Sharp Rees-Stealy Medical Centers and Amerigroup Florida are among an emerging breed of healthcare providers issuing asthma applications and devices to patients.
Both systems are issuing Propeller Health’s app and sensor, which attaches to a standard inhaler, as part of their respiratory health management programs to monitor wheeze factors.
Propeller Health is not the only game in town. Among the other players, AsthmaMD offers a Peak Flow Meter to measure lung function, and iSonea gauges adherence. All three take a unique spin toward successful patient outcomes and reducing the number of visits to healthcare providers.
Let’s take a closer look at each.
AsthmaMD
As in any new market, asthma solution providers like AsthmaMD aim to give potential customers what they want. In the case of AsthmaMD, co-founder Sam Pejham knows that the professional healthcare market wants crowdsourced data to help find answers to major questions. With a reported 100,000 users, AsthmaMD can make a claim to having the kind of stats that researchers are seeking.
The aggregate data collected includes patient location - not just place of residence but actual GPS location data where and when a reading of lung function is being taken. Other data collected by the accompanying software includes names of medications, dosage amount and number of times per day a patient takes those drugs. Patients can also add notes to describe the severity of an asthma attack.
A study prepared by AsthmaMD used two groups, a control group of people who only used the mobile solution occasionally, and a group of active users. The active users saw 10 percent improvement in lung function, compared to the control group. In another study carried out in Great Britain with 6,000 users, AsthmaMD saw a reduction in hospitalization and in readmissions.
Pejham said in coordinating pollution data from the National Oceanic and Atmospheric Administration with AsthmaMD patients, they found direct relationships between pollutants such as ozone and the rise in the need for patients to take their asthma meds.
AsthmaMD uses a Peak Flow Meter - “a thermometer for the lung” - to measure lung function, Pejham said. The application synchs via Bluetooth to the meter, gives a value and explains to the patient what the value means. The analysis is based on predictive values and tracks lung function over time. This allows the physician to change medications when the results indicate a change is needed. It also allows healthcare providers to evaluate the surrounding environment if a patient moves.
For care providers the software charts the peak flow meter results into an easy-to-read, color-coded graph. For patients who use the action plan there was a 79 percent in hospital admissions, Pejhman said.
“It saves physicians evaluation time before the patient comes in to see them,” Pejham said.
Available over the counter, a meter costs $20 and is sold in CVS and Walgreens, among other retailers.
iSonea
Telling a different story than either AsthmaMD or Propeller Health, iSonea’s device, called iSoneaAir, measures, gathers and records the wheeze rate over time. The physician’s ability to listen to breath sounds outside of the clinical environment allows them to see how effective medications are before and after inhalation. In the bad old days, all a doctor could do was ask how a patient is feeling. By aggregating the actual wheeze rate, AirSonea turns a symptom into a sign.
“Doctors as well as insurers are looking at our application because it gives them a disease management focus,” said Ross Wilson, senior clinical manager at iSonea.
Unidentified information from all users is aggregated and reviewed on a regular basis, with in-house statisticians determining the value of the Big Data they gather. “We have hundreds of thousands of data points that we are putting together with our current users,” Wilson noted.
Beyond the consumer market, iSonea can make a good argument to the healthcare industry in general, as current surveys indicate that for every dollar spent on disease management and education a payer can save anywhere from $5 to $11.
The solution consists of an iPhone or Android application and the wheeze monitor, which is placed on the throat.
For self-management, users can set reminders for taking their medication and enter notes into a log. The device synchs with the smartphone via Bluetooth. The user slides up the sensor portion, which launches the smart application, and is then directed where to place the sensor on the throat with a “hint screen” that guides the user to the correct placement. A 30-second reading follows, wherein the duration of wheeze is measured and converted it into a percentage of time. The wheeze recordings can then be sent to the physicians or placed in the cloud.
Over time, caregivers can use the saved data to look for triggers such as pollen, pets or anxiety. Patients can view physician-created action plans and other caregivers can modified those.
Propeller Health
Propeller Health’s hardware and software solution is used for self-management of asthma and COPD. The app, along with the sensor, tracks the time and frequency of the need for medication with the exact location and time the medication was taken.
David Van Sickle, co-founder of Propeller Health, likes to say that his company works with organizations that have an economic and clinical interest around asthma - that includes just about everyone in the healthcare community, including providers, employers and population health management organizations.
The unique sensor, sold separately, fits on top of an inhaler - thus allowing, for instance, parents to have their own sensors in order to track the frequency and time of day a child takes his or her medication.
Many more to come
Other mHealth asthma solutions are coming to market with the aim of decreasing the numbers of physician and hospital visits through better management of this chronic disease.
There’s certainly demand. Some 14.2 million office visits when asthma is the primary diagnosis occur annually, with 1.3 million patients going to a hospital outpatient department and 1.3 million to an emergency room - and when a hospital admission is required, the average length of stay is an astounding 3.6 days.
What’s more, the annual cost of medical expenses to treat asthma is $48.6 billion, according to the Centers for Disease Prevention and Control, while the cost forl prescription drugs is $6 billion. The number of non-institutionalized adults with asthma is more than 18 million, and there are an additional 6.8 million children, with that population segment seeing the most rapid growth.
Consider it a sign of the times that AsthmaMD, iSonea and Propeller Health all started as business-to-consumer solutions but now see new business-to-business markets opening up as ACOs, healthcare providers and payers begin to realize the benefits of mobile self-management in terms of healthier patients and populations, reduced admissions and cost-savings.
Ephraim Schwartz is a freelance writer based in Burlington, Vt. He is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of them covering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine.
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