Controversy remains over whether digital health and/or telemedicine can be useful to control chronic medical conditions, cut costs and improve outcomes. It is this author’s opinion that simple monitoring is insufficient for chronic diseases, and hence many of the negative “telehealth” studies involved digital tools whose functionality involved exclusively recording and reporting. Patient portals abound but are of limited without concrete action suggestions, connections with health care providers and integration with medical care plans.
This month’s European Respiratory Journal provides further support to this thesis. In it, a device/program combination called AsthmaTuner was evaluated against routine asthma care in patients with severe and uncontrolled asthma (ACT >20). AsthmaTuner is a software for asthma management which is tethered to a digital peak flow meter/spirometer and patient questionnaire. Based on the results of the patient reported symptoms in conjunction with changes in the patient’s peak flow, clinical recommendations are suggested to the patient (i.e. to consider stepping up therapy for worsening asthma symptoms). Of note, the study design featured a 2×2 crossover design – intended to eliminate the bias of self-motivated patients ( a variable that is difficult to control for). Brilliant.
In the treatment arm, namely those using the AsthmaTuner program, asthma control (as measured by the ACT) was significantly improved as compared to routine therapy by 30%! In other words, using an intuitive and integrated clinical/digital program can improve outcomes, lower costs and improve patient care in the most sick and unstable patients! By a significant margin! It is time for the medical community to band together and demand that more programs like this be provided, thereby improving healthcare delivery and patients lives!
https://erj.ersjournals.com/content/early/2019/08/14/13993003.00983-2019