With increasing frequency, we hear more and more people in the health space claim that they are putting “big data” in “the cloud.”

In the past, most big data opportunities were limited; only analysts at large businesses dealt with them. However, mobile technology is expanding the reach and impact of big data sets, empowering individuals domestically and internationally.  Now, health-related applications and technology are starting to saturate the market with ways to track activity, analyze data and change behaviors.

As the costs for collecting data decrease and the questions asked of the data increase, the potential for personal utilization and added value continues to grow.  By evaluating patterns, habits and historical data in addition to tracking current, real-time data, predictions can also be made about future behavior.

Big data is no longer something we use only in hindsight.  Additionally, in the broader health setting, big data is no longer something just for the “C suite” and leaders of a company.  Instead, data can be accessed and assessed for real-time, daily insight into a company, client or individual.


According to a recent poll of doctors by Epocrates, one-third of physicians planned to purchase the iPad Mini prior to its public announcement. It makes sense, given the size of lab coat pockets and the fact that almost 2/3 of physicians use tablets.

doctor with iPad

So, what does this mean for developers?

First, it means that doctors want to use medical apps. We developers will see an increasing demand for apps that medical professionals can use in their daily practice, including apps that make use of the device’s camera and audio recording capabilities. Animation and imaging must become areas of our expertise for us to succeed in creating cutting-edge medical apps that doctors use and recommend to their colleagues.

Second, it means that our apps and interfaces must scale for a variety of devices. Some surveys indicate that a majority of physicians prefer Apple products, and prefer them because of their ease of use, familiarity, and build quality. While iPhone and iPad apps currently dominate the medical App Store category, the iPad Mini should not be ignored. iOS 5 and 6 have made auto-resizing and auto-layout easier to use than ever, and there is no reason that our apps should not look good and work well on any iDevice.

Finally, it means that we need to build apps that medical professionals need and want to use. Doctors and nurses have high expectations, and for good reason. If the apps we build do not function perfectly, do not provide an intuitive and simple user interfaces, or do not solve problems and make health care more efficient and less error prone, then they will not be used.

Julie Vilardi, a registered nurse and executive director of Kaiser Permanente’s clinical informatics and strategic projects was quoted in VentureBeat “iOS phones and tablets really are the devices of choice in hospitals today.  This is because vendors in general are taking more advantage of iOS than Android.”

Technology has the power to revolutionize the health care industry, but as we all know: the device is only as useful as the apps it runs. As developers, if we ignore the iPad Mini or iPad, we risk missing out on a huge opportunity.

Are you building an app for doctors or clinicians?

Send us a note maybe we can answer some of your questions.

Learn about our process here.

About Author, Taylor Briggs is a Developer extraordinaire at Pathfinder.

You can find him on

One of the reasons VGBio is one of Pathfinder’s favorite clients is because they show how four of the most powerful technology trends affecting healthcare (body area sensor networks, smartphones, cloud computing and big data/predictive analytics) can be used together to reduce costs and improve outcomes.  VGBio technology enables the daily monitoring of patients with chronic diseases and provides early notification to clinicians of a negative change.

VGBio has been going strong, including presenting at TEDMED last month as part of The Hive, and having the The US Department of Veterans Affairs Center for Innovation recently produced a video describing their use of VGBio’s Vitalink:

According to Dr. Abdulfattah Saidi, Heart Failure/Transplant Research Fellow at the George V. Whalen VA Medical Center, “When we admit patients, and we take care of them, and then send them home, there’s a 20% chance that they will come back to the hospital within 30 days of discharge.” 

Dr. Jose Nativi-Nicolau, Heart Failure/Transplant Cardiology at the George V. Whalen VA Medical Center, ads that “The benefit to the VA is to reduce readmissions and improve the care from hospital to home, and from home to clinic.”

Systems like VGBio are part of a growing trend of companies that combine bio sensors, mobile technology and bioinformatics to transform the management of chronic diseases from a reactive to a proactive care delivery model.  Other examples include:

*  Asthmapolis, which leverages the advances in sensor technology and mobile data monitoring to help people manage their asthma more effectively, in turn reducing the costs both for those suffering from asthma and for the U.S. healthcare system itself. 

