Migraine disease is a condition that affects over 48 million Americans, and about one billion individuals globally. With only a small number of headache specialists around the world, availability for care is widely limited. Luckily, one of the leading centers for headache and migraine joined forces with Ctrl M Health, a digital wellness company to bring their valuable findings to a wider audience.
Arcweb Technologies got the chance to work with Ctrl M to bring their digital wellness platform to market, solving for a wide variety of product and experience challenges. The end result was a full-featured digital product that speaks directly to complex user needs and helps bring migraine expertise to more people.
Using Digital Wellness to Address Migraine Disease
Ctrl M Health collaborated closely with the Jefferson Health Headache Center to create an integrated digital wellness platform for people who experience migraines. The partnership pioneered a unique digital experience for migraine sufferers using the methodology developed by researchers at Jefferson Health.
Today, we’ll be speaking to some of the minds behind the platform. First up we’ll have CEO and Co-Founder of Ctrl M Health William Gadsden explain the major barriers to care for migraine disease and how the company aims to help remedy that accessibility gap. Next, we’ll chat with pain psychologist Dr. Caryn Seebach and Arcweb UX/UI Designer Mike Balcerzak to find out how they worked together to bring the Ctrl M Health product to market. The podcast will focus on these major questions:
- What is Ctrl M Health’s mission?
- What are the major facets of the Ctrl M platform?
- What’s the nature of Ctrl M Health’s partnership with the Jefferson Headache Center?
- What are the barriers to care in the headache and migraine community?
- What major challenges do migraine sufferers face?
- Why is a mobile app a good fit for migraine management?
- What was it like bringing the Ctrl M Health product to market?
- What are the core features of the Ctrl M Health Platform?
- How was UX design considered in the making of the Ctrl M app?
- How does Ctrl M define success and what’s next?
Next in our “Engineering Healthcare” series, we’re joined by our partners over at Ctrl M Health who launched their wellness app this past summer. CEO & Co-Founder William Gadsden will highlight major challenges the migraine community faces and how the Ctrl M platform uses a multimodal approach to help migraine sufferers manage their pain. Later on in the episode, Pain psychologist and Director of Programs at Ctrl M Dr. Caryn Seebach will share why mobile apps are ideal for chronic pain management and how the core features of the Ctrl M platform are personalized for each user. Arcweb Mike Balcerzak, a principal UX/UI designer on the project, will also chime in to describe how they made careful product strategy and design decisions to cater directly to the needs of users experiencing migraines.
Kurt Schiller [00:00:00]: Hello and welcome to Product Hacker. I’m your host, Kurt Schiller.
Kurt Schiller [00:00:04]: Consumer apps that coincide with patient experiences are nothing new, from prescription management tools to direct-to-consumer devices like fitness trackers. But there’s a new class of digital health tool that’s arriving on the market, tools and apps that help people directly manage their conditions and can open up care to even more people in the process.
Kurt Schiller [00:00:21]: Today, we’ll be speaking with the team from Ctrl M Health. They’ve partnered with the Headache Center at Jefferson Health in Philadelphia to create a first of its kind digital health and wellness platform that helps people living with chronic headaches and migraine access a personalized plan of support through an innovative mobile app and a lot of evidence-based supplements. First up, we’re speaking with Ctrl M CEO William Gadsden to talk about the journey and mission of Ctrl M Health. And a little bit later on, we’ll be joined by pain psychologist Dr. Caryn Seebach and Arcweber Mike Balcerzak, who helped bring the Ctrl M app to life.
Kurt Schiller [00:00:50]: I think a great place to start, Will, would just be kind of can you give our listeners a quick overview of Ctrl M Health and the mission that you’ve been on?
The Purpose of the Ctrl M Health Platform
William Gadsden [00:00:59]: Sure. Let me start by saying thank you, Kurt, for having us on the podcast. We appreciate the opportunity to speak with you. The mission for Ctrl M Health is really quite simple. Our goal is to empower people living with migraine, with the knowledge, the resources and the tools that they need to engage in healthy, proactive self-management of their chronic disease. There’s a lot to unpack in that sentence there, Kurt. But it really boils down to the fact that medical research has shown that there is a lot of efficacy, a lot of benefit to those living with headache and migraine to engage in healthy behavior change and lifestyle modification as an extremely effective way of navigating their personal journeys with migraine. No two people’s migraine is the same.
William Gadsden [00:01:50]: Everyone experiences it in a different way and the traditional models for care have focused extensively on pharmaceuticals and drug-based therapies for the management of migraine. These drugs are typically or have typically been borrowed from other diseases: beta blockers, anti-seizure medications, things like that. So there are a handful of new drugs, CGRPs, which have been developed specifically for migraine. All of these drugs have limited efficacy and the potential for side effects. So what we found is that the feedback we received from those living with headache migraine is that they’re looking for ways in which they can engage in their care, but they’re confused as to how to do it.
