What if asthma outbreaks could be tracked real-time by public health organizations to help healthcare organizations and individuals identify its origins and triggers? Asthmapolis, a GPS-enhanced inhaler, is doing just that.Asthmapolis is the brainchild of David Van Sickle, Ph.D., Mark Gehring, and Greg Tracy, who were colleagues at the University of Wisconsin School of Medicine and Public Health. Since last fall, Asthmapolis, which is developed by the Madison-Wis.-based Reciprocal Sciences, has outfitted asthma inhalers with GPS and GSM (global systems for mobile communication) radio to collect patients’ precise location when the inhaler is puffed, as well as the time and date, and report that information to a database for analysis.Studies show that U.S. patients use asthma inhalers more than 50 million times each week, and that as few as one-quarter of patients with asthma adequately manage their disease. The Asthmapolis GPS-enhanced inhaler allows providers and patients to map and track asthma symptoms, triggers, and use of rescue and controller medications from their computers or smartphones.Two studies funded by the Centers for Disease Control (CDC) have shown the efficacy of the Asthmapolis sensor and have proven that the majority of documented asthma attacks don’t happen in the home and that rural residents are suffering from unexpectedly frequent symptoms. The first pilot, a four-month study in 2009 that involved 40 people in Wisconsin, found that 75 percent of the asthmatics studied improved their control and the number of people with uncontrolled asthma fell by 50 percent.A second six-month study in 2010 focused on rural areas in a 12-state area in the Midwest and documented more than 1,600 inhalation events from 42 people. “The goal of the rural study,” says Van Sickle, “was really to understand some unexpected findings from the national surveillance information for asthma that found that folks in rural areas of the United States were having more frequent symptoms than expected, and their rates of asthma were comparable or even higher than folks living in urban areas.”
David Van Sickle, Ph.D.New Prototypes and PilotsA new Asthmapolis medication sensor has recently been unveiled and is in its alpha prototype phase. This new sensor will be piloted in early 2012 in several locations to determine if the data that is collected and presented to physicians and patients will improve asthma control. One pilot in conjunction with the California HealthCare Foundation will take place at Woodland HealthCare, part of Catholic HealthCare West system, and will be conducted with English- and Spanish-speaking underserved patients in the Sacramento area. Another pilot will be in conjunction with the Southern Piedmont Beacon Community in North Carolina to allow about 2,000 asthma patients to enroll in a text messaging program that will follow them after discharge. Another pilot will take place in Louisville, Ky.Van Sickle and his colleagues are currently renovating patient and provider interfaces with new data visualization capabilities and also building out mobile apps. Van Sickle says the challenge so far has been to create systems that are effective and engaging, without adding to the burden of managing the disease for patients. “The same go for clinicians, [we want to] deliver systems that are more efficient and don’t overwhelm them with data, while providing them with new, effective ways to manage and improve the optimum control of their population,” he adds.Beyond asthma, a partnership with VA Puget Sound Health Care System (Seattle, Wash.) is underway to use the Asthmapolis sensor to lower the costs of disease management for patients with chronic obstructive pulmonary disease (COPD), who generally use the same medications as asthma. COPD, which affects people later in life, has the same unexplained pattern of attacks, Van Sickle says, and when poorly managed, can be extremely expensive.The Asthmapolis sensor has not yet received U.S. Food and Drug Administration approval, but hopes are to start selling the sensor in 2012 to health systems on a subscription basis, with a monthly fee charged per patient.
