guy with a fluorescent green vest pushing and industrial broom. Maybe he can help? ‘Doubt it’ responds the voice in my head. But who else could I ask? Even the cash registers are manned by self-serve machines.

I use my best ‘sorry to be a bother but I really need help’ voice to ask about the drops. Mel, that was the name on his vest, shocks me.

I expect him to tell me he either doesn’t know where things are located OR he doesn’t work for the store. Instead he pulls out his phone and quietly says ‘eye drops’ into the microphone. It seems like a covert operation. He looks at his phone and pleasantly he suggests I try isle 5.

Eye drops are in isle 5, of course.

And I realize Mel has just shown me the future of mobile health apps: simple to use, accurate information, just in time.

Just ask and get the information you need, when you need it.

Right now it seems that there is a whole industry developing around mobile health apps. But so many miss the mark. They are clumsy, often just mini-versions of web pages or clearly designed by someone who doesn’t have a clue about what a particular health problem actually involves.

Why else would you

  • Put medications only used in an intensive care into an app designed to help someone with daily outpatient management of asthma?
  • Have so many complicated steps that you give up using the app in frustration?
  • Have cute animated videos that don’t actually involve any of the concerns of a real patient?

User interface exert Ann Wawrose agrees. She specializes in making computers and all things digital easier to use.

“The problem is with design of the application. Many are not designed with the end user in mind or are designed by people who thought they knew or thought they were the end user. This is dangerous. For example, doctors might be tempted to assume they know how patients want things to be designed because they have a lot of contact with patients.

Doctors have far more knowledge of how diseases work, not all patients do. It’s easy to forget what you already know, so you make assumptions. It’s best to find out, to evaluate the assumptions, the limits of patient knowledge and how patients think”

Ask Mel

I ask Mel how he did that voice thing with his phone. It turns out is very proud of it.

He recently moved to Las Vegas to be near his grandchildren. He got a little bored so he applied at Albertsons to get a job and began sweeping the floors.

People ask him every day where things are so he decided to make notes in Evernote. When he walks down the isle with his broom he talks quietly into his phone listing the items on the shelves. Then when people ask where items are located he simply queries Evernote. I didn’t even know you could talk into Evernote, let alone create a searchable list.

It turns out that Mel isn’t your average Grandpa either. For years he had been in charge of the Santa Barbara Business College. He is tech savvy and a problem solver. We need more Mels creating solutions to our healthcare problems.

My experience meeting Mel highlights four essential features of mobile health apps:

1. Accurate information updated regularly

When recommending healthy habits, it’s important the suggestions be accurate and update regularly. Time moves on and so does medicine.

If people are making decisions about their health it’s imperative that they have the most accurate information available. You might need just-in-time explainer videos, dashboards monitoring meaningful information and aggregating data from reliable sources.

Mel does this by re-recording what’s on the shelves every time he walks down the isle.

Healthcare apps can be updated when new treatments or insights are developed for a specific condition. It’s important that the apps don’t become bloated and slow, but instead keep a small amount of actionable information at the users fingertips.

Updates are expensive; it requires someone with expertise to be monitoring how best to treat a problem. I suggest we move away from anemic free apps to alternative pricing models. People should expect to pay a modest fee and in return get highly valuable insights and recommendations.

2. Intuitive, easy to use interface

Nothing is more frustrating than products that are difficult to use. Most people stop using them rendering them useless.

I suggest testing to see how people interact with a particular app. I prefer using my voice since I am a human and talking is what I do. And I have fat thumbs. This may not be true of all end users, testing will reveal the best interface options.

3. Communicate With all Relevant Parties

Healthcare is a team sport. If all the members of the team don’t know what is going on they can’t execute an effective game plan.

We cannot harness the power of apps unless there is communication between patients, practitioners and digital products. Right now there is a significant deficit in horizontal integration; the Information on a person’s phone is not available to his/her healthcare team. It’s hard to make a mid-course correction if you don’t even know what is going on.

The need for privacy needs to be balanced with the need for communication across platforms. If banks can transmit private information securely in real-time, I believe that healthcare can too.

4. Test Effectiveness

App developers and healthcare researchers need to come together to ensure effective products. To make lasting improvements in people’s lives we need to allow the apps to undergo scientific scrutiny.

This underscores a persistent tension between the two industries. Developers often use a lean start-up model, putting the least viable product on the market and making improvements on the fly. On the other hand, healthcare waits for a preponderance of the data to support an intervention before making a change, which can take years. Somehow these two diametrically opposed styles need to be reconciled so that we get useful apps to market in a timely manner, ones that undergo careful, scientific evaluation to determine efficacy.

Mel is testing his supermarket app too. He is in talks with management to make sure that the success of one store can be replicated across a variety of store sizes and community settings.

A simple solution to locating items within a supermarket can provide insights for the healthcare industry.

I have no doubt that apps to improve healthcare will proliferate. I want to see products that provide real value, ones that really help people take charge of their own health. In order to do this they must provide accurate information, be easy to use, communicate with the healthcare team, and be tested to be sure they are effective.


Sarah Kohl, MD is a practicing pediatrician and Clinical Assistant Professor of Pediatrics at the University of Pittsburgh School of Medicine. She helps individuals harness the power of digital medicine so that they can take control of their health. Dr. Kohl speaks and consults about digital health. Download her guide to the 5 Best Apps to Improve Your Health HERE.