William Gadsden [00:02:41]: And that a gap exists between the needs of the community living with migraine and what the traditional medical community has provided. And that gap really is centered around the idea of health and wellness, lifestyle modification and non-medical approaches to managing migraine.
Kurt Schiller [00:03:04]: So when you get down to kind of the Ctrl M model, how how do those considerations turn into the actual product that you’re bringing to market?
William Gadsden [00:03:15]: Sure. So the first thing we did in trying to think through how to deliver these was think through what’s currently being delivered to this target audience. Nothing that Ctrl M is delivering is necessarily new to the market. The challenge has always been that no one has centralized or integrated all of these programs into one single source, coordinated and personalized for those living with migraine. There are some great apps out there for meditation right now. Yoga practitioners have offered classes for those living with migraine, and sleep experts often work and provide advice for people living with migraine. But no one has has taken the time to consolidate and integrate all of those various disciplines into one integrative program coordinated for the unique needs of the migraine community. So Ctrl M at the earliest point, really just tried to focus in on how do we organize this? How do we present this so that it is not just understandable, but it’s accessible to those living with migraine.
William Gadsden [00:04:37]: And that is best seen in the M power system, the Ctrl M power system health wheel where we have identified six core health pillars, which we think create a multimodal approach to navigating and managing health and wellness with migraine. And those pillars are core health, movement (exercise and the like), self-awareness which is mindfulness and meditation, connectedness which is really delving into the critical nature of social aspects and interpersonal relationships in the management of any chronic pain disease. Self efficacy; developing the confidence and the belief that you can make changes in your life successfully that will have a positive impact and improve your quality of life. And then finally, growth. How do you celebrate and reward yourself and recognize the small achievements that you can make day-by-day, which add up to big changes over time.
William Gadsden [00:05:41]: And so by structuring our six health pillars in our health wheel, we then started to develop programing that worked its way down to various strategies, various activities, and created what we think is a very rich and robust program to teach people why certain activities are helpful for managing migraine. What about those activities has been scientifically shown to be helpful. And then, most importantly, how do you engage in them? How do you integrate them into your daily routine? Because there’s nothing harder than trying to fit something into a busy schedule. So anything we can do to help try to to ease that transition and make them available anytime, anywhere became are our primary objective.
Kurt Schiller [00:06:32]: And in terms of the product, I think you had mentioned before that there were three key forms that it basically took for your users.
The Integrated Ctrl M Health Experience
William Gadsden [00:06:40]: Yeah, well, we think of it as our digital platform. And Arcweb was wonderful. They helped us in each. Obviously, their primary mission was to focus on the mobile app for which they did a wonderful job, but really with what we built with Arcweb, an ecosystem of three different platforms for delivering our services and products. The first is our website. Our website is home to what we call the Ctrl M Knowledge Portal. The knowledge portal is extensive library of articles about various migraine topics overseen and curated by the headache specialists at the Jefferson Headache Center and really developed to create an accurate and balanced perspective on a variety of migraine topics to help people think about what’s relevant to them. Help put it in context and to help educate them on their chronic disease. And believe it or not, it’s hard to find accurate, balanced information out there. So we’ve got a lot of positive feedback on the knowledge portal.
William Gadsden [00:07:45]: The second part of the platform is the mobile app. Right now it’s offered for iPhones, but it is our delivery mechanism for all of the health and wellness programing that we have created. It has scheduling capabilities, reminders, a digital avatar who acts your digital health coach to keep you on track, to encourage you and to help you in the hard process of developing behavior changes that are healthy and impactful for your quality of life.
William Gadsden [00:08:18]: And then finally, the third part of our digital platform is our e-commerce shop. We’ve developed a proprietary line of dietary supplements, each evidence based in its design and scientifically shown to be impactful for many in the management of headache and migraine. Again, everyone’s migraine is unique. What works for one may not work for someone else. What Ctrl M is really set out to do is try to put all of the various options, all of the various strategies which again are evidence-based in a structured format to help people explore, to experiment and define what works for them. And when they find the things that help them navigate life with migraines, to give them the encouragement and support to again integrate that into their lives so they can make lasting change.
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Ctrl M Health’s Collaboration with the Jefferson Health Headache Center
Kurt Schiller [00:09:17]: So we’ve mentioned the Jefferson Headache Center a couple of times now. Could you talk a bit about what that partnership looks like?
