Tracking inhaler usage to improve asthma management

The Wisconsin-based company Asthmapolis is using tech to plug the gaps in asthma management.

The Wisconsin-based company Asthmapolis is using tech to plug the gaps in asthma management. From a mobile app that tracks asthma events to a passive device that monitors inhaler usage, co-founders David Van Sickle and Greg Tracy explained the team's innovations in a recent interview. Below are excerpts from our talk.

How does your mobile application for asthma patients work?

Tracy: The goal is to give users the ability to track asthma-related events. We're working on a new version. There are only a couple of functions now. We want to keep it simple so the barrier is low to record events. You can record use of medications, symptoms and triggers related to events. You can record the location where those events are occurring.

So people can use the app to track the environments where they have asthma events?

Tracy: It's somewhat like a check-in event. You launch the app and there's a big, yellow button that says, 'I had an asthma event.' Once you do that, you have the option to tag that event with symptoms and triggers, a location and some personal notes.

What's the benefit for users?

Tracy: You collect a history of your own events. You can start to understand the location a little bit better. You can understand the history about what your triggers are. It will sign you up, if you choose, for an email report each week. In addition, you can see a snapshot of what's going on in the community with other people that are using the tool.

Van Sickle: Most people who have asthma are uncontrolled. This means they're having symptoms and experiencing a worse quality of life than they should be based on what we know about asthma and how it can be treated. Part of the reason for that is that most people with uncontrolled asthma think they're doing fine. They're not aware that they should be able to avoid symptoms everyday with the current medications. The mobile application in a large sense is about helping people understand how well managed they are and giving personalized guidance on how they might do better.

Are you also studying the data and looking for trends?

Van Sickle: Part of the goal of the company is to look for patterns in the aggregated data. We've made the devices available in focused research studies with academic teams or public health agencies. Last year, we ran a study looking at patterns of asthma among rural residents in the Midwest. Their aggregate data is being used to better understand what kind of exposure, behaviors and activities are characteristic of rural folks having asthma symptoms.

How does your inhaler tracker work?

Van Sickle: The device is designed to track and record the location when and where a patient uses a metered-dose inhaler. They use [the inhaler] at the time and place when they're exposed to something that causes symptoms. That's what we record. We do it as passively as possible. It's essentially just a sensor on the end of an inhaler with varied electronics in it. Those electronics capture the event and get the event information to our remote server. The patients with well-controlled asthma will probably use that medication fewer than two days per week. By figuring out how often they're using that, we can see how well-controlled they are. That's one of the main reasons for monitoring it. The device has only been made available for focused projects at academic centers and health agencies. We're building a commercial version of that device that will be available sometime in 2011.

What have you learned from the data you've collected so far?

Van Sickle: By monitoring use of the inhaler, we can quickly tell how well a patient is doing. We can identify patients who are more impaired than they should be and patients that are at a greater current risk of going to the emergency room or being hospitalized. We're able to remotely monitor asthma control. We learned that by providing feedback about asthma control and personalized guidance about how they might improve management, we can improve asthma control.

In our first study, 75 percent of the people who entered had uncontrolled asthma. When they left, 50 percent of those folks had gotten their asthma under control. We're able to make significant improvements in asthma management. Those will translate to lower costs. Asthma patients who are better controlled don't need to go to the hospital. They don't have as many unscheduled office visits. We're learned that a lot of people are having symptoms outside of their homes. We're seeing quite a percentage occurring out in the community. We're getting feedback from patients [who say] that becoming aware of their asthma control is helping them use their medication more appropriately.

What else are you working on?

Van Sickle: Our goal as a company is to address gaps in asthma management. There are quite a number of them. We're nowhere near where we want to be in terms of reductions in ER visits and hospitalizations. Virtually all of those could be prevented. We see gaps in the way asthma could be optimally managed. We're tackling those one at a time.

What are the gaps?

Van Sickle: We see gaps in understanding of medications, in asthma education, in public health surveillance data. Rates of ER visits and hospitalizations haven't declined significantly. This could be used in other chronic and respiratory diseases. Through technology, we can enable better behaviors and help people remember to take medication they would otherwise forget. We can improve doctor-patient communication and provide a better understanding of environmental health and the triggers of asthma symptoms.

You mentioned other chronic diseases. Do you plan to expand this technology to other conditions?

Van Sickle: We're looking carefully at how it could be expanded to other chronic respiratory diseases. There's a potential application for chronic obstructive pulmonary disease. That would be an obvious place where we would work next.

Photo, top: Greg Tracy

Photo, bottom: David Van Sickle

This post was originally published on Smartplanet.com

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