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CareStream - an app for expectant mothers with chronic illness.

CareStream bridges the communication gap between expectant mothers with chronic illnesses and healthcare providers.

Photo of Melissa Stegner

Written by

In no more than 3 sentences, please tell us who your idea is designed for and how it reimagines the new life experience.

Expectant mothers with chronic illnesses such as rheumatoid arthritis need access to reliable and consistent information from all of their health care providers. To make this happen, their doctors need the most current data on their condition and the ability to communicate amongst themselves. CareStream would allow expectant mothers to record information about their condition, and send questions to their physicians and receive answers in a timely manner.

This app would 

Allow expectant mothers with a chronic illness to...

  • Gain evidence backed recommendations and insights based on their reported symptoms
  • Record illness symptoms, moods, and experiences with pregnancy
  • Send relevant data directly to their doctors (Primary care physician, rheumatologist, obstetrician-gynecologist, etc.) to 
    • (A) accompany relevant questions or 
    • (B) give a summary of their health status in advance of an in-person appointment

Allow health care providers treating mothers with a chronic illness to...

  • View historical data on symptom levels, medication dosage, and more
  • Encourage and allow communication with other health care providers to find the best treatment for the mother
  • Openly communicate about discrepancies between treatment suggestions leading to a healthier newborn and mother

Allow friends and family supporting mothers with a chronic illness to...

  • Be actively involved and aware of the treatment of the mother
  • Ask questions to health care providers in a discrete, safe environment
  • Have a better understanding of how to best support a mother with a chronic illness

Background on sources

Management of rheumatoid arthritis during pregnancy: challenges and solutions, Megan L Krause and Ashima Makol, Open Access Rheumatol. 2016; 8: 23–36.

Big shout out to Kate Rushton for her informative posts on chronic illnesses, pregnancy, and health care providers Profiles: Kate Rushton


Laurie Proulx for being amazingly patient and helpful answering all my questions. 

Supporting individuals with illnesses BESIDES RA

Throughout the refinement phase, many people we talked to mentioned how this app would be useful for other chronic illnesses in addition to RA.  

Individuals planning to get pregnant, or who are currently pregnant with lupus, fibromyalgia, hemochromatosis have needs that overlap with individuals with RA.

This app would allow expectant mothers with chronic illnesses to...

  • Tailor the app's tracking option to their unique needs
  • Gain evidence backed recommendations and insights based on their reported symptoms
  • Share data with their health care providers 




Throughout the refinement phase, we spoke with several people from different areas of expertise. After learning more about RA and the healthcare industry, we decided to integrate the feedback and focus on creating a platform that allows mothers with rheumatoid arthritis to record their medication intake and track symptoms. This data can be shared with their treatment providers, leading to better-informed decisions and conversations between patients and their doctors during appointments.

Attached is a summary from some of the interviews.

Interview - Mother with RA

Interview - Innovation Consultant

Interview - OBGYN

Interview - Pharmacist

At what stage is your idea?

  • Back of the Napkin Sketch: I came up with this concept and would love support in making it come to life!

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Create an interactive prototype of the app to test with different focus groups. Potential focus groups could be expectant mothers with chronic physical illnesses, medical professionals (obstetricians, primary care doctors, rheumatologists), expectant mothers with mental illnesses, therapists or psychiatrists specialized in treating postpartum depression.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

-Feedback on how to define business value for this idea -Marketing and outreach planning -Info. on other chronic illnesses that could benefit from CareStream

Tell us about your work experience:

I'm a student at VCU with experience in UX design and entrepreneurship.

This idea emerged from...

  • An Individual
  • An organization or company

Are you an expecting, new, or experienced mom?

  • no

Are you a healthcare practitioner?

  • no

Are you a current employee of UCB Pharmaceuticals or Sutter Health?

  • no

How would you describe this idea (in 2-3 sentences) while in an elevator with someone?