William Gadsden [00:09:24]: Sure. So the Jefferson Headache Center has been our collaborator in the development of Ctrl M from the start. And frankly, the earliest visions of Ctrl M really stem from Jefferson Health and the Jefferson Headache Center. The Jefferson Headache Center is one of the leading comprehensive headache centers in the United States. It has been around for over 25 years. It has done some pioneering research, both medical research and clinical research into the management of headache and migraine. And Dr. Stephen Silberstein and [Dr.] William [B.] Young are two of the most respected neurologists in the field of headache.
William Gadsden [00:10:05]: Ctrl M is blessed in a collaborative partnership where we have the exclusive license to the medical protocols for the Jefferson Headache Center as the foundation for Ctrl M Health and its health and wellness programs. Ctrl M Health benefits from the collective experience and wisdom of the Jefferson Headache Center and Dr. Silberstein and Young and the entire staff at the Jefferson Headache Center really were our sounding board; our source of critical information and inspiration as we thought through how to best build and develop our programing and then our delivery mechanisms.
Addressing the Gap in Headache and Migraine Care
Kurt Schiller [00:10:51]: Will, you touched on a bunch of great things. One of the ones that I wanted to circle back on was the question of access, which I know is something that you were deeply passionate about when we talked kind of in the pre-episode discussion. And so I’m a migraine sufferer myself. And I am privileged enough to have pretty good access to healthcare. But obviously, so many people don’t. With the pandemic, people’s ability to see specialists, to travel, to get to appointments has been even further restricted. So I just think that that’s such an interesting aspect of kind of the digital health experience. And we’ve seen this with with telehealth; we’ve seen it with telepsychology. Could you talk a little bit more kind of about how that goal of access kind of played into your thinking?
William Gadsden [00:11:38]: Sure. So as we start to explore the migraine community, their needs and the provider market; i.e. doctors, physicians, hospitals and those who are there to help support the migraine community, we identified a very glaring gap, which is that there simply aren’t enough headache specialists for the size of the population.
William Gadsden [00:12:05]: 550 headache specialists for 40 million people. We also discovered that the study of headache medicine has really just never been prioritized in medical school. The average medical student has one, maybe two hours of headache education so that whether it’s a family practitioner, whether it’s an emergency room doctor, whether it’s any primary caregiver. While I am confident that their desire to help their patients is 100-percent focused on the patient, their access to the knowledge and the nuanced understanding of headache and migraine is limited just simply because it’s not been given a lot of coverage in medical school.
William Gadsden [00:12:46]: So you had talked about in your own experience, you know, access to care, whether it’s geographic or whether it’s access to a specialist. This is a wide-ranging problem that a lot of people face. The headache specialists tend to congregate largely in large urban centers for obvious reasons. So if you’re living, you know, 30 miles away, 90 miles away from a large urban center or more, your ability to access those resources is limited. It’s also hard sometimes to get appointments with these specialists. And then, as I mentioned, going to family practitioner, et cetera, you may not be availing yourself of the breadth of medical knowledge that otherwise you could receive.
William Gadsden [00:13:29]: So I should pause here and simply say that Ctrl M Health is not practicing medicine. We’re not in the telemedicine business. We are in the telewellness part of the spectrum. But what we’re really focused on is not replacing the the healthcare provider, but more augmenting that relationship and taking the knowledge from the Jefferson Headache Center, from some of the leading headache specialists in the world and making it available broadly and equitably to anyone living with this chronic disease. The power of technology and the Internet allows for this dissemination of information relatively easily. And really what we had to focus on was how can we deliver programs which are evidence-based, which are vetted for medical accuracy, but which allow for incredibly powerful strategies, tools and programs to be employed by individuals on their own, or as I said earlier, between physician appointments. You had talked earlier about telemedicine.
William Gadsden [00:14:40]: Telemedicine has had tremendous acceleration in its impact for patients throughout the pandemic as people have been reluctant or unable to go to hospitals or see their medical provider. Telemedicine has created a wonderful option where they can consult with their physicians remotely via the telephone or via video call or similar technologies.
William Gadsden [00:15:11]: Ctrl M Health services are, I guess, within the family of telemedicine; we’re telewellness. But really what we’re solving for in our programing is instead of being the once a month or once every quarter consultation with your doctor, we’re providing you the support and access to the knowledge of these headache specialists every single day via your mobile device so that you can learn about what’s healthy for headache and migraine, engage in programing, schedule it and really make it part of your daily existence as you try to build healthy routines in between consultations with your physician.