* Proteus Digital Health, whose digital health feedback system is powered by ingestible sensors, a patch, and bluetooth enabled smartphones.  

Are you working on a similar project?  

Do you have questions related to connecting sensors to mobile devices?  

Send us a note!

Learn about our process here.

About Author, Bernhard Kappe is a Founder and President at Pathfinder.

You can find him on Google+

If you are new to agile development, you’re probably swimming in a sea of unfamiliar terms: user story, spike, sprint, stand up, points.  In this series, we’re going to tackle one of agile’s trickiest concepts: What exactly is an agile “point,” and how does it relate to time and budget?

Points measure the complexity and effort required to complete a unit of work.  Pathfinder uses points because we find they are both more efficient and accurate than estimates of hours.

That’s the technical definition, but let’s relate this to something you’re probably more familiar with: Thanksgiving dinner.  You’ve decided your MVP (Minimum Viable Product) for Thanksgiving dinner is:

Roast Turkey
Mashed Potatoes
Green Bean Casserole

cooked turkey photo credit: Benjamin Swift

A pretty slim offering, but you’ll have the guests bring the other sides and dessert.  Now that you know what you’re making, you’re ready to estimate.  To show increasing complexity and effort, we’re going to rate on the Fibonacci scale, where the next number in the sequence is equal the sum of the previous two numbers.

1, 2, 3, 5, 8, 13, 21

You assemble the team: you, your partner, and your teenage son.  Decisions are made based on the recipe, the team’s experience making this recipe before, and the team’s general understanding of the time and expense involved.  We don’t dive any deeper, because experience has taught us that the extra time spent hashing through details may actually reduce our accuracy.

Photo Credit: Stacy Spensley

To establish a baseline, let’s agree on a 2-point story.  Mashed potatoes are about halfway in complexity between the turkey and green beans, so the team agrees that this is a 2-pointer.

Next, green bean casserole is probably the simplest and least expensive thing here, and the team estimates it as 1 point.

There’s some discussion about the turkey, because even though we’re planning on a pop-up timer, grocery store turkey, it takes a long time to defrost and roast, and requires a bit of monitoring.  The team finally agrees on 3 points.  Gravy is barely any effort at all, so it is rolled in with the Roast Turkey.

Roast Turkey + Gravy


Mashed Potatoes


Green Bean Casserole


Total Points:


Great!  But now you find out that your boss is coming.  Suddenly, you need a more impressive MVP.

You start scouring the Food Network and Epicurious.  You decide to upgrade to a free-range, brined turkey and truffled mashed potatoes.  You’ll replace the green bean casserole with Brussels sprouts, maple syrup and bacon.  And you call Aunt Fern asking her to please not bother to bring the green jello/cheddar cheese salad, because you’re making Arugula salad with roasted beets, garlic and shallots.

Photo Credit: Father Jack

Your complexity and effort just went up, but that’s OK, our agile process is designed to accommodate change.  The team just has to re-estimate, taking into account the fact that we’ve never made these recipes before.

Brined Roast Turkey + Gravy


Truffled Mashed Potatoes


Roasted Brussels Sprouts


Arugula salad


Total Points:


Your MVP has more than doubled, but you decide the additional time, effort and expense are worth it to impress your boss.  And if new changes arise – like additional guests or the sudden need for six different kinds of pie – your team is now familiar with the process, and can easily revise the estimate.

Next week: how to points translate to budget and timeline!

So, you’ve developed a great product and now you want to take it to market. Let’s just say it’sMP900439239 a widget.  You’re so excited about it that you want to announce it over loud speakers, “Hey everyone, try my new widget, it will change your life!”.   This may be what you want to do, but it’s not the right move.  Where do you go from here?

Five tips to market your product are:

  1. Know your product
  2. Know your customers
  3. Know your competitors
  4. Build your following
  5. Keep your customers coming back

Tip 1 – Know your product

What is unique about it?  What sets your product apart from your competition To be successful, your widget needs to do something that no one elses does or at least, does it better.  Why did you develop it in the first place and what pain does it relieve?  Take those “special” things and make them a BIG deal.  While your widget is in production, talk it up and getting people excited about it.

