Live asthma mapping opens new frontier in telemedicine
A US project to track and map asthma inhaler use live by satellite is opening up new frontiers in telemedicine with potential benefits for both patients and health services.
The "Asthmapolis" project has developed a small, lightweight sensor that attaches to the top of an inhaler and uses satellite location technology and the GSM mobile phone system to record location, time and date when a puff is taken. The system also links to a free app running on Bluetooth-compatible smartphones.
An asthma diary and online dashboard is created for patients using maps and tables to summarize patterns of use over time, and help identify locations that may cause asthma to worsen. Patients can also choose to receive text message reminders reminding them to use preventative medication and sign up for weekly email reports and personalised guidance.
For health services and doctors, the system can help identify patients who need more help controlling the disease before they suffer a severe attack; track widespread asthma outbreaks in real time, helping to identify origins and triggers such as air pollution exposure; and help improve adherence with controller medications: studies show only a quarter of asthma patients adequately manage their disease.
A new trial of the technology launched this month in Louisville, Kentucky is set to equip 500 patients with sensors for a year. The trial is free for patients, with funding from health care and charitable foundations and support from the Louisville Mayor's office and city government. Louisville has also received a Smarter Cities Challenge grant from IBM, to link in other sources of data to find potential connections between asthma and the environment.
"Traditionally public health has had a top down approach - it has captured information about hospital visits, emergency room visits," David Van Sickle, co-founder and chief executive of Asthmapolis, told UKAuthority.com."This model has a bottom-up approach, we are providing information on asthma events up to public health workers so they can do a better job."
Other studies are running in California and Missouri and the technology is also awaiting clearance from the US Food and Drug Administration which will allow the team to market the device directly to consumers in the US and worldwide.
Early studies using the device have found that most asthma attacks don't happen in the home; that rural residents suffer unexpectedly high levels of asthma; and that use of the sensors can improve asthma control.
"For us one of the goals is guidance and education that is personalised and targeted, helping a patient manage a disease like asthma day to day", Van Sickle says. "But there is work to be done to make these kinds of technologies more widely accepted, and there needs to be more attention given from the mobile health community to people on lower incomes."
The real-time geographic element also adds a far greater immediacy to creation of health policy, he says. "We weren't able to do that before, with hospital data that came two or three years after the facts."