Kurt Schiller [00:15:53]: Yeah, and I think that point is so key to make about it being a support service, because something else that we’ve heard, we’ve heard come up again and again. I’ve been saying this a lot myself, is that these digital health tools should should augment, not replace the human component in healthcare. And I think especially, you know, someone coming from outside of digital health has a really fresh, you know, view on this. And another thing that you had mentioned to me was kind of that that you don’t see Ctrl M as a disruptor. Because disruption has an element of destruction in it. And I thought that was such a good metaphor. And it seems so, so essential kind of to the Ctrl M mission that it be supportive and augmentative.
William Gadsden [00:16:46]: Yeah, I’m glad you brought this up, because I think it is a key concept to sort of how we view Ctrl M fitting into the general health and wellness environment. When we started thinking through the business model for Ctrl M we did a lot of reading of big thinkers within the medical world. People who are thinking about the future of healthcare and thinking about the role of technology in healthcare and the opportunities which exist. And there are so many businesses now where, including businesses within healthcare, where technology is seen as a way of replacing how the previous model was done. So replacing in this case, doctors or nurses replacing the traditional medical relationship.
William Gadsden [00:17:42]: And we also read a lot of really, really thoughtful articles and research reports that highlight that it’s not clear that within medicine that that type of replacement is possible or even prudent. That medical providers have a specific training, but they really bring to that a personal one-on-one relationship, which is both medical as well as emotional and supportive. And to try to disrupt that relationship didn’t feel appropriate to us and didn’t feel like a successful model going forward. So we really we recognized early on that we wanted to complement or augment that relationship. Technology has a tremendous ability to extend and to build efficiency for the medical provider, not to replace them or try to cut them out of the equation.
William Gadsden [00:18:38]: At Ctrl M, what we realized is that while disruption can have a creative component, it can also have a destructive component. We felt that we wanted to focus on the creative. We wanted to focus on the constructive and that augmenting and focusing on helping to extend the reach and the access to top tier medical care was far more of an attractive opportunity than trying to rethink how people think of their relationship with their care provider.
Kurt Schiller [00:19:12]: So I think it’s a great opportunity to pivot to talking a bit more about the specific technology of Ctrl M Health and especially the Ctrl M app. And to that end, we’re also joined today by Pain Psychologist and Director of Programs for Ctrl M, Dr. Caryn Seebach, as well as Arcweb Technologies’ UX Architect Mike Balcerzak, who worked with the Ctrl M team to help bring the app to life. Dr. Seebach and Mike, welcome to the podcast.
Dr. Caryn Seebach [00:19:36]: Thank you. It’s a pleasure.
Mike Balzcerzak [00:19:38]: Yeah, thanks for having us.
Major Challenges of Migraine Disease
Kurt Schiller [00:19:39]: Absolutely. So I’d like to start things off with you, Dr. Seebach. Could you give our audience just some context about the challenges of people living with chronic headaches and migraines?
Dr. Caryn Seebach [00:19:54]: Absolutely. So you heard some of the stats that Will have mentioned earlier, and they probably bear repeating. There’s 40 million Americans that are estimated to have migraine; one billion in the world. And that is highly disproportionate to the amount of providers that we have of headache specialists. So we think there’s about 600 headache specialists in the US and there’s far less behavioral health specialists who are trained in headache and migraine. So there’s huge barriers to care. We’ll also mention that, you know, these centers that when they do exist and they’re very few and far between, they’re largely metropolitan areas. So in addition to having the burden of managing a very painful, complex, unpredictable neurological disease, people have to travel. They have to take time off work, figure out child care, because it’s very rare that even if someone does get to see a provider, that they’re able to fix the problem in that first session. It takes multiple sessions with your provider. It takes lots of trial and error, trying different treatments, finding what works for you.
Dr. Caryn Seebach [00:21:12]: So it’s a lot of back and forth and that’s, you know, in addition to the burden of trying to live with migraine. So we think there’s about twenty eight million Americans that are undiagnosed living with headache and migraine. So that’s a lot of people trying to piece it together on their own and figure it out. And so we found when, you know, when I was working with patients, I would help them try and piece together all of these different options of how could they manage their migraine from the non-medication side of things. And, you know, it’s been an hour in a session, so maybe I’d see 10 patients a day, right. And so that if you think there are very few behavioral health providers out there and the amount that it kind of funnels that we can see as providers, that so many people living with headache and migraine who are not getting access to resources, access to providers who really have to piece it together for themselves.
Why Apps Work for Chronic Pain Management
Kurt Schiller [00:22:16]: So I know that the use of apps for chronic condition management has been a pretty hot topic for a while. Is there anything particular to migraines or chronic pain management that makes it an especially good fit for building an app around it?