Build your website with dynamic content about your product and build your SEO to get found. Here are a few blogs to check out to get started on this: Kissmetrics-, Full Quota and Word Stream –

Tip 2 – Know your customer

Build persona’s to hone in on who your ideal customer is, visit HubSpot’s blog by clicking here for more information on building persona’s.  When you know who your best customers are, it makes it easier to target that market and build your niche.  You want to know how your product fits into their life.

Some questions to ask: link to your customers
Where does this customer live?  (city, suburbs)
What problems do they have that my product can solve?
What are their interests and hobbies?
What are their behavior patterns?
What is their socioeconomic situation?

Once you have a clear idea of your ideal customer and have tested the market, make it easy for your widget to fit into their life.  Build your social networks and and get the “buzz” going. You can use a tool such as HootSuite to help blast out messages to several social networks at the same time.Tip 3 – Know your competition

What’s so special about their widget?  If yours fills a need that isn’t already being filled or not being filled well, take advantage of that.  Don’t call out your competitor but if your widget lasts longer, costs less, is brighter or better for the environment, talk about it.  Expand on those competitive advantages to build your niche.  

Do some research and find out what tradeshows, conferences, groups, meet -up’s, etc. they belong to and attend and sign up.  Doing these types of things, not only helps to to know your competition better but it also aligns you with your ideal customers and builds your following. At the conference try some Guerilla Marketing tactics such as handing out a special offer on a postcard or a tchotchke (trinket or doodad) with your information on it.  Or, you could be really crazy and organize a flash mob where the participants hold up signs with your website or stick post-it notes on passersby.

Tip 4 – Build your following

Building a buzz can be achieved by becoming a thought leader in your industry and expanding on step 3.

Some ideas that don’t cost anything but time and could end up being your best strategies: 

  • Start a LinkedIn Group or comment in groups you already belong to.  If you don’t belong to any groups, join some.
  • Comment on blogs you follow with links back to your site. If you comment enough, and with relevant information, they may ask you to be a guest blogger.
  • Join and speak at associations, clubs, chamber of commerce and conferences
  • Submit a free press release, here is a website you can use to get started –
  • Networking, networking, networking – When people can put a name to a face or product,   they remember.  
  • Build your social online networks such as Facebook, Twitter, LinkedIn, Google+, etc. 
  • Host a webinar, workshop or launch and have an enticing offer for your followers to invite others such as a discount or free item.  

If you have a larger budget, consider advertising using online banners, pay per click (ppc), affiliate marketing, remarketing, radio, tv, billboards, etc.

Find something special you can reference when sending an email or when following up rememberwith a potential customer.  Wear a shirt with a picture of your widget and maybe in a bright color like yellow.  Mention the widget and the shirt when meeting new people and maybe even go so far as to put it on your business card.  When you follow up, mention that you are “The widget guy in the yellow shirt”.  If you do this consistently, you WILL be the widget guy in the yellow shirt and may even become “remarkable” when that person is speaking with someone else.  It’s the same principle as what Afflac has done with the duck.

Tip 5 – Keep your customers coming back


If you take step #4 and build upon it and provide customers with outstanding customer service and a great product, they will come back.  Word of mouth, customer testimonials and referrals are the best kind of marketing you can possibly ask for.  It’s more than okay to ask a customer for a quote for your website or for a brochure.  If posting on your website or marketing materials, make sure you get their permission as no one wants to stumble upon a quote that came from them that they didn’t know about or approve.

Loyalty programs work amazingly well for getting and retaining customers. The airlines got it right when they started offering points for travel a long time ago.  By offering customers discounts, upgrades, club memberships, etc., they built a loyal customer base.  I know of people who will book trips at the end of the year and fly to several destinations in one day just to secure their statuses.

