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Helping Cancer Patients Build Resilience & Community

We helped Blue Note Therapeutics broaden access to clinically proven stress management strategies through a flexible guided therapy app.


  • UI/UX Design
  • Content
  • DevOps
  • Mobile & Platform Development


  • HIPAA Compliance Support Group Feed & Chat Product Analytics


  • iOS & Android for Mobile & Tablet
Attune product image

Product Background

Closing the care gap

About one in four cancer patients suffers from depression, but many of them lack access to conventional forms of therapy. Blue Note Therapeutics’ attune mobile app puts proven stress management tools and guidance right at their fingertips to support their mental, physical, and emotional health—with potentially life-changing results.

Activity screen from the feature tour of the attune mobile app by Blue Note Therapeutics.


From “in-person” to “all-person” care

Blue Note came to us with an early iteration of its flagship mobile app, based on a psychologist-developed stress management program designed for cancer patients in a group therapy setting. They asked us to help maximize user engagement by identifying and optimizing new and existing features that facilitate the sense of community and trust found in an in-person support group – with the ultimate goal of motivating patients to stick with the program (and experience its benefits).

Collage of three images showing the attune mobile app, a woman in a headscarf hugging someone, and a calm mountain and lake scene.
Collage of graphics and style elements from the attune mobile app.


Remaking “group” for a new medium

We worked with the Blue Note team to identify and understand the essential components of the group therapy model: the scheduled group sessions and the group facilitation. We also conducted user research that validated the need for a group communication component to encourage patient engagement. Then, we designed a platform that combined the existing self-paced user journey with a new private group discussion feature for program participants.


A digital space for real community

We designed an in-app group discussion feature to allow users to connect with other patients and show support with comments and custom-designed reaction icons. For more personal interactions, we also incorporated private one-on-one messaging between community members.

Mobile screens from the attune mobile app's group chat and private messaging feature.
Onboarding screen from attune mobile app directing user to upload photo.


Making good first impressions

We enhanced the onboarding flow to support group communication with new fields like photo/avatar and condition information to promote trust and empathy among participants, and to facilitate the possibility of customized segmentation in future groups.


Improvement you can count on

We worked with a third-party quality management system (QMS) to develop and maintain software products within a formally documented software development environment.

Hands working on open laptop with translucent images of checkmarks, cogs, and other graphics representing a quality management system for an app.


Starting inclusive conversations

With accessibility and equity in mind, we developed group discussion prompts designed to resonate with patients from many backgrounds. We participated in feedback sessions with focus groups of diverse patients, clinicians, and advocates to craft prompts with content, tone, and language that would be understandable, relevant, and respectful to attune users.

Mobile phone sitting on a white block displaying screen from attune mobile app group chat feed.


A better way(finding)

To optimize the user experience, we created a navigation structure that forwards the patient’s therapeutic journey while making other important features discoverable and accessible. By configuring key elements in standard iOS patterns, we enabled participants to easily move back and forth between the session roadmap and the group chat forum, without losing focus or motivation.

Mobile phone displaying My Journey screen from attune mobile app.


Right user, right access

As a digital therapeutic, attune’s users include program participants, facilitators, and researchers. We constructed the mobile app and web-based admin panel with role-specific feature access, such as group chat moderation actions for facilitators and analytics dashboards for administrators.

Edit user screen from attune mobile mental health app for cancer patients.

No time wasted

Working closely with BlueNote and its team of patient advisors, we delivered an attune MVP ahead of the client’s original schedule, beating a deadline for regulatory fast-tracking for an accelerated speed to market. To learn more about attune, please visit

The technical team has been a great strategic partner, looking far beyond the scope of the project to our long-term needs and helping us make good choices.

Michael McKinley

Head of Product at Blue Note Therapeutics

Working with Twenty Ideas has been a game-changer for a science-based start-up like us. They showed genuine investment in our mission to ease the burden of cancer, in their attention to detail and quality, and their commitment to serve patient users.

Geoffrey Eich

CEO of Blue Note Therapeutics

Featured Technologies

Discovery & Design

  • User Experience Research & Design
  • Rapid Prototypes with Figma
  • User Testing with Maze

Amplitude Analytics

  • Analytics Strategy
  • Detailed Implementation Plan
  • Dashboard creation

Server with TypeScript & Nest.js

  • Integration with Patient Management System
  • Integration with Prescription System

AWS Infrastructure as Code

  • AWS CDK & Cloudformation
  • Continuous Integration & Continuous Build (CI/CD)
  • Multi-environment architecture
  • Managed Hosting

React Native for Mobile App

  • iOS & Android on Mobile & Tablet
  • Push notifications
  • Twilio SMS integration
  • Integration with Amplitude Analytics

HIPAA Compliance

  • Infrastructure & Code
  • Work with Enzyme’s Quality Management System