Dr. Caryn Seebach [00:22:34]: Yes, I certainly think so. So by nature, migraine is very unpredictable and certainly people with migraine are very conscientious, bright people and they try and figure it out. They constantly try and figure out what causes migraine and what triggered it.
Dr. Caryn Seebach [00:22:50]: And largely, it’s many, many things that come together at the same time. I like to think of it as a bucket, you know, and so you have this bucket that has a certain amount of space in it. And once you start to fill that bucket of things that could instigate or perpetuate your migraine. You have very little leeway. And it could be just a very last thing that, you know, piece of chocolate that you ate and then you get a migraine. Well, wasn’t necessarily the piece of chocolate. It was all the things that went into the bucket beforehand. So there’s been lots of apps that have come out that are helping people try and figure out their triggers, right, to get some semblance of control.
Dr. Caryn Seebach [00:23:30]: But we wanted to do is really help people figure out, OK, once you have a sense of what may be perpetuating or migraine, what do you do about it? And that is where largely the lifestyle changes come into play, behavior change principals, habit change principals come into play of really trying to develop a lifestyle that is gonna to lower or I should say, raise the threshold for what would cause a migraine. And to have that in your fingertips of this whole library of options, whether it be education or activities like listening to mindfulness or meditation. Learning about nutrition strategies or doing an exercise, it is all in the palm of your hand. And the fact that it is digital allows you to pick and choose from this library based on what particular thing you may need in that moment. So that piecing it together and that trial and error that we talked about becomes a lot easier when you don’t have to rely on going to see your provider.
Bringing the Ctrl M Health Product to Market
Kurt Schiller [00:24:38]: So like I mentioned before, we at Arcweb were lucky enough to have the opportunity to partner with you to help kind of bring this app to life. Mike, you had a pretty direct hand in this. Could you kind of talk us through a little bit of that process of taking this kind of very organic clinical challenge and knowledge base and then turning it into, you know, an actual app experience that could be put into someone’s hands?
Mike Balzcerzak [00:25:05]: Yeah, absolutely. On so kind of contrary to how we work with – or the types of projects that we get through Arcweb; Ctrl M actually had kind of a wealth of research and thinking and ideation and even some wire frames that they kind of brought to us on as this idea had been kind of brewing for a long time. And it wasn’t just kind of –– you know, we typically get a napkin sketch and then we kind of help, you know, untangle that web.
Mike Balzcerzak [00:25:36]: But, you know, the folks that Ctrl M really came with a lot of ammunition, a lot of that research and a lot of those building blocks. So, you know, we typically start off projects with what we call a design studio. We just kind of a collaborative design section. And here we even eschewed that because a lot of that work would have just been duplicated and we would have wasted time. So we kind of just really jumped right into it. But, because there was this mountain of stuff in a space that, you know, Arcweb aren’t migraine experts we’re, you know, kind of digital healthcare, you know, kind of helpers, if you will. And, you know, we had to kind of uncover, you know, what makes the migraine community tick and the kind of people that need help, what their issues are, how users are going to use this app and really just start to kind of dive into those details.
Mike Balzcerzak [00:26:37]: And again, that research that you guys had done prior really kind of helped kickstart that process. I mean, I remember one of the first items that you guys had shared was a set of interview questions. And I forget how many total people that you had interviewed, but it was various migraine sufferers across a wide age band.
Mike Balzcerzak [00:27:00]: And it was a very kind of detailed set of what, you know, how long people have been experiencing migraine and how they treat it today. What kind of drugs they take has it been effective, et cetera. And even looking at that is typically a thousand percent better than what we get at the start of any project, really, just because it was so insightful and getting that kind of tangible user, you know, insight was really great. And that kind of help set us on the right path right from the beginning. And it was, you know, diving into all of that and then starting to kind of put all those pieces into place into really a large kind of user journey.
Mike Balzcerzak [00:27:50]: And as Will touched on, it not only covered the mobile app, which was what our primary deliverable was, but it was touching the the website and the knowledge portal and how users are going to kind of find their way to the mobile app and then ultimately, you know, discover the store and the various nutraceuticals. So it’s kind of laying out this whole map; we call it a user flow diagram. But I think it was a lot more comprehensive than that, really kind of seeing all those entry points, seeing how users get through. And then most importantly, seeing how all those things connect and then even down the road, you know, where does this scope go beyond that? Right. You know our engagements are always kind of a finite time span of, you know, a few weeks, few months, et cetera. And we actually spent a ton of time with you guys, and it was fantastic. But that initial relationship kind of has an end point but from a design perspective, we always trying to think beyond that. Right.
