Design and Best Use of mHealth Apps

Chosing the right mHealth App can be confusing.
Chosing the right mHealth App can be confusing.

Chosing the right mHealth app can be confusing. Today, we see an array of health & mHealth mobile apps designed for consumers. But are you using them correctly, or are you wasting your precious time and money?

Whether it be for monitoring of exercise, fitness, or weight loss, or for more serious conditions like diabetes, sleep disorders, or shunt malfunction in hydrocephalus, consumers and developers would be wise to better understand how health and mHealth apps can benefit one’s health. The biggest problem I see is how health and mHealth apps are categorized, which then determines how they will be used. So I have written up a few suggestions to better help consumers and developers in selecting their mHealth apps. I have grouped health and mHealth apps into three (3) categories.

mHealth Technology, are we there yet?
mHealth Technology, are we there yet?

First, a little info about me. I am an early designer and pioneer of a 1997 neuromonitoring app, the DiaCeph Test, intended to run as a dedicated PDA device. I worked in nuclear medicine technology from 1976 to 1992. My specialty was setting up very technical medical instrumentation for best use. But a brain injury & CNS shunt for hydrocephalus in 1992 changed all that, and I became involved in artificial intelligence (AI) in assistive cognitive applications, and in mHealth apps for hydrocephalus monitoring. In 1997, I designed and patented one of the earliest mHealth apps, the DiaCeph Test. It was to run on a PDA. I was not able to raise enough funding for development and FDA guidance, but offer free paper FORMS and user INSTRUCTIONS, plus provide consults to individuals with hydrocephalus and their families. The link below explains these services.

Hydrocephalus & NPH Monitoring by Stephen Dolle/Dolle Communications

This also includes global health information on hydrocephalus. From 17 years earlier work and consulting in nuclear medicine, I’m well versed in medical software and UIs for medical technology. Today, I am also a drum circle facilitator, and put on drumming workshops for a number of medical conditions. Furthering our understanding of cognitive therapies and cognitive accessibility will play an increasingly important role in designing future mobile apps and interfaces, or UIs.

mHealth designs & monitoring must be tailored to the medical condition and patient.
mHealth designs & monitoring must be tailored to the medical condition and patient.
Cognitive Accessibility accommodations er CognitiveAccessibility.org
Cognitive Accessibility accommodations er CognitiveAccessibility.org

First Health App Category:

Apps that only provide medical resource information, i.e. WebMD, Medscape. They are generally not harmful if from a respectable source. Still, there are dangers in relying on a single site and piece of advise. I prefer to search for medical sites on the web, where topics will be hyper-linked to other web pages. This way you’re not limited by one app. One of my favorite sites is MayoClinic.com. I like their format. You should become familiar with an array of health & medicine sites, where you’ll come to know who you can trust and which formats you prefer. Now that you’re reading up on health and medicine, it’s time to select an app you might use to help track everyday things like exercise & fitness, or nutrition and weight loss. These apps I put into my Second Health Category. But if you have a chronic medical condition, or are being evaluated for some new serious medical disorder, then you’ll want to skip to my Third Health Category.

WebMD mHealth app and solutions in health and medicine
WebMD mHealth app and solutions in health and medicine
The Mayo Clinic web site offers an easy to understand interface & wealth of reliable health and medical information.
The Mayo Clinic web site offers an easy to understand interface & wealth of reliable health and medical information.

Second Health App Category:

Apps that collect information on health, fitness, nutrition, sleep, and stress management, plus a few more not mentioned here. For the most part, these apps do not serve a medical purpose, unless you are being treated by a physician or therapist who will review the data. So if you plan to use them for this purpose, you should really skip up to the third catagory. This second app category is perhaps more intriguing, than medically useful. And it then raises the question, What are you going to do with the data? Unless you are working with a trainer, therapist, or physician who knows how to interpret them, and will advise you accordingly, you may be wasting your time. Once your results reveal a true health issue, then you’ll need to move up to the third category.

Third Health App Category:

Apps for disease management, which is my specialty. Here you track specific data for a specific medical condition via an app designed to monitor your condition. But you should really be working with a physician or specialist who can interpret the data and treat you. You may also have to pay extra fees. Otherwise, you will likely be left with useless data, and no specialist to act on it. I recommend physician concierge services where you can pre-arrange apps, and then interact via email and telephone. Besides concierge services, some physicians will communicate with you via email, which can be very helpful. Disease management apps also help in the prevention of medical errors and incorrect diagnosis. We’re still in the early years for these apps. But in time, they will become an integral part of patient care in the management of chronic disease.

Below, is my blog discussing how weather apps can be used to manage migraine and triggers due to dramatic change in barometric pressure. The barometric pressure image below is a screenshot of my Elecont HD app from Jan. 31, 2016, where the curve reveals a dramatic fall, and then rise, in barometric pressure which can cause migraine and related problems for persons with an array of neurological disorders, including, hydrocephalus, which I live with. This blog discusses migraine in depth and how weather apps are an effective tool in managing these health challenges. Also SEE my blog on how decibel meter apps can help with sound induced headache due to sensory processing disorder. Coming soon: Integration of Brain Wave Readers in neurology apps.

