18. 08. 2021

App-Review: HC&ME App of Christoph Miethke GmbH & Co. KG.

In our daily work at D-LABS, our core task is to enable user-centered interactions between humans and machines and to simplify them for all parties involved. This often includes looking beyond the proverbial horizon. Outside of our daily base work, we deal with apps that somehow gains our attention and we then take a closer look at them. Miethke is the new main sponsor of SV Babelsberg 03, a 4th tier club from the region. As a volunteer and long-time fan, I took a closer look at the company.
Christoph Miethke GmbH & Co. KG is a Potsdam-based medical technology company that develops innovative neurosurgical implants for hydrocephalus patients. Hydrocephalus describes the phenomenon when, due to various possible circumstances, increased intracranial pressure occurs.
In addition to its products, the company also offers “apps and digital applications” that allow patients to document their course of the disease and learn to better interpret their symptoms.

“The HC&ME app is a digital hydrocephalus journal that allows you to comprehensively document your life with hydrocephalus and everyday life with a shunt.”

According to the company, the app should fulfill two main tasks. On the one hand, tracking the Hydrocephalus conditions over time to document well-being, symptoms and activities at different times of the day. On the other hand, it is the data enables science to develop better forms of therapy and devices:

“But if you look at science, there is still a lot to do: There are no large data analyses that provide a uniform overall picture for the pathophysiology or therapy of HC. In particular, the question of the factors that positively or negatively influence HC patients in everyday life has hardly been investigated.”


With ~120MB, the app is relatively big for what it offers. In the App Store there are a total of 6 reviews, all with a full star count. The situation is similar in the Play Store. The Android version of this app here is ~80MB big and also only available in German as on the iPhone. It has been available on both platforms since May 2020 and, if the Play Store is tellung the truth, has something around 100+ installations.
The name of the app seems a bit bulky to me. It has a scientific claim and these abbreviations may serve their purpose in this context. In the end, however, it is humans who try to find a suitable app. They often do this by searching in the respective store. It can happen that under the term “hydrocephalus” the Miethke app is the 8th result, even after a dating app.


After the successful installation you will find a new app icon with a white head on a blue background on the home screen. In this head an illustration is showing, unrecognizable for me as someone who has no experience with this condition. People who deal with hydrocephalus may recognize this abstraction and can assign it accordingly. I can’t judge that at this point.


The first opening of the app is accompanied by a short introduction. It provides information on what the app can do for its users and why it makes sense to use it. Subsequently, you will be informed about data protection. After ticking “Agree” you get to a screen with a lot of text. A lot of text. After ~2 seconds on this screen, an alert appears informing me that my data is currently not available for research.


Already when starting the app, it is put to the test. Below is a brief analysis of the onboarding process and any resulting usage issues.
Text is always challenging to design in the app development. Especially if there are larger amounts of text, it can quickly lead to oversaturation. Text only applies when it is necessary and even then only in short, concise segments. Using the example of the onboarding screen of the HC&ME app, it would probably have been a better step to shorten the text to the essentials. In my eyes, the important statement here is: “This app stores and sends my data to Miethke for research purposes”.
I can agree with that or not. If I need more information about this, I can go deeper if necessary. For this purpose, you could open details in a suitable place.
When I have made a decision, I am confronted with two options in the form of buttons at the end. Left: “Do not support research” and right: “Agree”. The naming of the first button is not very well done. It is reproachfully formulated, generalizes and manipulates the users. It would have been better to use “reject” or “disagree”. You increase the number of users who are willing to send research data, not by trying to unsettle them. In the worst case, this leaves a lasting overall impression and the app loses its professional expression.


In the next step you have the possibility to create a lock code for your journal. At this point, unfortunately, the end has already been reached for me. With an iPhone 12 and the current operating system, I get stuck on this screen. I have entered my lock code and it does not go forward or back at this point. Only by restarting the app can I use it again. Without creating a lock code, I get to the main area of the app.


Only one last click away from the main part of the app, I get greeted by an overlay on how to use this app. That in itself is good and right, only in the execution a bit cumbersome. The selected font does not read well and the button at the top of the app is marked with an “i” like Info. Marking and position do not comply with the iOS standard.

Information architecture

The bottom main menu reveals the most important segments of the app. Here you will find (in order) profile, journal, overview, calendar and more. It is now unusual to consider the profile as a main menu item and to locate it in the menu bar. In addition, the menu item “More” contradicts the iOS standards in the current version.
Immediately it is noticeable that only the Tab Bar is used for navigation in this app. A navigation bar, as described in Apple’s Human Interface Guidelines, does not apply here. However, looking at the existing information architecture of this app, it would have to become an important segment for navigation in the next development steps.
If we exclude “Profile” and “More” at this point, the navigation points “Journal”, “Overview” and “Calendar” remain. As menu items in the first level, they undoubtedly have their raison d’être. If you click through them, you will notice that a separation between overview and calendar does not seem absolutely necessary. My recommendation at this point is to combine “Overview” and “Calendar”. Calendar is already a kind of (temporal) overview. One possibility would be to design the calendar accordingly in such a way that you get a first overview from it. This is already being done very successfully. In various mood apps, calendars are commonly used to provide an introduction to the overview. This way of displaying is also often used in fitness/activity tracking.



In the design of the app, many fundamental challenges can be recognized. Color encodings overlap, font is too small in places, icons do not come from a uniform icon family and the combination of flat contrast and shadow elements makes the entire surface very restless. But from the front:
An important segment that should not be missing in the app review is the grayscale test. I use the color filter function of iOS and thus completely change the iPhone to gray.


Icons and fonts have too little overall contrast and could cause problems in people with visual impairments. In addition to the size of the font, important font elements are too low-contrast due to their gray color. The lines of the illustrations in the icons are very thin and break up at higher resolution.
If we turn on the colors again, we notice a color coding. Pipetted directly from the app results in the following color palette:


There does not seem to be a uniform system that distinguishes the information level from the navigation level. (If there is such a system, I can’t make it out). The confusion of colours is joined by the shapes. It is not a concrete formal language. For the symptom gradient, lines with gradient are used and activities are made clear by circles. The different times of the day are marked by icons where simple text would have been better.


The app offers, at least in theory, the possibility to export your own data. You select a period of time and can choose between the formats CSV and PDF. I find that very practical. There are certainly also users who carry out their own analyses or medical personnel who can work better with raw data. Unfortunately, this can only be done via a mail interface from the app. So you do not save the data, but initiate a handoff between the app and the installed mail client on the smartphone. If this is not installed, the process is aborted and you cannot save the data. This moves you into a dead end. It is not uncommon for users of smartphones not to use the mail client and instead retrieve and send their e-mails via web interfaces.


In addition, this app is currently only available on German. (As of August 9, 2021) It would sometimes serve a larger group of users if it were also available in other languages. Especially with regard to the resulting data for research, a larger group of users would certainly be desirable.


This app review shows a brief insight into the usability of the HC&ME app from Miethke. I took a closer look at how the onboarding of the users works, got into the information architecture and also analyzed the UI. If Miethke decides to further develop the app in the future, the so-called low-hanging fruits (i.e. quick changes that can make a big difference) would be a simplified information architecture and UI changes in UX writing, colors and font.
I think it’s great that a manufacturer of medical devices has developed an app that helps people on the one hand and provides valuable insights for the further development of their devices on the other. This initiative is an important step in the right direction. After just over a year since its release, the app has got off to a good start. Now it is a matter of gradually developing improvements so that it can ultimately be used by even more people every day.

Sebastian Rauer
by Sebastian Anders
Digital Experience Design


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