CareStream is an app designed for expectant mothers with rheumatoid arthritis (RA). It bridges the communication gap between patients and their treatment providers by allowing women with RA to track their symptoms, medication dosages, and share that data with all their healthcare providers—OB-GYNs, rheumatologists, general practitioners, and others.

What is the specific problem your idea is trying to solve? 1 sentence.

Reduce the amount of conflicting information women with chronic illnesses receive when they are pregnant or thinking about pregnancy.

How has your idea improved or evolved throughout the Refinement Phase?

Four brainstorming sessions, five interviews, three mentorship calls, and many post-its later our idea transformed from a back of the napkin sketch to a full-fledged working prototype! We definitely couldn't have done it without the support of everyone who has helped us. It's been an eye-opening experience to learn about the intricate health care system and hear the strength and struggles that women with chronic illness go through every day. Overview: The original app aimed to create an environment almost like a chat room where the patient could talk to all her healthcare providers at the same time. We realized, however, that this would be difficult for doctors to manage, and the likelihood of multiple doctors being available to talk at once would be infinitesimal. Based on feedback from women and doctors, we chose to refocus on improving communication through sharing tracking data instead of in-app, direct communication. One of the people we interviewed from the advisory panel was Cynthia Perazzo from AVIA Health. She highlighted two features that she believed would set our app apart from the rest—the focus on chronic conditions in conjunction with pregnancy and the availability of curated health content. While direct contact with the doctor will still be a feature of the app, we now place a greater emphasis on background information and smart recommendations and insights based on the patient’s reported symptoms. Contact with the doctor will now be reserved for only sending patients logs. The feedback we got on the connectivity feature was very positive. Shanaka, the Department of Pharmacotherapy and Outcomes Sciences Director at our university, told us that there has been a growing movement in recent years towards team-based healthcare—especially with respect to treating chronic illnesses. Allowing the patient to share data with and contact all of their healthcare professionals from a single platform takes this approach and makes healthcare simpler

How do you plan to measure the impact of your idea?

We tested our prototype with two mothers who have RA. Moving forward we would like to perform more in-depth user testing with both patients and doctors to see if CareStream is helpful for preventing miscommunication, filling knowledge gaps and providing enough support for mothers with chronic illness.

What are your immediate next steps after the challenge?

We plan to continue to develop the app and hopefully pitch it for initial funding.

How is your idea different or unique from what is currently on the market?

Several apps currently exist that allow patients to track various data and share it with their doctors. There are apps for pregnancy. There are even apps for RA. CareStream is the first that combines all three. The app would be able to track RA symptoms as well as fertility data or pregnancy progress. Allowing the patient to communicate with all her physicians is another feature that few, if any, apps include, and would help them give her better care.


Join the conversation:

Photo of Kate Rushton

Hi Melissa Stegner Abie Kanu Cal Costic and Sarah Gibson 

The refinement phase closes on Nov 5 at 3:00pm PST. Please reach out to me if you have any questions at all.

Photo of Kate Rushton

Hi Melissa,

It is great to see all the progress on your idea. There are 11 days left in the refinement phase.

Please reach out to me with any questions you have.

My tip is to incorporate any relevant information in the comments section for your idea into your main idea submission. Then anyone glancing over your idea submission can quickly understand what your idea is about and all the key information they need to know.

Photo of Melissa Stegner

Hi Kate,

Thanks for reaching out. I have some answers for the questions you previously asked but was wondering what contribution section it would be appropriate to include these in?

How would your idea account for the fact that health care professional are extremely busy?
We have a few ideas for how we can make the app accessible for busy healthcare professionals but we're hoping to get feedback from advisors to make a more informed decision. Our assumption is that HCP would actually save time by communicating with patients and their treatment team through the app, instead of spending valuable time contacting others by phone or email.

For example, if a mother were to receive medical advice from their family doctor and want to confirm this recommendation with her OBGYN, instead of the mother or family doctor calling the OB-GYN, the mother could ask the question through the app and the OB-GYN could quickly “like” and show their support for the family doctors advice.