Mike Balzcerzak [00:29:00]: What do you need for the next release after that or for next year or for, you know, two or three years from now. So we try and think about kind of the bigger picture and really make all those connections. But once we kind of had that user journey in place, it was really diving directly into wireframes and all the folks on the Ctrl M team. You know, Karen, Tamara, Ash, Will; even many others. I think there’s some interns, too, that we even got to interact with. It was hugely collaborative process to really kind of take that map and start to build out both kind of app journey. These other touch points and then layer in a lot of the research and the content and the programing on that Dr. Seebach had put together. So it’s kind of just taking–– t was a lot of information gathering and kind of one step at a time and very collaboratively kind of putting all those pieces into place and then ultimately having an app at the back end.
Kurt Schiller [00:30:16]: So I’ll put this to both Mike and Caryn. But what were some of those kind of key experience bullet points that you had to understand about kind of taking this knowledge base, about people experiencing migraines and turning that into an experience that could actually fit into their everyday life?
Dr. Caryn Seebach [00:30:39]: Yeah. So really, you know, from my perspective, it came down to let’s take the principles that are tried and true that are evidence-based from various relevant areas, pain neuroscience, acceptance and commitment therapy, cognitive behavioral therapy. And how do we translate that into something that someone can use every single day? So largely what that means is that we are trying to implement activities and strategies that people can apply little bits every single day, they’re going to down regulate the pain centers of the brain. Because when you have my migraine, all that’s happening is those pain centers of the brain are firing at will with no great rhyme or reason. We can train that through behavior change, through lifestyle change, to down regulate so we can calm that.
Dr. Caryn Seebach [00:31:33]: And so what we’re trying to do is now teach people through education. Why is this important for your migraine? So there’s a huge education piece of the app because that really helps with rationale and motivation. If someone understands, oh, that’s why I’m supposed to sleep consistently every single day because that inconsistency can be one of those things that might perpetuate my migraine.
Dr. Caryn Seebach [00:32:00]: So once they understand that education piece that helps the motivation, then it’s about doing a little bit every single day. And an app is really quite poised for that because as we mentioned, it is right there. It’s in the palm of your hand. And what leads to behavior change that is sustainable, is tiny little baby steps that add up to big change.
Dr. Caryn Seebach [00:32:27]: So by being able to think through and incorporating this program into this lifestyle app, we thought through, okay, how do you take these little sound bytes? You know, maybe a two-minute breathing exercise. But let’s do that two-minute breathing exercise every single day. Now, the brain starts to look for that thing. And it starts to recognize it and now becomes a routine. Well, we just laid down a new neural network to initiate the relaxation response, which is going to increase that threshold for migraine. So we really tried to bring that intersection of, you know, what we know about pain or science and now think through how can we deliver it in the program?
Mike Balzcerzak [00:33:10]: Yeah, no, that was excellent. I mean, I think that touched on kind of all of the psychological points. And from an app-perspective, our focus was really, you know, all this was very well researched and very well, you know, kind of thought through. So to taking a lot of that knowledge and a lot of, you know, those psychological triggers and those points and really trying to, you know, funnel those down into something that was easily accessible, you know, easy to use, but also very content-heavy. There’s a lot of, you know, Caryn mentioned it at the start where education is probably one of the biggest things that this app tries to get across is, you know, why this thing triggered you or why this activity helped, you know, kind of reduce that trigger or even eliminate it.
Mike Balzcerzak [00:34:09]: So it was trying to marry a lot of, you know, the core kind of application and web functionality of, “hey, it’s got to be simple and easy to use and well-designed”. And, you know, those are the things that that are kind of expected. But really, there’s this other layer of, you know, how can we layer in various elements that kind of help kind of perpetuate that, educate users, allow touch points to kind of help make them start to make these changes in their life. And one of the things in particular in helping users walk through that was the introduction of kind of a mentor or a guide, because one of the things that really stood out to me, I think from from the get-go with some of the research that we were doing into migraine communities and how people kind of suffer through migraine was really this outstanding fact of “hey maybe, my friends and family don’t really realize how bad this situation is or don’t believe me”. I mean, even stories about doctors that are kind of like, well, it’s just a really bad headache. And those things really, really kind of stuck out in my mind. And it kind of forced us to to think through the app as much less like, you know, an application and much more of a companion.
Mike Balzcerzak [00:35:44]: So having kind of a voice that guided you through some of the various parts of the app and kind of motivate you throughout was a way that we could kind of put a more human element and spin on it. And I think it kind of helped lead users to kind of make those changes.
