Small Gadgets That Make You Healthier: Scientific American · change that. In Louisville, Ky., in parts of California and in Washington State, asthma patients are using rescue inhalers

Image: Mark Allen Miller

At any moment, someone in the U.S. mostlikely is having an asthma attack. Thebreath-robbing disease afflicts around 25million Americans, and every year abouthalf of them lose control of their asthma.They may rush to the emergency room orreach for a rescue inhaler, a source of quick-acting drugs that can relax constrictedairways in minutes. Predicting who is at riskof such crises is difficult, however, becausethe relevant statistics that would identifytrends come from the patients' ownrecollections days or weeks after theemergency.

In several U.S. cities, a new technology maychange that. In Louisville, Ky., in parts ofCalifornia and in Washington State, asthmapatients are using rescue inhalers toppedwith a small sensor that wirelesslybroadcasts when, where and how often thedevice is used. The data pass through asecure server to patients' mobile phones anda physician's Web dashboard, providing aninstant record of how well a patient is doingand archiving the information for futurereference.

The device and data-monitoring system—which are collectively called Asthmapolis and which were approved by the U.S.Food and Drug Administration last July—constitute just one example of an emerging

Small Gadgets That Make YouHealthierMobile phones and tiny sensors are making it easier to quickly flag healthtrends

By Maryn McKenna

Health :: The Science of Health :: February 21, 2013 :: 6 Comments :: Email :: Print

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movement holds great promise because it combines traditional medical recordkeeping and public health surveillance with data mining and mobile phonetechnologies. Together these tools produce deep, up-to-date reports that can benefitpatients and medical researchers, as well as public health and environmentalauthorities, all at the same time.

“If you think about the driving forces that are going to shape health care for the next20 to 30 years, three things stand out: major aging in the population, massive growthof chronic disease, not enough caregivers,” says Steven DeMello, director of healthcare at the Center for Information Technology Research in the Interest of Society atthe University of California, Berkeley. DeMello says that mobile diagnosis andsurveillance could help blunt the impact of changing demographic trends byrecognizing health crises early, by providing connections for remote care and bygiving patients enough information to gain control of their disorder.

First Breath

Asthmapolis emerged from co-founder David Van Sickle's frustration withgovernment asthma data, a feeling that burgeoned after he received his Ph.D. andwhile he was serving as a disease detective in the National Asthma Control Programat the Centers for Disease Control and Prevention. “Despite all that we know aboutasthma and how to treat it, the majority of individual patients actually haveuncontrolled disease,” he says. “Their physicians can't course-correct, becausepatients don't report how poorly they're doing, and so they end up at higher risk of ERvisits, hospitalizations, missed days of school and work—and that's all below publichealth's radar.”

Van Sickle realized that patients were already carrying around devices that couldobjectively report their status: rescue inhalers. Most asthma patients take slow-actingdrugs daily to keep their condition in check; repeated use of an inhaler signals adeveloping emergency. Beginning in 2006, Van Sickle and several partners created awireless sensor that is now being tested in various settings. In Louisville, for example,researchers are using the device to identify local environmental triggers of asthma; inSacramento, the focus is on proper follow-up care.

The Louisville project's sponsor is the municipal government. Ted Smith, its directorof innovation, says Louisville hopes to deploy at least 500 sensors to construct ayearlong portrait of the impact of the disease on the population and the role that thecity's notably poor air quality plays in making it worse. The Sacramento project isbased inside Woodland Healthcare and Mercy Medical Group, two subsidiaries of thehealth care system Dignity Health. The goal is to test whether patients' health isimproved by real-time feedback of their symptoms to their physicians. MichaelPatmas, Woodland's chief medical officer, says the project may benefit other patientsas well. First, many local asthma patients are farmworkers whose dusty outdoor workprovokes their attacks; better management of their health might keep them out of theER and thus reduce overcrowding. Plus, comparing the aggregated data from thepatients' sensors with local weather reports could allow the hospital to alert allpatients to possible risks through, for example, short text messages (SMS). “If it's dry,and it's hot, and the wind is blowing in a certain direction, we can send an SMSwarning: ‘Bad weather conditions today,'” Patmas says.

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View Oldest to Newest1. drscarlat06:03 PM 2/22/13

One small gadget that has a great potential in making onehealthier is the old fashioned....bathroom weight scales.This low tech device was shown in numerous peer reviewedarticles to be especially helpful in monitoring the congestiveheart failure patients' weight, since gaining a few pounds forthese patients is usually due to fluid retention / salt overload,usually preceeding an exacerbation of the heart failure.A. Scarlat MD

Reply | Report Abuse | Link to this

2. AlexZiegler06:09 AM 2/23/13

In terms of getting people to use them as well as to counteractthe afforability, assuming that the fitbit leads to healthawareness and as a result people are encouraged to behealthier, it would just be a matter of someone doing a studyto see if individuals within buisness who had the fitbit showedincreased productivity. Once this connection is made, manypeople who wouldnt buy the fitbit normally wouldnt have to,buisnesses would because it would be in their best interest to.Not only that but its a good PR move as well.


3. Patbrryin reply to AlexZiegler04:05 PM 2/27/13

How much are fitbit paying you to tag their product inconnection with mobile health articles?shill.


4. Patbrryin reply to AlexZiegler04:09 PM 2/27/13

Ahh, page2 - I apologise :)


5. szlfsmit05:15 PM 3/1/13

There are significant differences between consumer athletesand healthy consumers reflected by use of Run Keeper mobileapps and Fitbit health awareness devices versus mobile healthdevices to engage, monitor and support patients with adiagnosis.

Software applications with dashboards summarizing the largevolume of data and alerting both patients and their physiciansand securely communicating the data and status directly intothe patient's medical record in a standardized way remain astechnical, legal, and organizational challenges.

However, the potential to alter the common disease

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healthcare cost and suffering is great.

(Disclosure- I am member of Woodland HealthcareAsthmapolis project team.)

LFS


6. waldmanrachel02:47 PM 3/22/13

I wonder if this kind of mapping technology could be used toaddress gun violence by transmitting the location of registeredweapons each time the safety is removed? It would instantlyalert police if safety locks are removed outside of a gun range,hunting zone or other legal gun use space. For example, if aprivately owned rifle transmits safety lock removal at say, amall or school... well, the police would be on their way. Just anidea.


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Small Gadgets That Make You Healthier: Scientific American · change that. In Louisville, Ky., in parts of California and in Washington State, asthma patients are using rescue inhalers

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