Asthma is a chronic disease that affects quality of life, productivity, and healthcare use, and can ultimately lead to death. The costs of asthma are largely due to uncontrolled disease and accordingly rise as its prevalence and severity increase. Unfortunately, the incidence and impact of asthma attacks have not improved despite widespread adoption of effective universal treatment guidelines by healthcare providers, revealing an unmet need to facilitate implementation and monitoring of large groups of asthma patients. We seek to improve the detection of the presence and severity of an asthma attack for proper triage of patients to receive immediate medical treatment versus continued observation at home. Telemedicine provides an opportunity for better management, but these visual and verbal evaluations are often incomplete without vital sign measurements. Our approach of remote monitoring with video-based vital sign capture offers a game-changing alternative to address asthma attacks upon their initial presentation and prevention through improved management of chronic asthma symptoms. This innovative technology will: (i) extend the reach for physicians and accessibility for patients; (ii) improve efficiency of healthcare delivery to the highest risk patients; (iii) limit exposure to infectious disease for both patient and provider; and (iv) utilize common (relatively) commercial off the shelf (COTS) technologies instead of expensive boutique equipment. The distinguishing characteristics of asthma (inflammation, airway hyperreactivity and remodeling) are the expression of a unique and complex set of molecular interactions that also manifest as symptoms and changes in behavior that result in observed clinical phenotypes. Our next steps are to enhance remote medical monitoring with extracted vital signs by developing a biopsychosocial approach to refine phenotypes of asthma. Ultimately, the approach here will enhance the data gathered from each digital touchpoint to improve early detection of acute health status before more costly interventions are needed, thereby improving quality of life, and providing lower SES patients with asthma or other respiratory illnesses a more viable means to obtaining access to healthcare.
Public Health Relevance Statement: Improving access to healthcare technology can help address obstacles to care associated with socioeconomic status (SES), demographics, and age, where travel to a clinic is complicated by cost, limitations with transportation, and safety concerns related to transmissible infections. We aim to transform asthma management through deployment of a telemedicine application, targeting at risk and underserved populations, to enhance data gathered from remote visits with vital signs extracted from video, cognitive assessments, and data from wearable sensors. A multidimensional approach will be used to refine clinical phenotypes for asthma that can be used to develop endotypes to help forecast near-term outcomes and manage healthcare utilization.
Project Terms: Achievement Attainment; Achievement; Adoption; Affect; ages; Age; Asthma; Bronchial Asthma; Baltimore; Behavior; Black race; Black; Chronic Disease; Chronic Illness; chronic disorder; Cities; Communicable Diseases; Infectious Disease Pathway; Infectious Diseases; Infectious Disorder; Darkness; Data Collection; Cessation of life; Death; Dedications; health care delivery; Healthcare Delivery; health and care delivery; health delivery systems; health services delivery; Disease; Disorder; Education; Educational aspects; Equipment; Feedback; Goals; Grant; Health Personnel; Health Care Providers; Healthcare Providers; Healthcare worker; health care personnel; health care worker; health provider; health workforce; healthcare personnel; medical personnel; treatment provider; Health Status; Level of Health; Hospitalization; Hospital Admission; Incidence; Infection; Inflammation; Laboratories; Longitudinal Studies; long-term study; longitudinal outcome studies; longterm study; Maryland; Medical Device; Methodology; Nurses; nurse; Patient Monitoring; Patients; Phenotype; Physicians; Pilot Projects; pilot study; Productivity; Quality of life; QOL; Risk; Safety; Technology; Testing; Transportation; Travel; health care; Healthcare; Hispanic; Socio-economic status; socio-economic position; socioeconomic position; Socioeconomic Status; Ecologic Systems; Ecological Systems; Ecosystem; Telemedicine; improved; Acute; Chronic; Medical; Evaluation; Visual; Individual; Health Care Utilization; health care service use; healthcare service use; healthcare service utilization; healthcare utilization; health care service utilization; Measurement; Funding; WWW; web; world wide web; Internet; Exposure to; Machine Learning; machine based learning; Disease Management; Disorder Management; Dimensions; Severities; Complex; Clinic; Techniques; System; respiratory; Visit; Services; innovative technologies; data management; Early Diagnosis; early detection; Health Insurance Portability and Accountability Act; HIPAA; Kennedy Kassebaum Act; PL 104-191; PL104-191; Public Law 104-191; United States Health Insurance Portability and Accountability Act; novel; Participant; Prevention program; Categories; Prevention; Reporting; Health Technology; Health Care Technology; Healthcare Technology; Intervention; Intervention Strategies; interventional strategy; Skin; Provider; Molecular Interaction; Binding; low socioeconomic status; low SES; low socio-economic position; low socio-economic status; low socioeconomic position; telehealth; Address; Symptoms; Adherence; Data; Detection; Improve Access; Collection; Not Hispanic or Latino; Non-Hispanic; Nonhispanic; Monitor; Preparation; preparations; Characteristics; point of care; pandemic disease; pandemic; Health Professional; Health Care Professional; Healthcare professional; clinical phenotype; cost; asthma patient; asthmatic patient; digital; under served group; under served individual; under served people; under served population; underserved group; underserved individual; underserved people; Underserved Population; Airway Hyper-responsiveness; airway hyper-reactivity; airway hyperactivity; airway hyperreactivity; airway hypersensitivity; airway hyperresponsiveness; airway remodeling; biopsychosocial; Outcome; Prevalence; prospective; data acquisitions; data acquisition; health application; mobile device; handheld mobile device; demographics; high risk; data transfer; data transmission; data exchange; Secure; Patient Triage; cognitive assessment; cognitive testing; study population; access to health care; access to healthcare; accessibility of health care; accessibility to health care; accessibility to healthcare; health care access; health care service access; health care service availability; healthcare access; healthcare accessibility; healthcare availability; healthcare service access; healthcare service availability; health care availability; recruit; body sensor; body worn sensor; wearable biosensor; wearable sensor; wearable sensor technology; intervention cost; barrier to health care; barrier to healthcare; barrier to treatment; obstacle to care; obstacle to healthcare; barrier to care; health care management; healthcare management; health management; health assessment; treatment guidelines; asthma attack; exacerbation in asthma; exacerbation prone asthma; exacerbation prone asthmatic; asthma exacerbation; assess effectiveness; determine effectiveness; effectiveness assessment; evaluate effectiveness; examine effectiveness; effectiveness evaluation; digital health; remote visit; remote monitoring; homes; Home; implementation facilitation; chronic respiratory disease; chronic airway disease; remote assessment; remote evaluation; verbal
