For most of us, breathing isn’t difficult. I certainly don’t spend much time thinking about it, except for the occasional scary sea-swimming moment, caught clutching the sand after diving beneath an unexpectedly large wave. For asthmatics though, breathing can become impossible and the signs of deterioration are often small and subtle and only noticed by patients and their families once the patient is already in trouble, ‘trapped below the surface’ of a tight chest, needing urgent rescue through medical care, and often hospitalization, to avoid death. Keeping these patients out of the dangerously deep water of a serious attack is about helping them to identify danger signs long before they are serious, to take action, or to identify and avoid triggers that accelerate a plunge into the abyss.
Open mHealth says that mHealth is about making “health data as useful and actionable” for patients and clinicians. The growing industry around mHealth is equally interested in reducing costs and the burden of care faced by health workers by reducing hospital visits. For asthmatics, both will sound like good news and they are no doubt pleased that innovators are not sitting idle.
A number of companies now offer Apps and sensors to monitor breathing and help manage Asthma. Three quite different examples, sharing the same aim, are AsthmaMD that offers a Peak Flow Meter to measure lung function, iSonea that gauges adherence by monitoring wheezing, and Propeller Health’sapp and sensor, which attaches to a standard inhaler. All focus on helping asthmatics manage their condition and reduce the number of visits to healthcare providers. Ephraim Schwartz provides more detail in his June piece in mHealth News.
AsthmaMD uses a Peak Flow Meter, a device that measures the force with which the patient breathes out, a key aspect of breathing particularly reduced in asthmatics. The meter syncs with an App via Bluetooth. When patients blow into the meter, a value is transmitted to the App, which then explains to the patient what the value means. The App will also track lung function over time and produces easy-to-read, color-coded peak flow charts, which provide healthcare providers with information to use to tailor treatment plans. They’ve reported a 10% improvement in lung function for active users, compared to a control group, and reduction in hospitalization and readmissions. It’s available over the counter in the US for $20.
AsthmaMD apparently has 100,000 users and its developers have begun thinking about how to use their growing data source to answer questions about how to improve asthma care.
iSonea’s device is called iSoneaAir. It records wheezes, a characteristic sound associated with obstructed airways. By measuring the wheeze rate, health workers are able to monitor patients’ progress outside of the clinical environment and assess how effective medications are before and after inhaling. “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.
The solution consists of an iPhone or Android App and the wheeze monitor, which is placed against the throat. The device syncs with the App via Bluetooth and wheeze recordings can be sent to health workers or stored in the cloud.
The Propeller Health App, along with its sensor, tracks exact location, time and frequency of medication taken.
Africa’s health challenges need solutions of their own, and the mHealth community in Africa is expanding its capacity to deliver. There’ll be lessons to learn from projects that gain traction elsewhere. Though probably none that will help me avoid the next big wave, or hold my breath longer when I get it wrong.