
Apply HN: Mental Health Medication Self-Assesment App - thevibesman
Selection of medication used in mental health treatment is often a complicated process of trial and error. A prescriber will begin with an educated guess for the most effective treatment for a given patient and the patient begins a period of medication evaluation to determine if if the right ratio of efficacy and side-effects are met; if not, the process is repeated.<p>Sometimes during this process, patients will only meet with prescribers for 30-minutes once a month providing a narrow window for observation.  Patients are given the difficult question of answering if they feel the medication &quot;is working&quot;. There are two main challenges to this evaluation:<p>1. In a study of 1, it is very difficult to control for other factors that effect mood or the effectiveness of the medication (e.g. sleep, diet, dosage timing, external life events)<p>2. The nature of these medications could change perception, so it is sometimes difficult for a patient to self-evaluate how their mood one day compared to the past. A patient may have one feeling about the effectiveness of their medication and another a week later when visiting their doctor.<p>I would like to build an app that acts as a friend during this difficult evaluation: regularly asking questions about sleep, diet, stress, mood, and general impressions of the medication. The patient and doctor could use the data from this app together to discuss a more complete picture of the patient&#x27;s recent mood than may be revealed in a discussion on any one particular day.<p>With the correct privacy controls in place, this app could provide a source of research data for studies to help discover why some medications work better for certain patients.<p>I would like this to be a tool to help people and create greater efficiency in this are of mental health and would like to make it available to all patients. I am considering if a non-profit would be a better path than attaching a business model to this.
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thevibesman
DISCLAIMER: I already submitted one 'Apply HN'
([https://news.ycombinator.com/item?id=11584508](https://news.ycombinator.com/item?id=11584508)),
but as the YCombinator application asks about other ideas founders are
interested I thought I would post this as well.

This is an idea I am passionate about as over the years I have seen friends
and family struggle with the difficulty of being part of a study of one; so
aside from being my 'other idea' post, I was curious for any feedback on how
to get a project like this started that does not have a business model
attached (my thoughts are around non-profits and research grants, although I
have not looked into the later).

I'd also be curious to get connected with anyone else interested in similar
ideas.

~~~
tcj_phx
My experience as an observer of the mental health system is that it's a
complete disaster. See my submissions & comments.

If your app was combined with my "scrap & rebuild" of the System, it'd
probably be quite useful. The worst of the patients are stuck in a tunnel, but
such an app could be especially useful for helping family & friends keep track
of how the patient is doing - what helps, and what makes their condition
worse.

~~~
thevibesman
> helping family & friends keep track of how the patient is doing - what
> helps, and what makes their condition worse.

This relates to one of my motivations for this idea: there is only so much
family and friends can do and when they are tasked (if at the request of the
patient) with this sort of tracking it can put strains on relationships.
Sometimes the friend or loved one asked to watch out for this things is not
the right person to hear it from when the data matters.

I feel it would empower patients to have their own access to this information
than it being held by a friend or family member---other users contributing to
the patients data is a good idea I think.

EDIT: (below)

>If your app was combined with my "scrap & rebuild" of the System, it'd
probably be quite useful.

What I am proposing is a way for patients to better understand data about
themselves, which would be important in any mental health system.

There are many mental health success stories today; I'm not proposing a
replacement but a way of improving an existing system. I think it is important
to better understand these success so they can be duplicated (and failures in
the evaluation-loop learned from).

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ryporter
I think that tools like this are great, but there already are some in this
space (e.g., mySymptoms [1]). How will you differentiate yourself?

[1] [http://skygazerlabs.com/wp/](http://skygazerlabs.com/wp/)

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thevibesman
The first differentiator will be price: I would like to figure out a way to
offer this to patients without charging for the app or turning the patients
into a product. As a tool to help people help themselves, I would like to
lower barriers to entry as much as possible; which is why I'm exploring the
possibility of pursuing this idea as a non-profit. Other apps that I have
found are either paid apps or free with in-app purchases (e.g. in-app purchase
to keep your mood log private; I wonder what privacy is like in an app whose
default state is public posting).

There are many more mood trackers than apps that allow you to track one
dimension such as mood and not both symptoms and potential contributing
factors, but as you point out there are some apps doing this already. Existing
apps that track both symptoms and mood have two challenges:

1\. Staying motivated to continue to log data daily as a patient goes through
an evaluation is difficult if record keeping is done with pencil+paper or an
app.

2\. Apps that track more than mood have a more complicated UX to handle input
across a variety of dimensions.

Apps like mySymptoms do make self-evaluation and data collection easier
because the patient will usually have their phone with them; but this is still
a chore. mySymptoms was designed to track symptoms for Irritable Bowel
Syndrome and the UX reflects the motivation level of that user group.

Instead of a log keeping app, I want to make an app that will act like a
personal lab assistant guiding the patient through their study of 1. Here is
how I am trying to make this process of record keeping easier:[EDIT: fixed
line breaks]

1\. A UI/UX that allows data entry with as few touches as possible: each
datapoint should be able to be entered with a single touch or gesture (voice
interaction would be useful too, but one step at a time).

2\. Present the user with one question from the lab assistant at a time
instead of providing a daily grid to update.

3\. Don't wait for user action, but prompt the user to interact with the app.
Timing of prompts can be triggered by learned timing of user interaction with
the app, desired medication/eating schedule, and sensor input to ask questions
at the right time (some users my respond to prompts better while on the move
while others when at home).

~~~
thevibesman
After posting the above comment I was thinking that, if I mentioned 'free-app'
as a differentiate, I should say something about revenue generation; even if
going the non-profit route, charitable donations may provide enough cash flow.

How to pursue this idea without charging patients is still a problem I am
trying to solve. Here are two ideas I have:

1\. If we are able to ethically collect anonymous data for use in research;
institutions could pay a subscription for the data (This seems more suited to
a non-profit company)

2\. With the increase in use of mobile applications in patient care and
research, this app could be put out for free as a promotional tool for a
company that specializes in creating mobile software for medical research.

------
brudgers
Interesting idea. How are clinical standards and expertise to be incorporated
into and expressed by the software?

~~~
thevibesman
There are a number of 'workbooks' used for self-evaluation and simple data
collection between sessions in clinical treatment of depression, anxiety,
bipolar disorder, etc. These workbooks will be used to develop the set of
measurement dimensions used in the first prototypes.

Initially, development focus will be around designing a user experience that
is easy to use and promotes consistent use of the app because this is needed
to take advantage of any clinical expertise embodied by the software. In
working on this design, I plan to consult existing research literature on the
use of existing at-home evaluation methods and issues of non-compliance for
general out-patient medical treatment.

After designing the initial experience, I would plan to consult with M.D.s and
doctors of psychology both to find out ways to increase patient use of the
software and to develop in-app analysis that would be beneficial clinically.
(EDIT: forgot this sentence) I have a friend who is a M.D. working in research
psychiatry here in Boston, as well as some other contacts that I plan to reach
out to as I try to grow a network of possible consultants.

Another important part of this consultation would be to make sure this app is
viewed a tool to help patient and doctor and not as a tool for patients to
make their own medical choices without doctor consultation.

Being based in Boston/Cambridge, I am surrounded by a large hospital community
with a lot of interesting mental health research going on outside of drug
trials. If I could get this software involved with one of the studies on
clinical methodologies it would be a great way to get user feedback and
incorporate clinical standards into the software.