Mobile Wealther Apps help in Managing Weather related Migraine Headache

Barometric Pressure graph reveals steep drop and rise which can trigger micraine headache
Barometric Pressure graph reveals steep drop and rise which can trigger micraine headache

I initially wrote this blog in response to an April 16, 2015, article in the New York Times technology section, which wrote about health and mHealth apps and whether they are good for everyone. Sadly, I found their conclusions and recommendations vague and incomplete. But without a comments section, I ended up writing my response on LinkedIn, and then on my blog here. The title of the NY Times article was:

Report Questions Whether Health Apps Benefit Healthy People

Women play and entrain with dolphins on this boat excursion out of Dana Point, CA.
Women play and entrain with dolphins on this boat excursion out of Dana Point, CA.

On March 23, 2016, the New York Times “On Technology” magazine ran an interesting story on women’s use of mHealth apps for managing women’s health. I found it provocative in that it delved into the female psyche & biology of women, and perhaps a superior ability to entrain to one another (McClintock Effect, synchonicity of monthly cycles).

New York Times: Women more Honest w/ Phones than Doctors

The article then cites a study of over 130 women who were more comfortable keeping personal health information in an app, than sharing with doctors. Is this an aberation? Perhaps not. It has been shown in multiple studies how women are more early “adopters,” and how women more readily entrain to one another than their male counterparts. But it’s unclear if men similarly are less willing to share medical information with doctors. In either case, I think these findings give us insight into design preferences in  mHealth apps.

As for women being more able to entrain with each other, I can attest to this from my work with drum circles. They are more emotionally connected. It definately comes through in my work with drum circles, or “group drumming.”

Whatever your needs are, I hope you find a health or mHealth app that works for you, and find a physician or therapist to interpret your results, and advise you medically. If you’re an mHealth developer, I hope you learned something here you can use in your development and marketing of mobile apps.

As far as prep on my DiaCeph Test app for hydrocephalus, I am mostly done with my Creative Brief/App Proposal. If I can advise (consult for) others on mHealth app development, I am happy to do so.

The DiaCeph app was designed initially for a PDA before mobile data apps were available. Still, its diagnostic design is state of the art today. This could also be coupled for monitoring of migraine, EEG readings, SPD, PTSD, and other app functionality. Below, is my blog on the DiaCeph Test.

Below are links to my recommended neuro apps for Hydrocephalus

eWealther HD App by Elecont for managing Migraine Headache

Metal & EMF Detector – App Smart Tools app measures magnetic fields of electronic & magnetic devices in one’s living environment that could alter the setting of a programmable CNS Shunt for Hydrocephalus

  Sound Meter – Smart Tools Decibel Meter app measures the loudness of sound helpful in SPD or sensory processing disorder.

Smart Tools Page on the Android Play Store

Smart Tools Apps on the iTunes Apple Store.

You may contact me below if interested in speaking to me about my work with drumming therapy, app development, or speaking in the neurosciences.

Stephen Dolle

Tel. (949) 642-4592

Email: contact[at]dollecommunications[dot]com

Dolle Communications

Contact Stephen Dolle
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The Good Bad News about PMS and Women’s Brains

List of common symtpoms of PMS
List of common symtpoms of PMS

I am writing this blog about PMS and the brain as a response to psychologist, Robyn Stein Deluca’s TED Talk on PMS, or pre-menstrual syndrome. And I do so in honor of Brain Awareness Week 2015.

TED Talk by Robyn Stein DeLuca: The good news about PMS

Let me share that I am shocked at Robyn’s unscientific approach to the syndrome of PMS, which is reported to be associated with a spectrum of physical and emotional health problems. In my 23 years of public health brain research, and in my drumming for the brain work with special populations, including, women’s health, I’ve seen countless examples of how physical disorders actually affect brain health, and how disorders of the brain affect physical health. It’s no longer a mystery. The real question is, what to do about it? So I left the comment below on Robyn’s TED talk page. I hope she and others read it.

Brain health and mental health is the biggest challenge of the 21st Century.
Brain health and mental health is the biggest challenge of the 21st Century.

Let’s use 2015 Brain Awareness Week to take a fresh look at PMS.

Migraine headache can get you out of your routine
Migraine headache can get you out of your routine

As a scientist, my gut sense is that PMS is rooted more in the brain’s sensitivity to changes in hormones. For instance, women are far more affected by thyroid, arthritis, and autoimmune disorders. They are more likely to feel empathy and have higher levels of the hormone oxytocin. Women also are able to “entrain” their menstrual cycles readily to each other, which is a function of their sensitivity. So, it would seem with this increased sensitivity to emotions, hormonal changes, and activities going on around them, that women could also suffer problematic physical changes in the brain and body from this resulting sensativity. Interestingly, I suspect there are similarities with PMS to that of PTSD, or post traumatic stress disorder, where for one cause or another, an individual’s brain is less able to process sensory information, and the results are physical changes in the brain, and eventually, in their overall health. Where PMS is a women’s syndrome, PTSD more disproportionately affects men.

