Decisions the clinician console needs before it is built. Answer the ones in your area and skip the rest. The option marked as now is how the current design works, so choosing it means no change. Recommended marks our suggestion, not a default.
Answers save in this browser as you go. When you're done, press Submit answers at the bottom. You can submit again later if you change your mind. “What we found” under each question has the research behind it.
Problems in the current console. Neither one depends on the new design.
When a patient answers item 9 (thoughts of self-harm) above 0, the app shows them the 988 card. But it uploads only the total score, so the clinician is never told. Fixing the app is a one-line change. What's missing is a follow-up plan.
The report treats any check-in move of 4% as a clinical change. On the PHQ-9 that is about 1 point out of 27, and on the GAD-7 less than 1 point. The published thresholds are 5 points (PHQ-9) and 4 points (GAD-7).
Each patient's summary opens with a cover: one word per clinical area (e.g. “Balance: Stable”), then the recommended next steps in three tiers, Top priority, Next step and Keep watching. Flags and test detail sit below it. These questions decide what goes on the cover and in what order.
The current design:
| Signal | Tier |
|---|---|
| Fall during a test | Top priority |
| Clinical cutoff crossed | Top priority |
| PHQ-9 item 9 above 0 | Top priority |
| Confirmed decline (2 tests in a row) | Next step |
| One large move, not yet confirmed | Next step: re-test |
| Early sign of improvement | Keep watching |
| App likely deleted / phone signed out | Top priority or Next step (coordinator) |
Some steps need an in-person exam or a referral, not just a note to the patient or a re-test.
Each measure is placed on its own, not each test, because one test can measure two things. Our proposal, one line of reasoning each. A ? marks the ones we're least sure of.
| Domain | Measures | Why |
|---|---|---|
| Balance & gait | Sway: all 15 | Standing still |
| Balance & gait | Timed Up & Go: total time, turns, transitions, sitting back down | Walking and turning |
| Balance & gait ? | Timed Up & Go: sit-to-stand power and duration | Rising from a chair. Could be Motor (leg strength) |
| Balance & gait ? | Timed Up & Go: delay before the first step | Could be Cognition (planning the step) |
| Balance & gait | 10 m walk and everyday walking: all | Walking |
| Motor | Finger tapping: all | Hand speed and rhythm |
| Motor | Line & circle, spiral: all | Drawing accuracy and tremor |
| Motor | Reach: all | Arm reach |
| Motor ? | Arm Raise: all | Arm, like reach; shoulder, not hand. Listed with reaction time. Could sit elsewhere |
| Motor | Reaction time: simple and choice time | A phone tap is mostly hand speed after stroke [12] |
| Motor ? | Reaction time: variability | Could be Cognition (attention) |
| Cognition | Reaction time: choice cost, error rate | Choice minus simple takes hand speed out. A wrong side is a decision error |
| Cognition | Sky Search (game) | Far-space neglect |
| Speech | All speech measures | Motor speech from a read passage. “Words recognised” is clarity, not word-finding |
Two placements are left:
The current design: one Mood word on every view, PHQ-9 detail one click down.
The current design: each step has one owner (Physician, Therapist or Coordinator). Your own steps are marked Yours and listed first within a tier.
Six presets in three families. Medical: stroke physician, PM&R, primary care. Rehab: PT/OT, SLP. Coordination: stroke coordinator. A preset only changes order and emphasis; it never hides anything.
Clinicians may want to record medications and treatment plans, and to see next steps with medical reasoning (e.g. “DAPT for 90 days”). The current design only reminds them of their own plan (“Antiplatelet course ends around Dec 1”). It never proposes a drug.
The current design: AI suggestions can appear on the cover, with a dashed “Suggested” label and evidence. They can add a step but never remove or change one.
The current design: the lead clinician's 3–5 minute read before a visit or handoff, and the copy that goes in the chart.
The current design: patient tiles on the desktop show no test values (“Mood worse · two check-ins in a row”, not “PHQ-9 7 → 12”), and patients who are on track show as a count rather than as tiles. Both can be switched back in settings.
The identicon is the small pattern beside each token. It is made from the token alone, so it tells you nothing about the person. Its job is to make similar tokens (G3GT-Z6DK / G3GT-Z6KD) easy to tell apart.
Our reading: not for Deployed clinics. The platform becomes a business associate and needs a signed BAA. And the data isn't de-identified under Safe Harbor, because every test has a date and the phone's push token is stored.
E.g. the patient's primary care doctor at another organisation. HIPAA allows sharing for treatment without the patient's authorization [20].
Not legal or medical advice: a starting point for the people who sign off.