Healthy Notifications – 1/23/12

I’m an iPhone user. I like it a lot, although I don’t line up at stores for new product releases and I don’t like to spend time in the stores unless I’m with my kids.

With that out of the way, one of the new features in iOS 5 that I was particular excited about last fall was the new Notification Center. I was surprised it took so long to make the lock screen useful and to put a little user control in the way that notifications (e-mails, SMS, etc.) are displayed.

I like having notifications appear briefly at the top of my screen without requiring any user action. I also like the ability to adjust notification settings on an app-by-app basis. I still love the Notification Center after several months of use, at least compared to life prior to it. But I’ve recently discovered inconsistencies with some of my apps and notifications.

I actually only have a few apps that show up in my lock screen or pop up a notification when a new message or alert is triggered. Several (mail, calendar, and SMS) are Apple apps and seem to work fine. Others (for social stuff, productivity, or tasks) are non-Apple and have started to not work as set.

One app (Path), which I wrote about recently and love, does not work at all for notifications any more. I’ve turned notifications on and off, changed them around, uninstalled and reinstalled the app, and made sure I’m on the most recent version of iOS. Nothing seems to fix the problem.

(Before anybody suggests that this is user error, which I’m sure it could be, let me say that it doesn’t really matter. My point is that if I can’t fix it, then it is either flawed in deliver of notifications or in the experience of setting notifications. Either is a problem.)

This specific case with Path is not exactly life or death. it’s actually probably a positive for me because it’s not distracting. It did get me thinking of apps that are life and death, or at least billed as tools to help people manage their health. I’m thinking of things like medication reminders, ovulation calendars (life or death for some), appointment reminders, or any other health reminders. 

A reminder app or a reminder service should never be counted on 100%, but in reality, once people start using things like this, they become reliant on them. Once the apps stop working and people start missing appointments or doses or ovulation windows, there is a problem.

This isn’t unique to the iOS notification center. The same problem could happen on Android or one of the 14 BlackBerry phones still in use today or even with iMessage (iMessage has it’s own problems) or SMS-based notifications, though I imagine to a much smaller degree with SMS. It’s a problem with being reliant on any platform or wireless network when it comes to health.

If an FDA-approved diabetes app or connected glucometer takes glucose readings, uploads them, analyzes them, and then sends back an insulin or dietary recommendation that never arrives, whose fault is it? The platform, the app, the carrier, the provider that recommended it?

As I was thinking about this, it reminded me of an interview I read with MedApps CEO Kent Dicks several years back, in which he said MedApps had decided to develop a dedicated connected health device after trying to develop tools for mobile phone because "using a mobile phone platform helped us realize that we didn’t want to be at the whim of mobile phone makers." A platform maker can at any time change the way that notifications work as Apple did, how Bluetooth functions, or whatever a health app might depend on.

This issue — dedicated device vs. app — is a broader post. I’ll be reaching out to MedApps and a couple of other vendors with questions about dedicated devices vs. apps. For now, I’m curious if readers — especially providers or health systems looking at apps and services for patients — think about being dependent on platform and carrier performance for health issues?


Travis Good is an MD/MBA involved with health IT startups. More about.me.


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