Excedrin is used to help manage pain associated with migraine headache.
Excedrin is used to help manage pain associated with migraine headache.

Migraines more disproportionately affect women likely due to their higher hormonal activity and lower hydrostatic pressure in the brain from lower blood volume, and brain pressures. I’ve written about how weather apps and web sites can help in managing weather induced migraine headache.

Weather Apps helpful in Managing Weather Related Migraine Headache

Barometric Pressure graph reveals steep drop and rise which can trigger micraine headache
Barometric Pressure graph reveals steep drop and rise which can trigger micraine headache

Weather related low barometric pressure then is also more likely to induce migraine and hypotensive states in women, than in men. And, the slight loss of blood associated with menstruation, can cause a slight drop in blood pressure and exacerbate migraine syndromes. Together with each woman’s unique psychological makeup, these factors lend itself to a problematic cause & effect of mechanisms that impact brain health in women. Conversely, PTSD seems to affect women far less than men. So it would seem there are some unique health advantages to women’s physiology and brain health.

In support of women’s health, I put on drum circles and drumming events for women’s groups, and for women and others in the workplace.

Drumming for Wellness

Women were ecstatic at this year's women's drum circle at an Orange County area temple.
Women were ecstatic at this year’s women’s drum circle at an Orange County area temple.

Drumming for Workplace Wellness

Drum circles aid productivity and stress reduction for employees at this area Orange County firm.
Drum circles aid productivity and stress reduction for employees at this area Orange County firm.

Women tend to suffer fewer problems with homelessness, and drug and alcohol addiction, than their male counterparts.

Homelessness Affects Men far more than Women
Homelessness Affects Men far more than Women

This appears to be rooted in differences in the male versus female brains. One difference is with the neurochemical, oxytocin, widely regarded as the “love hormone,” which is found in higher levels in women than in men. But men who are active in community outreach and charitable activities, tend to have higher oxytocin levels. There is now an oxytocin nasal spray which has been greeted with mixed results. More recently, when I consider the plight of area homeless people and their associated mental health challenges, I can’t help but wonder whether oxytocin spray might help them, or whether their helping at an area outreach project might boost oxytocin levels, and help normalize wider brain function. Change has to begin somewhere. Here’s a related study:

Outreach can raise Oxytocin Levels (The Guardian)

In September 2015, I gave an in-depth presentation on how methods of alternative medicine can be used in drug and alcohol addiction, and covered related sensory processing disorder and cognitive accessibility. I also own the domain for CognitiveAccessibility.org.

Cognitive Accessibility accommodations er CognitiveAccessibility.org
Cognitive Accessibility accommodations er CognitiveAccessibility.org

Complimentary and Alternative Medicine in Drug & Alcohol Addiction

Illustration of the Meridian fields used in Acupuncture and Alternative Medicine
Illustration of the Meridian fields used in Acupuncture and Alternative Medicine

In my 23 years of being involved in brain care and public health as both a patient and researcher, I’ve seen countless examples of how the prevailing views can be wrong. And Robyn’s dismissal of PMS as a physical syndrome, would appear to be wrong. I also think an mHealth app, coupled with blood work, counseling as needed, exercise, and wellness strategies, could be very helpful in management of PMS.

mHealth Apps in Neurology
mHealth Apps in Neurology

I am concerned with how Robyn Deluca glosses over the obviousness of PMS as NOT having “measurable medical sequela.” Instead, she attempts to label it a mental health or psychiatric disorder.

Avoidable deaths from medical errors in the U.S.
Avoidable deaths from medical errors in the U.S.

I think PMS should be labeled an actual disorder, a bit like PTSD (post traumatic stress disorder), where both are a collection of physical complaints secondary to stress and sensitivities in physiology. The medical field seems intent on denying the existance of both of these, as it similarly has with SPD. I have found shooting baskets to be a wonderful mindfulness therapy for stress and SPD related complaints, and authored this blog.

Sports Science vs the Brain Science of Basketball

Basketball allows participants to feel and move rhythmically with a touch sensitive ball
Basketball allows participants to feel and move rhythmically with a touch sensitive ball

Over the longer term, untreated brain health issues can result in the development of sensory processing disorder, or SPD, which is a collection of real neurological complaints that the U.S. government continues to refute today. I’ve written a great deal on this topic.

Sensory Processing Disorder (SPD)

Brain Diagram of the Cranial Nerves
Brain Diagram of the Cranial Nerves

Apparently, PMS is a heated topic. I was attached by a fellow reader after I initially posted my impressions on Robyn’s conclusions on PMS. I hope those of you with firsthand experience who work with PMS patients will continue to voice your views against the politics of medicine.

Stephen Dolle in Washington, D.C. for the FDA's Hydrocephalus STAMP Conference in 1999.
Stephen Dolle in Washington, D.C. for the FDA’s Hydrocephalus STAMP Conference in 1999.

To learn more about my work, contact me at Dolle Communications.

Stephen Dolle
Drum circle Facilitator & Neuroscientist
Public Health Advocate
Email: contact[at]dollecommunications[dot]com
Web site: Dolle Communications
Telephone: (949) 642-4592