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Core Features of the Platform
Kurt Schiller [00:36:06]: So what are kind of some of the I guess the core features that a user would expect to encounter? Let’s say that, you know, I experience migraines and I decide to sign up for the app. What am I going to encounter? What sort of things are going to be directly available to me? Mike kind of are already mentioned the mentorship and some of the behavior change things. Like what specific forms to those take?
Dr. Caryn Seebach [00:36:34]: Well, you know, one person’s migraines is as unique as their fingerprint as we mentioned, so we wanted to make sure there was a personalized experience to the extent that you can within an app. And the very first thing that they might encounter when they come into the app is they have the opportunity to take a survey that’s going to ask them various questions about their migraines, their lifestyle, their life in general, and help craft a personalized wellness plan, which is really their roadmap for navigating the app that is specific to their needs, their migraine, their headache, what they might need to focus on. There’s things like key areas that they would want to focus on first. So it really helps us set the stage for “okay, we have this vast amount of information, where do I begin?”
Dr. Caryn Seebach [00:37:28]: And from there, you know, ideally when they start with that roadmap, they can start to explore. And we have two opportunities to do that. For people that like a little bit more structure, we’ve tried to deliver content through a module format. And within each module, people will learn why, what and how they might apply that particular strategy or activity. That’s why it’s going to help their migraine. So right up front they’ll get that education piece of it. And within each of those education pieces are activities that they can go apply in that moment. And it comes in various formats because people learn differently. People respond to different formats. So people might have the opportunity to reflect on something. And let’s say reflect on what their social supports are. Is there something that they want to change about that? Is there something that could be helpful for them to focus on?
Dr. Caryn Seebach [00:38:26]: There’s activities they can do in the moment, like audios–– mindfulness and meditation audios which will down regulate those pain centers of the brain. There’s all these exercises people can do that are paced specific to people who have migraine, because although movement and exercise is one of the most important areas for someone with migraine, it’s also one of the most intimidating. So we made sure that our movement exercises were really well paced for someone at any stage or level of fitness.
Dr. Caryn Seebach [00:38:59]: So what we did is we took all these different areas and we combine them into a multimodal format and people will get to know our wheel of health very well, which essentially is based on the most research, evidence based aspects of lifestyle changes that help migraine so that things like core health, which is sleep, nutrition, hydration. It moves into some of these higher order needs psychologically, like building self-awareness or mindfulness, relaxation, training and meditation.
Dr. Caryn Seebach [00:39:34]: It moves into connectedness with the things that we’re connected to. People or meaningful things in our life which, believe it or not, is a predictor of health. And then into these really higher order psychological needs like self efficacy, which is our confidence in our ability to do a certain behavior all the way to what we call growth, which is a path that we are all on in managing our lives, particularly to managing migraine, it is a growth process, as we mention trial and error. So we take people from the very concrete all the way up to these very high supportive needs and really try to help them slowly more than anything incorporate teeny, tiny behavior change steps to make positive change over time.
UX/UI Design of the App
Kurt Schiller [00:40:26]: So one of the things I thought was really interesting about the app is kind of the dark visual design of it, which I can tell you as a migraine sufferer, I’m sure I would really appreciate in the moment. I mean, first of all, I’m just interested about how that decision was made. But also, were there any other specific you UX concerns that surfaced kind of during the development process of the app?
Mike Balzcerzak [00:40:53]: Yeah, I mean, the dark design was definitely kind of borne out from a lot of that initial research and then kind of reading some of those, you know, some of those user interview questions and then kind of falling down this Reddit hole of, you know, there are migraine communities that are set up on Reddit, where you’re kind of reading horror stories. And it was just kind of that combination of discussions with Caryn and Tamara, you know, seeing some of the items online. Reading kind of migraine resources, which were all very new to us, you know, kind of on the on the design side. And really just kind of seeing, you know, are there colors that trigger migraines? Are brighter things better or darker things better? And really just kind of starting to unpack those types of things.
Mike Balzcerzak [00:41:43]: So, you know, is a pretty straightforward decision, but brought about–– upon by kind of a lot of research and trying to gain empathy for those users of “okay, you know, a lot of the stories are this headache was so bad that I was, you know, under covers in a dark room for 10 hours.” The last thing you want to do is just open up a bright phone screen. So, you know, kind of once we started to kind of dip our toe in that direction, we realized, oh, a thousand percent, we need to go is as hard in that direction as possible. And it was a pretty, you know, a pretty easy decision from that point. And then it was just a matter of trying to eliminate a lot of those kind of triggering colors and then make it both soothing in that sense that it’s not jarring, but also still well-designed. Right, there’s a lot of challenges in making something dark look good. Right. That’s why ninety five percent of the websites and apps out there that you see are black text on a white background. So there are a lot of kind of challenges to overcome but I feel like ultimately, at the end of the day, I’m pretty happy with the end result.
