Pain therapy with the apple watch

Sascha Schäfer Senior UX Designer

02/05/2017 • 6 minutes reading time

The cry for a meaningful app for the Apple Watch has been resounding since the product was released by the community. But it has gone rather quiet now. One of the reasons for this may be that the Apple Watch is not exploiting its full potential as a typical lifestyle product, but rather that it is being used in other areas. The best example of this is the medical sector.

In no other area is as much research being done into the meaningful use of smartwatches. Many American hospitals are already using the Apple Watch in pilot projects to record their patients’ vital data. Indeed, another article reported on the case of Ken Robson, who noticed that his heartbeat was irregular thanks to his Apple Watch. He took himself and his Apple Watch to the hospital, which confirmed his self-diagnosis. Additionally, he didn’t have to wear a heart monitor for one week, since the watch provided the necessary data. As a result of these circumstances, Mr. Robson could be operated on almost immediately. For us at Ergosign (as UX designers), it is also a matter close to our hearts that the Apple Watch is considered as more than just a nice gadget, but rather that it decisively improves people’s lives as a result of the new opportunities it offers.

The first project we implemented for the Apple Watch is an extension of our medical study Quiri, a pain assessment software for children and young people. The aim of this phase of the project was to tap into adults as a target group too.

The picture shows the left arm of a woman wearing an Apple Watch. A Quiri UI can be seen on the Apple Watch.
Pain therapy with the Apple Watch

Why the Apple Watch?

1. A Hardware Basis

Similar to the iPhone, the number of devices for which development has to be carried out is manageable. The watch is only available in two variants (38mm and 42mm) that differ only in terms of their display size. Both versions’ performance is the same.

2. The Hardware Sensors

It provides all the project-relevant hardware sensors.

3. The Distribution

Apple is dominating the market with an estimated more than 50% share. 3 This means that if a patient in pain has a smartwatch, it is highly likely that it is an Apple Watch.

4. The HealthKit

With the HealthKit, the data collected (movement, heart rate, etc.) can be efficiently exchanged within a network of Apple devices.

The image shows a mock-up of an Apple Watch, on which a notification from Quiri can be seen on the Watch display
Reminder: Take your medication

Adults are not Children

Even though we may (fortunately) have a different impression, adults are not children and their product requirements are fundamentally different from a child’s. Quiri was designed to assess pain in children and young people, to log these measurements in a chronological relationship and to present them in a prepared manner for the medical professional. While this may also be the goal when it comes to adults, interaction with the application must be tailored to an adult’s life.

Small Display, Big Benefits

While the small display may appear restrictive at first glance, if they have been thought-out smaller display sizes lead to better designs, as was announced by Lukas Mathis in “Mobile First” back in 2011:

„Losing that much screen space forces teams to focus. You have to make sure that what stays on the screen is the most important set of features for your customers and your business. There simply isn’t room for any interface debris or content of questionable value. You need to know what matters most.4” Lukas Mathis

That’s why the Apple Watch cannot be considered a miniature iPhone. Indeed, the nature and location of the interaction, as well as the duration of the interaction itself, are very different from the iPhone. We mustn’t make the mistake of trying to completely reproduce an iPhone app on the Apple Watch. Rather, we have to try to extract meaningful functions and prepare them for use with the watch.

The image shows a mock-up of an Apple Watch on which various functions of the Quiri app can be seen
Functions of the app on the Apple Watch

But the Apple Watch offers a great deal more in addition to the display which is seemingly too small. Never has a smart device been closer to the body, and never has it been more possible to generate a constant stream of relevant data. And without any assistance from the user whatsoever. Doctors now have access to a wide variety of data which previously was either impossible to obtain, or could only be obtained with a great deal of time and effort. New relationships that were only based on the patient’s statements beforehand can be formed using this data.

The user, Not the Pain, at the Center

The most important aspect of placing the user at the center of the analysis and identifying their needs was also considered when designing Quiri for the Apple Watch. Here, we were very fortunate that we were able to get the Outpatient Pain Clinic of the Saarland University Medical Center on board as a partner. Thanks to Dr. Bialas, Head of the Outpatient Pain Clinic, we were able to gain key insights into the (everyday) life of patients in pain. Additionally, he was able to explain to us what data was important at what level of regularity and at what time to support and improve his pain therapy.

2 men sit at a table in an office and look at an Apple Watch
Validation of the Quiri Apple Watch extension

This illustrates yet again just how important proximity to the user is when it comes to designing and developing software.

In the analysis, it quickly became apparent that – in adult pain therapy, unlike child pain therapy – no regular measurements are taken at fixed times. It is far more helpful to set a marker for acute pain, to query various parameters and to automatically record all relevant vital data. Equally important is the querying of positive events, so as to recognize progress made by new medication or measures.

Things Have to Be Done Quickly

Apple specifies an average interaction duration of 5 seconds for the watch. This poses something of a challenge for the design, since the parameters of pain severity, pain quality and trigger (anger, stress, injury, etc.) absolutely must be queried to enable therapy improvement. Input from the user is required for this purpose. Nevertheless, we were keen to enable the patient to assess their pain casually or when suffering from pain too. We tried to take that into account by automatically recording a multitude of environmental variables and vital data, and by having clear direction due to the individual functions.

You can see 3 mock-ups of an Apple Watch. A different function of the Quiri app is shown on the screen of each watch
UI on the Apple Watch for Quiri

Unlike the main application, which provides an overview of the measurements taken and extensive pain questionnaires, the range of functions for the watch app was reduced to the absolute essentials. The watch app allows patients in pain to set a marker if they are experiencing acute pain or positive events, to log the intake of medication and the occurrence of side-effects, and to see the type and quantity of medication prescribed by the doctor. The patient is also reminded to take their medication by the app.


This first project has shown us that the Apple Watch, or smartwatches in general, harbor a great deal of potential. Quiri has already been superbly complemented by the watch and we will be sure to think of how we can meaningfully use smartwatches in other projects too. Dr. Bialas was also positive in his assessment:

„Telemedicine has become an integral part of society. Once the teething troubles have been overcome and data can be transmitted securely, this form of data exchange will provide good support for chronically ill patients. Particularly in view of the age structure (people in Germany are getting older), data can be transmitted quickly to the doctors treating them, who can then start treatment if necessary. With Quiri for the Apple Watch, the developers have created a very good tool. Keep up the good work.” Dr. Bialas

We are looking forward to the next flatter and faster versions of smartwatches with longer battery lives and to other projects with and for smartwatches.

4 Wroblewkis, Luke (2011): Mobile First, A Book Apart, Page: 19