// Case Study

Trale

Mobile

Biomedical

In-field Data Collection

// Project Overview

Art+Logic has partnered with numerous medical and pharmaceutical service providers over the decades to create applications that support research and patient health. Some of the fields we’ve worked on include: cell microscopy and analysis, pharmacological research for degenerative diseases, medical hardware-software solutions, and EMR platforms. Used in labs, emergency rooms, and in the field, our clients’ solutions change and save lives.

One of our oldest mobile clients is TRALE, Inc. a leading wellness vendor in the field of work-site health. TRALE specializes in building customized health risk assessment (HRA) tools. TRALE’s software solutions offer cutting-edge technology, comprehensive reporting, and robust data-mining capabilities. TRALE’s products are designed to help companies improve the health of their employees and members while also reducing medical costs and claims.

In late 2010, TRALE reached out to Art+Logic with the visionary idea of porting their Win32 application to iOS so that they could use the newly-released iPad tablet as a data collection device.

For TRALE, the advantages of using an iPad in the field were obvious since the lightweight tablet and touch interface would provide a dynamic user experience. They had a novel approach to displaying the collected and analyzed data: Using a report-card format that is easily understandable in real time, with evaluations based on bio-metrics that are collected as the patient sits in the office.

The trick became navigating the new Human Interface Guidelines (HIG) of the first-generation iPad and creating a super-simple and easy-to-use UI for screeners who would be creating profiles and entering data for each new screenee. We also needed to account for the fact that, sometimes, the screeners would not be able to connect to the internet and the data collected from each screenee would need to be secure and anonymously aggregated.

Presenting data and user interactions intelligently and beautifully on the iPad and breaking the rigid history of the Win32 application was exciting. As we’d discover, though, the most challenging part of the project was clearing Apple’s hurdles.

mybiocheck iPad app

MyBioCheck makes it easy for you to quickly and efficiently collect, analyze, and report real biometric data. It was designed to allow screeners to enter and analyze participants’ biometric values more efficiently, and demonstrate the benefits of behavioral change while providing real-time feedback in the form of an easily understood report. MyBioCheck also delivers an aggregate report, clearly identifying the health strengths and deficiencies of the entire client-company or group.

// Goals + Objectives

TRALE’S goal was to grow their current solution offerings by creating a whitelabel health screening solution for companies conducting on-site screenings. Screeners would input blood level results for things like HDL, LDL and Glucose. The screener would also add demographic and biographic information: height, weight, smoking status, etc.

As the patient was sitting across from the screener, a custom report would be generated which would grade individuals on their overall health and evaluate individual areas of concern. This report could be sent directly to a printer so that screenees could leave the visit with a clear, understandable sense of their health strengths and where they could improve.

This data, which was valuable, would need to be scrubbed of all identifying patient information and sent to a server which would aggregate the data and allow administrators, HR Directors and company owners to view the data and create reports which allow them to effectively to monitor overall workforce or population health, create targeted initiatives and incentivize change.

TRALE knew that administrators would want to query the patient population at the time of screening as to which programs they would find most helpful, allowing those administrators to gauge buy-in and refine offerings before a single penny was spent on an initiative roll out.

// Implementation

At the start of the project, we entered into a green-field discovery phase and worked with TRALE to brainstorm how the iOS SDK could be used to more compellingly present content to patients.

Part of this discovery included the creation of the Health Tweakers™ functionality. The feature was the result of a rumination: “What if the screeners could, in real-time, demonstrate how small changes in the screenees biometric data could improve their overall health score?” The SDK allowed us to make that “tweak” dynamic with the slide of a fingertip.Screeners could consult with patients about proactive steps they could take to improve their health and lives.

Art+Logic worked closely with TRALE to develop their new product. Eventually, we took over development of the API we were developing against as well as the development of a complimentary web application: an administrator’s dashboard. The project further expanded as we solved the problem of how to allow screeners to securely load past screenings onto the tablet, perform a days worth of screenings off-line, and then export them and sync them after a day or a week or a month of being away from their desks.

The application Xcode source was originally written for iOS 3 in Obj-c. We’ve continued to update the application, not only in feature set, but through 8 OS updates, both major and minor (iOS 7!) and recently did a major under-the-hood refactor to bring the application into iOS 11.

Individuals who do the following five things, typically spend 33 – 50% less on healthcare costs:

Drinking alcohol in moderation

Not smoking

}

Walking 30 minutes per day

Eating healthy

Having a waist size less than half their height

// Challenges

The application was originally submitted to the AppStore

but we were surprised to find it was rejected.

Distribution hurdles and VPP

TRALE had decided that since the application was specifically designed for professional screening and coaching vendors, they would make the price of the application commensurate with what a vendor would expect to pay for an enterprise solution. The idea was to make the application uninteresting to the casual user and avoid support questions from non-vendor, untrained users.

Apple felt this was outside the parameters of the AppStore. We re-grouped with TRALE and decided that if we couldn’t sell the application for at an enterprise price-point, we would make the application free but make the screenings – an in-app purchase – expensive. We set the price-point at $599 for 100 screenings and re-submitted to Apple for approval.

And, again, were rejected.

As long-time Mac platform developers and having worked directly for Apple building software for them…

Art+Logic had a few inside contacts and we reached out to them for help connecting us to someone to whom we could plead TRALE’s case.

Apple was just about to launch its new enterprise, B2B platform, the VPP (Volume Purchase Program) Store and they suggested we submit to that platform. As it was, this still represented a problem because Apple’s application submission process wasn’t quite set up for this new avenue of distribution.

That said, and although not preferable to the client due to the hurdle of users in obtaining the application through the store, we were able to get the application approved to the VPP store. TRALE still opted to allow some of their users to access the application through an Ad-hoc channel – HockeyApp – in order to meet those users’ explicit use case.

9

Fast forward 8 years.

Apple has repositioned the VPP platform in such a way that it no longer supports TRALE’s business model. At the same time, they’ve relaxed both their application purchase price criteria and in-app purchase price limit.

Art+Logic recently finished work to update the application so that it can be distributed on the AppStore, as we had originally wished to do all those years ago. This move should greatly increase customer experience and smooth out version and update issues we have wrestled with under the VPP distribution platform.

It feels good to be home.

// Tech Stack

Back-end webservice

C#

Application

Objective-C

// The Team

Rob Rega

PM / Developer

Noah Harrison

PM / Developer

Matt Seeley

Developer

Bradley Macomber

Developer

Kendall Wyman

Account Manager

Susie Burton

Quality Assurance

Greg James

Project Supervisor

// Results

1/3

More than one-third of Americans are overweight or obese.

'

Depression & Obesity

Top two chronic health conditions driving health-related costs for employers were depression and obesity

60%

More than 60 percent of employers said workplace wellness programs reduced their organizations’ healthcare costs

ROI

Studies show that well-designed wellness programs have a return on investment of $1.50 to $3 per dollar spent over a two- to nine-year timeframe.