imPROVE-ing breast cancer care and outcomes via mHealth.

ADK and Brigham and Women’s Hospital Improve Cancer Care with mHealth App Kit

The purpose

Dr. Andrea Pusic is Chief of Plastic and Reconstructive Surgery for Brigham and Women’s Hospital (BWH), and Professor of Surgery at Harvard Medical School, where she and her colleagues work tirelessly to improve patient care and outcomes. Dr. Pusic can now advance that mission through the addition of her latest role as Director of the Patient-Reported Outcomes, Value & Experience (PROVE) Center. The Center’s aim is to improve the breast cancer patient care journey across cancer and reconstructive surgery, and other specialized surgery-based care journeys.

PROVE team members wanted to make it easier for patients to share accurate pain level information with physicians, so they joined forces with ADK. 

The goal? Developing a patient-facing application that would support the physical and emotional health of patients through carefully timed surveys and ongoing tips. 

The challenge

PROVE clinical and surgery specialists have decades of experience in communicating with patients at all stages of their breast cancer treatment journey. But there would be several challenges in creating an application that helped patients report accurate pain levels, including how to:

  • Create survey questions from important care milestones across a long and complex patient journey
  • Make sure survey questions and answers aren’t burdensome for patients
  • Maximize relevant data from patient answers for the provider/researcher-facing portal
  • Meet the short grant funding application window

The PROVE team turned to ADK as partners to collaborate on what would become the imPROVE application. ADK and PROVE teams began discussions in late 2019 to determine application scope and minimal viable product (MVP) considerations. 

Pre-pandemic discovery process meetings alternated between the PROVE Center and ADK offices to define the MVP and budgetary parameters along with timelines and project roadmap. 

The strategy

ADK suggested the mHealth App Kit as the ideal foundation for building the imPROVE app, considering the aggressive timeline and limited budget of the research project. The mHealth App Kit is a complete platform for clinical research apps that provides everything needed to launch a consumer-grade research app, manage a study, and more. Because the app would need considerable custom design and development, having a head start on the core functionality was crucial.

The two teams met biweekly for sprint reviews where the teams would work together to develop capabilities for:

  • Multiple surveys with health status questions for the patient
  • Release of each highly specific survey to the patient on a carefully timed schedule coinciding with milestone dates and periods during their care journey
  • Patient access to care information and tips on dealing with pain and different aspects of the recovery process 
  • How responses and other patient data from the app get stored in a HIPAA-compliant AWS cloud
  • A customizable dashboard that helped care providers and researchers improve outcomes, track responses, increase adherence, and develop long-term research advances in patient care
  • Daily health reporting through the mobile app

The app’s surveys and individual questions change based on each specific milestone point of the patients’ journeys. This made survey logic and phrasing critical for presenting the right question at the right time in their pre- to post-operative care journey. The teams would have to balance very nuanced surveys, questions, and wording with clear and complete information that was easy for patients to understand.

While PROVE experts spearheaded writing the surveys, ADK worked closely to implement UI and UX best practices while tailoring the mHealth App Kit to the study and its brand. This required seamless sharing of critical health and app design process knowledge. The teams could then work together to complete features and functionality at the end of each sprint.

Both organizations brought a problem-solving mindset to the project, seamlessly becoming one team. This enabled ADK to bolster the PROVE team’s understanding of UI/UX design best practices. At the same time, PROVE could deepen ADK’s understanding of clinical care communication best practices. The approach gave both teams a baseline of knowledge so they could support each other’s knowledge growth. This resulted in a truly collaborative experience where the PROVE team’s healthcare and ADK’s digital expertise could mutually shape app end-user questions.

The impact

The initial phases of application development in Q1 of 2020 transitioned to a PROVE/BWH research and testing phase with select patient and provider groups. In true agile fashion, this testing phase continued with ADK implementing feedback into the completed imPROVE app. 

As of this writing, the PROVE team was securing final internal BWH stakeholder sign off with a soft launch of the imPROVE app for select provider/patient group use in early 2021. The next stage will be broad use for any applicable breast cancer patient groups.

Partnerships and healthcare innovation are long-term pursuits for PROVE and ADK. This mindset also powers ongoing relationships between ADK and other Harvard-affiliated hospitals like Dana-Farber Cancer Institute and Massachusetts General Hospital.

While these and the BWH app pursuits have different goals, they all have the mHealth App Kit as their platform enabling novel clinical research. This reinforces a foundation of collaboration and innovation across Harvard hospital affiliates and ADK. The result is a common drive to improve patient outcomes by empowering patients, providers, and researchers through better data and communication.

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About the study

Dr. Pusic led the creation of an application that would support the physical and emotional health of patients throughout their cancer journey.


The app needed to be beneficial, not a burden, while maximizing relevant data. The project was also up against a short grant application window.


Using the mHealth App Kit as a jumping off point, the team added extensive customization. The clinical team focused on survey writing, while ADK's team was hired to complete the design and development of custom features.


The app was developed within the schedule and budget needed to secure grant funding. The BWH team is now securing final internal stakeholder sign off with a soft launch of the imPROVE app scheduled for early 2021.

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