What barriers are there to providing a connected system between patients, providers and support networks?
A barrier we were encountering is understanding the legality of having a patients medical records on an app and sharing these records with multiple people. After talking to advisors we have a better understanding of HIPAA (Health Insurance Portability and Accountability Act) and what medical information can be stored on the app.

Mothers can upload and input their own medical information to the app, but it cannot be retrieved from other hospitals or doctor’s office’s database systems. We also learned that ensuring privacy and safety of mother’s data on the app is a top priority. So encrypting the data stored will be extremely important.

What component is a solution to the most pressing problem?
The main component of the app is the group messaging feature that allows everyone involved in a mother's pregnancy to have open communication. This feature would decrease the amount of conflicting advice mothers receive from their HCP and provide. Understanding how to successfully implement this feature has also proven to be the most complicated in planning out. We’ve received feedback that creating the cross-communication feature will be really challenging b

Current Challenges:
A big challenge we're facing right now is figuring out who would buy the app/communication service. Possible customers could be RA specialists, OBGYN’s, hospitals or healthcare systems.

Photo of Kate Rushton

Hi Melissa!

You could copy and paste this information into a word document and upload it as an attachment to your idea or maybe include the information in the main body of your idea submission.

Photo of Laurie Proulx

Hi Melissa,
I have personally worked on a resource for people with arthritis concerning pregnancy and parenting. Through this work, I have connected with a lot of Moms and Moms to be because although I have 2 children of my own, I wanted to ensure the solution represented the broader needs of people with arthritis.
Resource -
Survey results -

I'd be happy to discuss how we can work together. I know both pharma and other private that have developed apps so it may make some sense to build on some of these existing technologies. I have some well-established contacts in this area.

A few thoughts:
** health care system variations -these vary country by country and some doctors will need to be convinced to use the app in their operations. It's very decentralized in Canada, for example, so it may be hard to scale the app more broadly.
** as a user and person with arthritis, I do think it's helpful to connect people. I think people with arthritis feel alone in their journey, especially at a time when society has so clearly stated that we should be happy.
** Engage health care professionals. They engage with people /patients more directly when they are facing pregnancy. Adoption won't happen without their help. There are many layers in all health care systems.

Anyways, I'd be happy to have a call with you to discuss further. Thanks for listening :-)

Kate Rushton 

Photo of Melissa Stegner

Hi Laurie,

Thank you for this detailed feedback. I definitely want to incorporate and solve the needs of all mothers that have some form of arthritis.

I would really appreciate learning more about your own story. I'll contact @KateRuston and see if she could possibly pass along my contact info.

Thanks again!

Photo of Kate Rushton

Hi Melissa,

I hope you are having a nice weekend.

If you would still like to combine this idea with Babystream Pro, what you would need to do is add Cal as a team member (press the 'Edit Contribution’ button on your idea, scroll down to the ‘Create Team’ button. Then you will be able to add a team member (remember to use their OpenIDEO profile name).

Also, when you press the ‘Edit Contribution’ button you will be able to see the questions for the refinement phase when you scroll down.

Please do reach out if you have any questions.

I look forward to seeing how your idea progresses and focuses.

How would your idea account for the fact that health care professional are extremely busy? What barriers are there to providing a connected system between patients, providers and support networks?

Also, there are quite a few elements to your idea, which component is a solution to the most pressing problem?

I have found a few ideas from previous challenges that have some elements that might be of interest (please do bear in mind that some of these ideas are mature and this challenge is open to ideas of all levels of maturity):

Employee wellness programs - - is a good example of identifying and testing the riskiest assumption with the use of A/B testing

Cobuy - Group buying software that helps people buy good food at good prices, together. - - really highlights their Unique Selling Point

Photo of Ryan

Hi Melissa,
I think this is a great idea! I really like that the app connects parents with their already-existing medical team, instead of aiming to supply doctors and specialists. This idea may be strengthened by removing the feature to connect with other parents, and instead focusing on creating a line of contact with medical help at all hours. Since medical teams aren't available at all hours, do you plan to incorporate scheduled times where patients can reach their medical teams?