Partner up with another company and join forces to gain access to each other’s customer lists.partner up   To work best, the company you choose to co-market with should be non-competitive but your customers could cross paths.  If you send out a newsletters or promotions point your customers to them and have them do the same.  You can also consider co-hosting an event and share the attendee list.  Use a registration such as  Eventbrite which will give options to sell tickets to your event if a fee is required.  You can also customize the registration form to ask leading questions about why they are attending.

These are a few tips that may help get you going on marketing your product.  Things to remember are; know your product, know your customer, know your competition, build your following and your customers will come back, with friends.

I hope you have found some of these tips from Pathfinder Software helpful.  If you have, share this blog and if you have more suggestions, I would love to hear them.


The explosion of the mobile health (mHealth) arena seems to have many players in the mobile apps

healthcare industry running a race they haven’t trained for. There are roughly 40,000 mobile health and wellness apps in the marketplace today, up from about 6,000 in 2010. That type of growth shows the demand for mHealth apps, but as user engagement remains relatively stagnant one must wonder how developers are deciding what to build. In order to increase user engagement while limiting the clutter on app store shelves, mHealth needs to be introduced to another fairly recent phenomenon called the Lean Startup.

Only about 10% of smart phone users have downloaded mobile health apps and those who have aren’t using them for very long. Like the shiny new toy a kid gets for his birthday, the majority of mHealth apps are ignored as soon as the initial excitement wears off. The question of how to increase user engagement is one that has rippled through the health care community. This was a recurring theme at the 2012 mHealth Summit in Washington D.C.

Customer DevelopmentThe problem starts as soon as the decision is made what to build. Just as the modern developer knows that the waterfall methodology is outdated, the modern product manager knows that the classical approach to new product development will no longer suffice. The Lean Startup is a movement that stresses constant learning and direct interaction with the customer. Discovering what a user is looking for greatly reduces the risk of building the wrong thing. This is summed up in the Lean Startup mantra, “Get out of the building!”

Coined by tech entrepreneur Eric Ries and described in his 2011 book, the Lean Startup is anInnovation entrepreneur’s adaptation of the Lean Manufacturing movement that came from Toyota. Your grandfather’s style of launching a new product was to build it and then execute a savvy business plan. The lean approach recognizes that new products are built based on hypotheses that must be validated or invalidated through experiments. The modern entrepreneur, who may very well work for a large corporation, views a business model as the end goal rather than the blue print.

With these principles in mind, it’s no wonder mobile health apps that are built on assumptions fail to bring value to the user. Users have so little interest in current mHealth apps because they weren’t consulted when the apps were built. Product managers and developers have to recognize that they are not proxies for the customer or user. Face-to-face interviews with actual members of your target market will expose shortcomings and superfluities in your plan. Don’t be discouraged! Determine your hypotheses, test them, and celebrate each validation or invalidation as one step closer to a product that will engage your users. Why are you still reading? Put some hypotheses together and get out of the building!




flickr images by: methodshop.comVictor1558, and AJ Batac

When you combine cheap sensors with the computing power and interface capabilities of modern iPhones and Android smartphones, you can get powerful mobile diagnostics.  When you add in smartphones’ data transmission capabilities to feed data analytics in the cloud, you have the potential to dramatically improve the state of medicine.

Last week I wrote about a project we worked on this area, VG Bio’s Vitalink, which combines wearable bio sensors, an android smartphone and cloud based predictive analytics to identify significant medical abnormalities earlier than current systems are able to do.

There is a lot of innovation happening in this space with a wide array of sensor types and applications. Here are a few other examples:


swipesense hand hygieneTracking Health Hygiene Compliance.   Swipesense designed a personal, portable hand-sanitizer dispenser that healthcare professionals wear on their scrubs so they can disinfect their hands at any time.  The device transmits usage data wirelessly so that administrators can track compliance. The founders of Swipesense are graduates of the Healthbox Accelerator, where I’m a mentor.


