“How satisfied are you with your physical health in the past four weeks?”. Knowing how a patient is feeling, what their symptoms are, and if they experienced any changes is often essential information to healthcare professions and clinicians alike. The use of patient diaries, or symptom trackers, can offer valuable insight into any range of symptoms and assist in making more informed decisions about a diagnosis or treatment based or recognise symptom fluctuations accompanying a new drug.
Depending on the clinicians or the research, self-reported questions on symptom tracking can vary immensely both in detail and time. Doctors will frequently ask their patients to keep a diary for recent health events, such as pain, fatigue and quality of life over the last 24 hours, the previous week, or the last month. The timeline of these symptoms can be analysed together with new treatment regimens or lifestyle modifications to gain valuable insight into a patient’s response.
So what are our options for symptom trackers? How can we also promote self-management from the patient’s side to take more charge of their health? In the past, we have relied on pen, paper, and a good memory. The downsides to these diaries and methods however often lead to low adherence, misplacement, and time consuming analysis. By shifting these diaries to the small buzzing electrical devices we all carry in our pocket, we can remind patients to answer at predefined times, we can create backups of the data, and instantly analyse it.
A digital symptom tracker is a computer software that allows a person or patient to self-report medical events and track what they felt and when it happened.
Traditionally patients have used paper booklets to track their symptoms. Paper logs have many upsides, they work anywhere, don’t require extra devices (beyond a pen), and they never run out of batteries. But this also means they can be misplaced or lost anywhere, without a backup, and the processing of paper diaries and notes also has its obstacles ; interpreting handwriting can lead to mistakes and data analysis is not instant.
To cope with the challenges of pen and paper data collection doctors and researchers have been using digital symptom trackers for decades.
With the advent of the smartphone, virtually anyone carries in their pocket a powerful note-taking device. App-based diaries ensure that entries can happen anywhere, anytime and can be coupled with push notifications to ensure measurements are not missed.
Data security is a crucial feature of these sorts of systems. Although any app with annotation or data collection capabilities may seem fit for tracking our health, there are essential data protection features that must be regarded when using a mobile app for tracking our health.
An example of the standard security features that a health journal app should have is passcode locking. If someone finds a smartphone with medical data, they should enter a passcode to unlock it, even if the smartphone has a general passcode enabled.
Also, the data should be stored locally encrypted. If the device is lost, this will mitigate the risk of someone gaining unlawful access to that data.
Clinicians and patients should look into what standards and regulations the mobile application they want to use complies with, such HIPAA, 21 CFR Part 11 (FDA) and Good Clinical Practice.
One of the benefits that a health journal app has over paper is the ability to visualize the data and share it with others quickly. Not all mobile apps store data in the cloud, some only locally.
Assure that you choose an app that is capable of providing remote access to the data and that even if the device would be lost, the data can be retrieved. If you are doing clinical research, check that the data can be exported in CSV or SPSS and with enough metadata that other researchers could possibly use it in the future.
Logging symptoms is all about capturing qualitative and quantitative data. In practice, this means creating a form with variables and fields. The complexity of your questionnaire will depend on the kind of data you want to collect. In some cases, advanced features might be required such as branching logic (a new page or question appears dependent on the answer of a previous one), automatic calculations, image and video capture.
Make sure the app you want to use will be able to handle the kind of symptom data you want to keep track of.
Making data collection a habit is no easy task, with the many distractions that patients have they will likely forget to enter data. Increasing engagement and adherence can be aided by scheduled reminders.
Build fully customizable data capture forms, collect data wherever you are and analyze it with a few clicks — without any training required.
With so many health journal apps out there, we researched the best ones to date. We reviewed them based on user-friendliness, security and suitability for research purposes, and the further services that set them apart.
Teamscope is a secure and easy-to-use data collection app for clinical and field research.
With Teamscope, patients and health professionals can create powerful forms, a.k.a electronic Case Report Forms (eCRF), collect data and visualize it with a few clicks. Patient’s can install the app on their smartphone and use their forms to log their symptoms, habits or any event.
The data is stored securely on the cloud, which makes it simple for a patient’s doctor or family member to monitor the data remotely, visualize with graphs and export it.
One of Teamscope’s strong points is in security and data protection. When a user closes the app and reaccesses it a 4-digit passcode is required, this prevents others from accessing the data in case a smartphone or tablet would be lost or stolen. Furthermore, data is stored encrypted both on local memory on the mobile device and in-transit.
Features: Offline data capture, data security, remote data monitoring
Cost: Plans starting at €0/month.
Availability: iOS and Android
Flaredown is a free web and mobile app (Android & iOS) that helps patients track and visualize their illness, treatments, and symptom triggers so that they can understand how their choices affect their health.
Flaredown is a free web-based and smartphone app (Android & iOS) that helps patients track and monitor their symptoms, medications and conditions, in order to understand the effect of their decisions on their health.
Flaredown collects data in a research-friendly manner that can be used to test real-world therapies and find the best new ones to share with patients worldwide.
One of Flaredown’s valuable features is the ability to schedule reminders. This allows a patient to receive a notification whenever they need to log their symptoms, thus increasing adherence to data collection.
Flaredown allows you to view charts directly from the mobile app to see how your symptoms have fluctuated over time.
Features: Email reminders, database of conditions, data visualization
Availability: iOS and Android
Tally is a mobile app, developed by Treebetty, that allows you to set goals and log your progress.
Tally is easy-to-use and offers a delightful user interface. You can use it for medical conditions as well as for habits and daily planning.
To get started with Tally, patients must create a tracker and set a timeframe for it to be repeated. Tally is free for up to 3 trackers, offers premium features such as passcode protection, export to CSV and multiple reminders for each tracker.
Features: Scheduled reminders, easy-to-use, passcode lock
Cost: Freemium, paid features cost $7.99.
Symple is a symptom journal and health diary app. The app is elegantly designed and easy to use. You may track how you feel, your habits and symptoms and explore your data with interactive charts.
Symple stands out for having the ability to import health data, such as heart rate, steps and sleep directly from Apple Health, giving a more comprehensive overview of your health.
The platform is free to use for up to 5 symptoms, and your data can be exported at any moment to CSV.
Features: Integration with Apple Health, image capture, reminders,
Cost: Freemium, paid features cost $9.99.
CareClinic is a comprehensive self-care platform for tracking symptoms, habits, physical activities, and any custom values.
The platform makes data entry intuitive and straightforward and offers unparalleled health symptom reporting. Patients can discover triggers and factors that influence their symptoms and track if they are on track with their health plans.
CareClinic stands out for having a comprehensive medication reminder solution integrated into the platform. Patients can define what medications are taking the set different reminders for each pill.
The data can be accessed remotely by a physician or family member using the Careteam feature. This gives the patients support circle the possibility to gain visibility to their progress, symptoms and medication schedule.
Features: Remote data access, medication reminders, Care team access
Cost: $9.99/month or $59.99/year
Availability: iOS, Android and Web
Digital health journals make it easier for patients to track their symptoms and share that information with their doctor and support circle. When it comes to increasing the accuracy of that information, our smartphones are a handy device to securely store events and valuable medical data.
Patients and doctors will find an array of solutions in the market today to keep track of their symptoms over time. The fit of each solution will depend on the use case, the ability for patients to quickly learn to use them and the possibility for the data this is collected to be used for other purposes, such as clinical studies.
For the patients themselves, the use of electronic symptom trackers also invites a new level of self-management. They can see how their symptoms change over time, perhaps learn to avoid certain triggers, and ultimately develop the ideal patient-specific treatment together with their health care professional. This development allows patients to (literally) take their symptoms into their own hands.