Cleveland Clinic's App Development Strategy: "Never Consider a Project Finished"

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In his role as both a physician and director of the Cleveland Clinic Epilepsy Center, Imad Najm, MD, saw epilepsy patients struggle with finding appropriate, reliable information for managing their condition.

"Patients, they sometimes stumble onto a good website and get good information, but sometimes they get their information in bits and pieces from different places, and it's tough for them to take this information and figure out what level or stage of their disease they're at," especially following a seizure, he says.

His patients' struggles ultimately inspired an interactive app that would put complete, trustworthy information in his patients' pockets. The app is meant to be a "companion," says Dr. Najm, that will help patients track their seizures and know when to see a physician, as well as provide medication management support and educational resources for patients and their families.

"We wanted to empower the patients," he says, "to give them the resources to control the seizures and control the disease."

To develop the app, Dr. Najm and members of the epilepsy center worked closely with the Cleveland Clinic's Mobile Center of Excellence, formed last year to help the clinic find and develop the most promising app ideas from around the health system.

The Mobile Center of Excellence provides technical guidance, assures adherence to institutional policies and acts as a liaison with outside programmers and developers. The center also contains the governing body that decides which app ideas deserve to be realized and exist under the Cleveland Clinic brand.

"We have 43,000 people that work here — there are a lot of app concepts," says Tony Crimaldi, Cleveland Clinic's digital marketing manager who also manages the Mobile Center of Excellence. It's the center's responsibility to ensure only the best ideas become reality, he says.

"We review it as a governing body, and then if it seems like a good concept it's presented to the mobile committee," he says. "There, we fire off questions and get answers, and then give our ultimate suggestion, whether it's to change things, or maybe this idea is better as a mobile website, or that it's a great idea and we have a piece of code that might be helpful."

The work of the Mobile Center of Excellence does not stop after an app's development is set in motion, or even at launch. At Cleveland Clinic, apps undergo continuous revisions and improvements to ensure they are as effective and useful as possible.

The health system's flagship app, Cleveland Clinic Today, provides daily, customizable health and wellness information from Cleveland Clinic experts, allows patient access to their health records and has a physician finder tool. The app officially launched last March on the iPad, and over the past year Mr. Crimaldi and his team have been analyzing user data to improve the app and the user experience before the app was recently expanded to work on all iOS and Android platforms, and will continue to work to improve the app for the expected influx of new users. .

"As soon as we launched, we were looking at it," says Mr. Crimaldi. "A lot of people think the development cycle is finished at launch — that's just the start of the next development cycle."

The "bells and whistles" on the first version of the app drew a lot of user traffic, he says, but the app team saw users moved on quickly to the more substantive parts of the app. For example, the app had a 3-D model of the human body that Mr. Crimaldi's team thought would be a large draw to the app.

"We thought it looked great, you could rotate it, but not a lot more," he says. "It turned out to be kind of a letdown for the audience, so we pulled it out."

The usage statistics also revealed infographics were one of the most popular features of the apps, so more were added and incorporated more into the daily content feed. The app team also soon realized the physician finder feature was popular but cumbersome, so the team took the code from a dedicated physician finder app and inserted it into the Today app, improving the functionality significantly without having to rework the original code.

To Mr. Crimaldi, these post-launch modifications and revisions are crucial to ensuring the app is as useful and as used as possible. "Never consider a project finished," he says. "Look at as many analytics as you can and take advantage of user testing."

He also stresses the importance of using continuous improvements as an impetus to experiment with new features. "Don't be afraid to fail, or to try something new," he says. "Keep iterating, keep looking for ways to keep them interested."

The epilepsy app, named MyEpilepsy, recently became available for download on the iOS platform. Now the app has launched, Dr. Najm is working to encourage users to provide feedback so the app can be made more useful to its target audience.

"What we think is important may not be the things that are important [to the users]," he says. "We want to improve… the feedback we get will help us come up with the next versions."

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