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By Meshari F. Alwashmi, PhD, Chief Scientific Officer, BreatheSuite
Today’s healthcare providers have an exciting opportunity to reshape healthcare. The cultural transformation in healthcare is incorporating greater use of digital tools to enable the “Virtual-First” care paradigm that is centered around the patient’s individualized needs. Payers and self-insured employers have been increasingly developing virtual-first health plans which, per the American Hospital Association, aren’t yet universally defined but have the common traits of having virtual care as the initial point of contact; utilizing informatics to deliver actionable utilization plans; providing concierge-style active care coordination to help patients get the highest quality care at the lowest price point; and clinically integrating health coaches. Evolving digital health technologies enable the creation of data-driven care plans that enable patients to better self-manage their treatment at home and have more meaningful and personalized interactions with their healthcare team. Ultimately, the result can be improved health outcomes, reduced healthcare utilization, and enhanced patient and provider experience.
This can be particularly beneficial for the tens of millions of Americans who currently suffer from chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma which, per the World Health Organization, are two of the most prevalent conditions affecting the lungs. It is estimated that 210 million people worldwide have COPD. Globally, according to WHO, COPD is the third leading cause of mortality, accounting for 3.23 million deaths in 2019. In comparison, asthma impacts an estimated 262 million individuals, resulting in 461,000 deaths in 2019. Patients with COPD and asthma may have occurrences of exacerbation, a worsening of their respiratory symptoms that requires medical attention (commonly referred to as lung attacks or flare-ups). Patients frequently fail to recognize or control exacerbations, resulting in increased disease burden and health-care costs.
To help in the prevention of an exacerbation, patients with respiratory conditions are often directed by their clinicians to follow written action plans (AP). It outlines the early signs and symptoms of an exacerbation and provides a plan on what actions to take to help manage a flare up early. However, many patients do not follow their action plans, especially when an exacerbation is imminent, and thus do not benefit from the of early detection and preventative measures. These measures commonly include a prescription for taking rescue inhalers. Unfortunately, about 90% of patients who use a Metered Dose Inhaler (MDI) demonstrate poor inhaler technique. Inhaler techniques such as shaking the MDI, as well as inhalation duration, can greatly affect the amount of medication that reaches the patient’s lungs, impacting their exacerbation management.
Advancements in smartphones, wearables, and other smart devices are not only enabling but also driving the virtual-first paradigm. These programs are centred on gathering data to positively influence behaviour change and disease management based on the patient’s unique needs. It may also allow family members or caregivers to participate in the care plan. To keep up with the growing number of data points, we must work on improving the tools used by providers. These technologies must be able to extract the signal from the noise in a way that is easy to use and offers actionable information.
Digital Health can play a crucial role in the management of asthma and COPD exacerbations. Remote Therapeutic Monitoring (RTM) devices can be coupled with a patient’s prescribed MDI to provide objective data about medication usage and it has the potential to digitize action plans. RTM devices can track, score and ultimately improve technique and adherence, making sure the right amount of medication reaches their lungs. With consent, this information can be shared with their healthcare providers to enable effective remote patient monitoring. In addition, data from RTM devices can be coupled with data from other innovative devices that capture the lung’s physiological parameter, such as smart patches, garments, and watches. This could provide greater clarity into how changes in treatment can impact the individual’s health conditions and the severity and frequency of their symptoms. The ability of clinicians to gather this data and digitize action plans will be essential to the long-term success and effectiveness of virtual-first programs.
Dr. Meshari F. Alwashmi has spent more than a decade introducing new technologies to traditional medical practice while bringing a heavy patient focus to his process. He is the Chief Scientific Officer at BreatheSuite, a digital health company helping people with chronic respiratory conditions live longer, healthier lives. He is also an associate member at the University of Michigan and a member of the Forbes Technology Council.
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