Dr. Caryn Seebach [00:43:00]: Yeah it’s not lost on us that it’s innately flawed, that we have an app which is a very visual experience for people with migraine, and that’s a huge trigger.
Dr. Caryn Seebach [00:43:11]: And so, Mike, the design team, all of Arcweb I hand it to them because I think they did an amazing job with incorporating, like they said, the empathy, that human experience through the design.
Mike Balzcerzak [00:43:23]: Yeah, that was a huge part of working on this project. I think that was never–– one of those things that I never wanted to lose was was kind of thinking about the end user. And we do that in general. Right. We always try and think about the end user. But I feel like here it was– it was much less users, right? People that need to interact with a spreadsheet and much more people that are suffering. So, kind of having that empathy, I think was key.
Mike Balzcerzak [00:43:50]: And the other designer on this project, Casey, who isn’t with us today, but she kind of helped drive a lot of that, too, and kind of always kept that in the forefront of “Okay, we need to make this little design change or incorporate a new feature or a new concept, what does that mean to that person kind of interacting with it?” You know and potentially interacting with it during a headache? And that was always a consideration. So kind of thinking about that stuff in the back of our minds was always paramount.
What Success Looks Like for Ctrl M Health
Kurt Schiller [00:44:23]: So I’ve got a question to kind of wrap up with. I’d like to put to both Karen and Will. And that is from your point of view, what does success look like for the Ctrl M app? Like what is the thing that you are looking for, whether that is user feedback, whether it is something to do with adoption and the company? Like what will tell you that, yes, we succeeded with this product. And then I guess my second question iswhat’s next on the journey for Ctrl M?
William Gadsden [00:45:01]: Sure, so why don’t I start and then Caryn can chime in with her thoughts on it. Success is pretty easy to define. Success is: we received feedback that people like the app and it’s helping them, that it’s making a difference in people’s lives, that they value it. And all the hard work that has gone into trying to think through how best to deliver these services has actually resonated with our intended target audience. That is success. If we help people, all the other aspects of running and building a business will take care of themselves. And so success is easily defined as helping people.
William Gadsden [00:45:49]: I think what’s next? You know, as any startup, our biggest challenge right now is increasing visibility. We have a wonderful partner in the Jefferson Headache Center in Jefferson Health. We have wonderful collaborators in Arcweb and other strategic partners who have helped us develop this. But now we have to get out there and get in front of those living with migraine. We have to tell our story and we have to articulate it in a way which resonates with them so that people give us a chance. They click through. They subscribe. They buy our products; what have you. And in order to drive any of those actions, we have to develop trust. We have to develop their confidence. And we have to become a trusted service provider in their eyes. So we’re going to spend the next couple months really focused on that. Working with customers, directly, working with providers to help introduce them, to Ctrl M in hopes that they refer their patients to Ctrl M. But really just building up the visibility, our credibility and people’s confidence in our products. That’s what we’re going to do for a while. And beyond that, we’ll tackle that. Once we’ve achieved that first goal.
Dr. Caryn Seebach [00:47:18]: Yeah, I’ll definitely second that. As a provider it’s really been interesting for me to go into this whole different space where there’s an opportunity to reach a greater audience because it’s been a struggle as a provider to know that you’re very limited in the amount of people that you can help. So if we can truly change the face of how people can improve their life with migraine and connect with those people and make their lives better and improve our quality of life, I don’t think there’s any greater success in my mind.
Dr. Caryn Seebach [00:47:55]: And then I would add to that, I think given the staggering numbers of people with migraine, it is largely unrecognized as a complex neurological disease. And that comes with lots of challenges from not enough providers, not enough funding. So if we can succeed through bringing more attention and awareness and progress the movement in that way and where people can maybe feel like they can talk about having migraine and realize that so many people do manage it on a day-to-day basis, I would consider that successful too.
Kurt Schiller [00:48:31]: Well, I think that’s a great sentiment to end on. And a great place to wrap up, I’ll say for all our listeners, if you want to learn more about Ctrl M health, you can visit them online at C-T-R-L-M Health dot com, ctrlmhealth.com. Or you can get the app right now on the Apple app store. Will, Caryn and Mike, thank you so much for joining us today. It has been a delight and I think it’s been really awesome talking through what is, in my opinion, a really interesting app and kind of a really tough product challenge. So kudos to all of you.
William Gadsden [00:49:03]: Thank you very much.
Dr. Caryn Seebach [00:49:05]: Thank you.
William Gadsden [00:49:05]: And thank you to Arcweb for all of their help in this process.
