ASARM: a digital patient diary for chronic fatigue From paper diaries to better clinical insight

Turning diary data into treatment decisions

Once clinicians could see the information more clearly, the next question was how to make it more useful during review.

A prescription calculator now works out the patient’s average hours of sleep, rest and activity as well as the intensity of any activity. Those figures do not replace clinical judgement, but they remove the need for repeated manual calculations and provide a more consistent starting point for discussion.

Clinicians can then use the averages alongside what they know about the patient to agree a new balance of prescribed hours. If needed, they can ask a colleague or senior clinician to review the prescription before it is sent.

That prescription is sent back through the same system and appears in the patient app. It is linked to the calendar, so patients can see their current targets and look back at earlier prescriptions.

Diary entries can be reviewed and used to guide treatment without clinicians having to move between paper records and separate calculations.

Helping patients understand their prescription

Creating a prescription was only part of the job. Patients also needed a practical way to understand how they were tracking against it.

ASARM’s dashboard compares recorded sleep, rest and activity with the prescribed hours. Daily and weekly bar charts update as diary entries are added, giving patients a clear view of how their time is being divided.

Clinician-approved messages appear beneath the relevant metrics and change according to how the patient is tracking against their prescription. This gives patients some context around the numbers rather than leaving them to interpret the charts on their own.

Before this was introduced, they would have had to work out the totals themselves or wait until the next appointment. Now they can see the pattern as it develops.

The calendar keeps the prescription connected to the diary. Patients can review previous days, look back at earlier targets and see how their treatment has changed over time.

This does not turn recovery into a score. Its purpose is to remove guesswork and make the relationship between daily activity and prescribed hours easier to follow.

Encouraging use without making treatment feel like homework

A digital patient diary is only useful if people keep filling it in. For young patients already managing fatigue, that can be a challenge in itself.

ASARM uses tailored push notifications twice a day. The message depends on what is happening in the app.

Someone who has kept their diary up to date may receive encouragement. A patient with gaps can be reminded to complete them, while a separate notification appears when a new prescription is available.

Streaks and badges provide light-touch reinforcement, but the tone remains appropriate to a clinical setting. More than 50 clinician-approved messages help prevent reminders becoming repetitive.

We also added diary planning. Patients can prepare future entries for predictable parts of the day, such as school, appointments, rest periods or weekend socials.

Planned entries are shown differently from completed ones. They are not included in totals or sent to the clinician portal until the time has passed and the patient has confirmed what actually happened.

That makes planning easier without confusing intention with clinical data.

Helping clinicians see who needs attention

As ASARM became more useful to individual patients, clinicians needed a quicker way to understand what was happening across the whole caseload.

The patient list now shows whether someone has used the app in the past seven days, whether their recent diary is complete and when they last logged in. Staff can also see which build of the app is installed. This helps ensure patients are using the latest version and aren’t missing new features.

Email alerts reduce the need for manual checks across every patient account.

One is triggered when a patient has completed ten days of diary entries. At that point, there may be enough information to create their first prescription for sleep, rest and activity. Another warns the clinician after an extended period of inactivity, before the patient is removed in line with the hospital’s retention requirements.

The portal therefore does more than display records. It helps staff decide where their attention is needed.

Keeping onboarding simple

The app still had to be easy and intuitive to start using. A long registration process, forgotten password or lost username could have created another barrier before the diary had even begun.

ASARM avoids this through QR-code onboarding.

During an appointment, the clinician generates a unique code through the portal. The patient scans it to activate the app and link it securely to their record.

There is no patient username or password to remember. If the phone is lost or replaced, another QR code can be used to connect the account to a new device.

As an added security measure, each code expires after 24 hours and can only be generated through the clinician portal. The process remains quick for the patient while access stays under the hospital’s control.

Protecting sensitive patient data

Moving sensitive diary information into a digital system solved several problems, but it also meant the data had to be protected at every stage.

ASARM was designed around data minimisation from the outset. The system collects only what the service needs, and patient information is automatically removed in line with the hospital’s retention policy.

Clinicians receive a warning before inactivity leads to removal. Where information needs to form part of the longer-term patient record, reports and diary data can be exported and stored outside the live application.

The platform uses AWS Lambda, a serverless architecture that scales with demand while reducing the infrastructure that needs to be managed.

Corporation Pop is registered with the Information Commissioner’s Office and holds Cyber Essentials certification. Before launch, ASARM underwent penetration testing and passed first time.

Designing for patients experiencing fatigue

The interface had to work for people who may have limited energy, reduced concentration or sensory sensitivities.

We avoided bright primary colours in favour of muted greens, blues, pinks, oranges and neutral tones. A darker visual treatment also helps reduce unnecessary screen brightness.

Buttons are large and straightforward. Time controls make it easier to enter blocks of activity, while prompts rely on subtle visual changes rather than intrusive effects.

The app reflects where patients may need to use it too. They can prepare entries in advance, add notes for their clinician and show a personalised explanation to a teacher if they need access to their phone during class.

The clinician portal follows the same approach. Charts are clear, caseload information is visible quickly and staff do not have to work through unnecessary screens to find what they need.

An evolving digital patient diary

ASARM began with one clear aim: replace a slow and unreliable paper process.

Solving that problem revealed the next one. Once better data was available, clinicians needed stronger tools to interpret it and turn it into treatment.

That led to more detailed charts, activity-intensity tracking and the prescription calculator.

Patients then needed a clearer way to follow those prescriptions between appointments, so the calendar, dashboard, tracking tools and tailored reminders were added.

As use of the product grew, the clinician portal developed again to help staff manage their caseload and identify patients who were ready for review or at risk of disengaging.

ASARM is now more than a digital patient diary. It supports recording, review, prescribing and follow-up within the same service.

The product remains in active use, and we continue to maintain and develop it as the needs of patients and clinicians change.