Raisin ProteusIngestible Biosensors.  Proteus Digital Health has developed a feedback system that includes wearable and ingestible sensors that work together to detect ingestions and physiologic data.  The sensors, each about the size of a grain of sand, contain tiny amounts of copper and magnesium. When you swallow one of these devices, you generate voltage that powers the device and creates a signal.  The digital signal is detected by an adhesive patch attached to your skin like a bandage. The Proteus platform received FDA de novo clearance in July of 2012.

gauss estimation ipadReal Time Blood Loss Tracking in the OR.
 Gauss Surgical has developed an iPad app geared toward surgeons to monitor and track blood loss during operations.  Surgical staff will be able to use the iPad to scan gauze and other surfaces that absorb blood; the app will use an algorithm to estimate the total amount of blood on those surfaces.  This app was given 510(k) clearance by the FDA in the summer of 2012.

Sensor SyncingAsthma Monitoring.  Asthmapolis has developed sensor that attaches to the top of an existing asthma inhaler to keep track of medication dosage, time and place, connects to an iOS or Android Smartphone via bluetooth wireless.  Data can be shared with Physicians for remote monitoring of symptoms.  Data can also be aggregated and analyzed for asthma research and public health purposes.  Asthmapolis also received FDA de nove clearance in the summer of 2012.

smart bra breast cancer screeningEarly Breast Cancer Screening. First Warning Systems has developed a breast health system to detect tumors earlier and cut the rate of false positives and negatives. A sensor device placed in a bra measures cell temperature changes created over time by new blood vessel growth associated with developing tumors. Proprietary software that uses pattern recognition, chronology and artificial intelligence looks for changes in breast tissue that could indicate the presence of a tumor.

One of the trends from the 2012 MHealth Summit I briefly touched on last week was the growing number of bluetooth and wifi enabled wearable medical devices.  I think this trend will become extremely important over the next few years.

remote patient monitoring system

Body Area Sensor Networks combine pervasive wireless networks, small non-invasive sensors and ultra-low power consumption chips to enable the continuous collection of physiology data from ambulatory patients.

VitaLink, a project we recently worked on with Insight Product Development and our client VGBio, illustrates the potential power of combining body area sensor networks with mobile apps, cloud computing and machine learning based predictive analytics.

The Vitalink remote patient monitoring solution consists of:

  • Wearable bio sensors that collect ECG, respiratory bioimpedance,  2-wavelenght pulse oximetry, temperature and 3-axis accelerometers
  • An off the shelf Android based smartphone that collects these physiological signals from the bio sensors via bluetooth and transmits them via the Verizon Private Data Network
  • A cloud-based analytics server which uses predictive analytics to identify significant medical abnormalities earlier than current systems are able to do.

This technology enables the daily monitoring of patients with chronic diseases and provides early notification to clinicians of a negative change.

remote patient monitoring diagram

We’ve only scratched the surface of where we can go with mobile, wearable sensors and big data.

In the future I can see the data this proactive monitoring system collects can also be combined with data from other sensors like activity monitors, intake monitors, weight and sleep monitors, as well as information on prescribed medications to help provide feedback on the effectiveness of different approaches to improving outcomes.

What I will talk about at DRC is the ‘research-product’ gap. I just gave a talk at the Stanford D School about some of these issues. I discussed the research-product gap. This didn’t concern them. I said that if they were not interested in how their work got into a product, they were wasting their time.

“And they said, ‘We’re just doing the research, we’re not responsible for the product.’ And that’s the problem (even with you folks at the Institute of Design). You guys do the research – who does the product? And you complain, ‘Why don’t they ever take our brilliant ideas and make them into products?’

“If you look back in history to before design research existed and take the lightbulb, the telephone, the automobile, television, radio—none of those came out of design research. I challenge people to give me a counterexample. Give me one major breakthrough that came because of design research – nobody has yet succeeded.”

Don Norman, Nielsen Norman Group

DN: No – It’s the way to come up with new uses, and modifications to things that exist. The important breakthroughs, which only happen every couple of years, never come out of design research. If you look back in history to before design research existed and take the light bulb, the telephone, the automobile, television, radio; none of those came out of design research.

[Verganti, Design Driven Innovation]

But Apple usually leads the way. I think the iPad is going to dramatically affect the design of laptops. It’s interesting what it does not have. For example, no external storage: it assumes that we’re all living in the cloud. The iPad isn’t really about production, it’s about consumption, entertainment and watching.

