The Apple Watch pilot that the MD Anderson Cancer Center at Cooper announced last May finally launched today. In collaboration with Wayne, Pennsylvania-based behavioral health technology company Polaris Health Directions, the cancer center is distributing 30 Apple Watches to patients in various stages of treatment for breast cancer.

"May through September was a lot of engineering the application and looking at the user experience, especially from the patient perspective and how they would use it and work with it," Mark Redlus, senior vice president at the Polaris Innovation Lab, told MobiHealthNews. "So we did a lot of functional testing. We’ve gone through I think 17 builds since May, just to give you an idea. ... So we were iterating through functionality and how patients would use the Watch, but also the phone, and how those devices would work together."

An app called emPower will run on the Apple Watches and the users' phones. Patients will use the Apple Watch to answer quick multiple-choice questions about their mood, symptoms, possible treatment side effects (like headaches or nausea), and more. The provider will also use the device to capture activity and heart rate data to help them anticipate potential issues before they worsen and intervene sooner. 

"It’s just as much about self-discovery as it is about patient care from the provider standpoint," Redlus said. "That’s really been pushed to the next level. The idea that information that’s being collected on your activity level, steps you’re taking, heart rate, physically what you’ve been able to do that day ... and then looking at how that’s affecting mood, anxiety, distress, and being able to see those interactions themselves and being able to see that [for instance] when the activity level is high, stress levels tend to be lower. And being able to look at those visually and understand those are happening at the same time is something we look forward to seeing and we hope that it really changes not just the treatment regimen, but the overall patient wellbeing and how they feel throughout this process."

In addition to tracking vital signs and comparing them to self-reported mood data, researchers also hope the role of the Apple Watch as a communication device will help improve patients' experiences.

"We want to see if that helps with engagement, and this idea of going beyond one-on-one engagement to more of a cohorted engagement, this idea that the watch lends itself really well to a social support network -- those contact circles within the Apple Watch interface," said Redlus. "We’re encouraging patients if they want to opt in to their own cohort so they can support one another. We find that this idea of just engaging the patient about the disease is not really as powerful as having them engage with one another going through the same or similar experiences."

The six months between the announcement and launch gave Polaris a lot of time to iterate on the behavioral side of the app, but there were also a surprising number of technical challenges, Redlus said. Mobile device management infrastructures aren't yet well-equipped to handle the Apple Watch, so Polaris spent much of that time making sure the devices would be supported, secure, and HIPAA-compliant.

The nine-month study that kicks off today is a feasability study, so it's still an open question to what degree cancer patients will be interested in engaging. The 30-patient cohort ranges in age from mid-30s to late 70s, so it should help answer some questions about demographic barriers to engagement. But Redlus has high hopes for patient engagement.

"Something that [medical project lead] Dr. Cori McMahon talks about a lot is the exciting thing about the watch and the phone together is it really puts the power back in the hands of the patient for a change," he said. "So the one thing I want to leave patients with is the idea that this is really all about you. You learning more about you and how you can improve how you’re feeling and how things are going and, eventually, the outcomes of your treatment. And that’s something that’s really hard to say about a lot of other products that are out there."