Flaredown: Decode your chronic illness

laredown is a website and mobile app that allows users to track their chronic illness through changes in medication taken, reactions to medication, and lifestyle changes. It also allows for users to share and communicate with one another about different treatment options. Flaredown has already surpassed its monetary goal on indiegogo.com, demonstrating the enthusiasm that soon-to-be users have for this product. I spoke with Logan Merriam, the designer and founder of Flaredown, about this app.

Why did you decide to start Flaredown?

For many patients, you try a medication, then if that one didn’t work, you try the next one. I have Chron’s disease, and I did that for about 6 years, until I’d gone through pretty much every medication on the market. At that point, my doctor suggested I check out surgery, and that was kind of the last straw. Up until that point, I’d always just gone with the doctor and medications, but then I decided that I needed some alternative. So what I started doing was journaling, and I realized that pretty much everything in your life can affect chronic illness – the way you eat, your activities, stress, sleep, everything. So I just started keeping track of those things, and over the course of a year, I was able to figure out things that triggered my symptoms, instead of just trying to medicate everything. I made so much more progress than I had previously. But, it was frustrating because there wasn’t an easy way to journal these things every day, and I could not believe that there weren’t any good apps for it. That’s how Flaredown was born. Then, over the course of a couple of years, I just managed to find a couple of people who were interested in the project enough to work on it with me, and that’s how the team got together.

Who is a part of your team?

Right now we’ve got myself – I’m the designer – a rheumatologist, a web developer, 2 data scientists, and a mobile developer who’s working with iOS.

Why the name Flaredown?

Originally, we called it patterns, and it was a little bit more general because the idea was that you were looking for patterns and correlations between a bunch of factors. Then we realized that the reason we created this was to help with chronic illnesses. It is especially helpful with flaring illnesses like Crohn’s because there is a very clear problem area, so you can look for triggers that cause that flare. And we realized that this tool was especially suited for those things, so it was just a process of focusing it down to a specific area. And it’s also a little bit of a punny thing because you usually have a flare-up, and Flaredown is the opposite – get better.

How do you come up with the questions that you ask patients on the app?

Chronic illness is really tough to quantify because by its nature, you can’t just take a test and see how bad someone’s disease has gotten. They all are collections of symptoms. But what researchers have done, because you need a metric for data research on an illness, is create disease activity indexes. So there are questionnaires for a lot of illnesses that will spit out a score that gives you the severity of the illness. That’s what we graph, and we ask the questions from those surveys. We call those catalogs internally in our system.

What types of chronic illnesses do you plan to put on the app?

We’re starting off with Crohn’s disease and rheumatologic arthritis because I have Crohn’s, and we have a rheumatologist working with us. Crohn’s has the CDAI (Crohn’s Disease Activity Index), which is the golden standard for any new medication or research. RA (rheumatologic arthritis) also has very good patient-focused disease activity indexes. So we’re starting with those two.

For the most part, a lot of what we’ve focused on are invisible illnesses. And the thing about those conditions is that they’re really hard to measure. If you talk to patients with fiber myalgia, for example, they have a lot of trouble, even with their doctor, communicating the symptoms they have and the severity of them. Giving them a tool, like a graph, is especially useful for invisible illnesses because it makes invisible illnesses visible, which is a pretty powerful thing. The reason why I started building this in the first place is because a lot of my worse symptoms, that I was having trouble getting treatment for, were those that come along with chronic illness, and are really hard to measure, communicate, and quantify.

Your app is able to track how different medications affect a patient. Hypothetically, if a patient were to take multiple medications simultaneously, how would the app figure out which one is actually affecting the patient?

That’s the kind of thing that you have to figure out because at a certain point, we can’t tell you that. We’re looking forward to trying to figure out the correlation between cause and effect, and to give an idea of those things, but we’re never going to be able to say that this treatment leads to this, etc. That’s unrealistic, but using a lot of data over long periods of time, you can start to figure and filter out which treatment tends to correlate with your illness the most. You also have to filter out things like triggers because avoiding a trigger can also affect you. We’re just getting started on that, and we can only hypothesize those things because we don’t have any data coming in yet.

How will your app be able to track multiple conditions and see how they interact?

The patients will have to try to figure it out for themselves, but having the visual helps out a lot because patient memory is so biased by how you’re feeling right now. When we launched the campaign, we focused mainly on one illness at a time, but now we’ve been sending out surveys with updates. At first, we suspected that it would be really useful to have multiple illnesses, but what we discovered from the first survey is that people have expressed the most interest about 2 to 4 illnesses. People aren’t just going to want to focus on one disease, they’re going to want to be looking at how multiple illnesses interact, so right now we’re actually having a big internal think-tank about how to do that best. Some of the ways we’re doing that is by splitting up the catalogs into symptoms, and letting people essentially build catalogs of symptoms because what we’re learning is that the illnesses are not completely demarcated from each other. Even the patient is not certain what’s attributable to what, so you end up with a tapestry of symptoms, and maybe a better idea of what the patients want to track. But this is something we are still right in the process of doing.

A beta version of Flaredown will be released in December 2014, followed by the open launch in February 2015.