That said, the thing that intrigues me most about the iPad is the iWork suite. A spreadsheet, presentation tool, and word processor, all controlled with your finger. And they did it very nicely from what I can tell. Obviously none of us have used it yet, but I think that’s going to be a major change. People think it’s killing e-books, but really it’s killing laptops.

DN: Inventors are the creative ones, and it’s almost always driven by some new technology. They see it and wonder if they could use it, so they create something. Sometimes it’s something they need for themselves, and they think everybody will too, or they build it just because they can. Most of these fail, but occasionally they don’t, and then design researchers can come along to find the real use and also make it work better. Often these inventions are only usable by the very dedicated early adopter.

My favorite story about Thomas Edison: he invented the phonograph and six months later he had a factory making them. He didn’t waste any time. But what was it for? He said he had invented the paperless office. It took a competitor to discover that the killer application was pre-recorded music by the great musicians of the day.

Gene Young: So inventions are this generative force that happen almost randomly, and once they’ve started to take shape, design research can come in and reconceptualize or refine them.

DN: Right. I’m not saying that’s the way it has to be, I’m just saying that’s the way it is. Maybe that will change in the future.

RD: So can you think of any people or companies who are bridging that gap?

DN: When I have this conversation with my friends, they always give me examples: XEROX PARC, Microsoft, IBM, Intel research labs. In my opinion, every one of those fails, they always have the same problem.

DN: That’s good, and that’s where design research is good, but it’s also consistent with my argument. That’s taking an existing product, seeing its flaws and making it better. I’m not arguing that design research is worthless – it’s extremely valuable for the transformation of an existing product – but it has its limits.

Design research is at its best when the product is out on the market and people are interacting with it. But anyway I’m part of the design research community, so if I’m going to go out and scold them in this way, it’s from a friend to a friend. Let’s think about what we’re doing and do it better.

Complexity is in the world, simplicity is in the head. The more you understand, the simpler things become. So the real trick is understanding.

Twas the night before a new release of FDA guidelines
Not a developer was stirring waiting on the sidelines;
The keyboards were hung by the monitors with care,
In hopes that interoperability soon would be there;

The physicians were nestled all snug in their beds,
While visions of Vinod Khosla danced in their heads;
And UX with their wire frames, and agile scrums
Had settled down with new problems but did not succumb.

When out in the office there arose such a clatter
New healthcare policies that really do matter
Away to the window I could only deduce
Tore open the shutters – hey meaningful use

The moon on my mobile phone my fingers did tap
Gave me comfort in seeing a new treatment app
When what to my wonderment a transformation
A process and method for new innovation

With a lots of health challenges and new informatics
I knew in a moment it was solved with mathematics
More rapid than standards and new care models
And a whistle and shout – no more waddles or dawdles

Now ONC, now PHI, and EHR
On HIT, on HHS and EMR
To the top of the challenges and problems we face
Now dash away, dash away and let us keep pace

Their eyes — how they twinkled, the patients did say
New help and better outcomes now that’s the way
Technology enabling and helping with costs
Payers and providers the message not lost

They sprang to their iOS, Android and Windows 8
Away they all flew new apps, wow that’s great!
And the delivery team exclaim as they moved with great stealth
Happy Holidays to all and to all Good Health!!

The challenges in healthcare are big –

  • 5% of patients accounting for 50% of costs
  • FDA regulatory is continuing to evolve
  • Improving outcomes and reducing cost are key performance measures
  • Security and privacy concerns exist
  • Interoperability and the development of standards continue to stifle progress in some areas

2012 brought lots of change and 2013 promises to bring much more. In this holiday season we are reflecting on the work we’ve done and the work that is to come and find ourselves humbled by the impact that we’ve had with our customers on the lives of millions and the healthcare eco-system. We look forward to working and collaborating with others that are tackling the big and important healthcare problems because it makes a difference in the world.

On behalf of the Pathfinder team, we wish you and yours a blessed, peaceful holiday season.

Poem by:  Ted Wallhaus