Photo of Melissa Stegner

Hi Ryan,
I never considered the limitations of work hours and how they might effect the app. Thank you for bringing this to my attention!

Moving forward I would include an app feature that allows mothers to message or call a medical team member that is available after hours for emergency questions that need attention right away.

Thanks again for your input! It's a feature of the app I would have never considered until now.

Photo of Nguyễn Nam

Hi Ryan and Melissa,
I can't agree more with Ryan on the iead of removing the feature to connect with other parents. It only brings the people coming trying to sell related products/services. About the availability, I suggest that the parents can contact to the medical centres in another country where they are still in working hours, for example, parents in European can contact to medical practices in the US or Australia.
I also suggest that you should consider the B2B model, it means our customers are medical centres and they will include it into their service packages. What do you think?

Photo of Melissa Stegner

Hi Nguyen,

Thanks for taking the time to give this idea thoughtful feedback. Selling the app as a service for medical centers and the B2B model is something I'll definitely look into soon. Right now I'm focusing on understanding what mothers with chronic illness struggle with during pregnancy and figuring out how to translate those unmet needs into definite features for the app.

If you have any other suggestions I would love to hear more!

Photo of Kate Rushton

Hi Melissa,

Congratulations on making it to the refinement phase!

Please tag me here with questions using '@' followed by my name (Kate Rushton).

Photo of Melissa Stegner

Thanks! I'm looking forward to working more with you!

Photo of Cal Costic

Melissa, this is a great idea! Making communication with doctors easier for the mother is always helpful, and connecting with other moms is a really innovative way to build on that. Some elements of your idea seem similar to mine, I encourage you to check it out and take any inspiration you can! Also, if you have any feedback for me, I'd certainly appreciate that too.

Photo of Melissa Stegner

Hi Cal!
Thanks for your feedback. I'll check out your idea now :)

Photo of ommy zubery

Hi Melissa,
Very great to see you commenting and need to learn more about the NIFUATE NILIPO post activities. So far I also praise you for the research you have done after all and come with  ''BRIDGING THE COMMUNICATION GAP BETWEEN EXPECTANT MOTHERS WITH CHRONIC ILLNESS AND HEALTH'' idea, though you are not the health practitioner but you have been touched by the situation that marginalised pregnant women suffers from chronic diseases and propose for the ideal solution for all who are responsible to act for their survival.

Photo of Melissa Stegner

Hi Ommy,

Thank you for you taking the time to learn more about my idea! It's interesting to see the different solutions people have come up with, such as the idea for Nifuate Nilipo.

Photo of Kate Rushton

Hi Melissa!

Thanks for the shout out. If you had to start off and focus on one user persona, which one would you choose, e.g. a mom affected by arthritis and why?

Photo of Melissa Stegner

I would focus on mothers with rheumatoid arthritis first. I think this app would be helpful to this user group since their entire treatment team (obstetricians, primary care doctors, rheumatologists) could use the platform.

Photo of Lauren Ito

Hi Melissa Stegner !

Thank you so much for joining our community member of 133,000 innovators across the globe! I'm excited that an individual with your expertise is joining our community.

I'm wondering, in the development of your Idea, what type of research did you conduct to understand the experience of individuals with chronic disease?

Two posts from our Inspiration Phase that provide a lens into the new life experience as an individual living with a chronic disease include I have Crohn's disease and I'm going to be a mom and 2 Beating Hearts + 1 Pacemaker . You may find these posts helpful in developing your Idea!

Excited to learn more!

Photo of Melissa Stegner

Hi Lauren,

Before posting this idea I read up on research articles relating to rheumatoid arthritis and pregnancy. Despite the wealth of information that's been published by academic institutions, it was hard to find personal, first-hand experiences from individuals living with chronic disease. So thank you for sharing these posts with me! It gives more insight on how this app could cater to the needs of individuals with different types chronic illnesses.

Photo of OpenIDEO

Hi Melissa Stegner !

Congratulations on being today's Featured Contribution.

Photo of Melissa Stegner

Thank you!