JMIR Publications

ABSTRACT

Background:

Asthma is one of the most common respiratory diseases with an ever growing healthcare burden . Remote patient monitoring has gained much importance in the respiratory care area with the outbreak of the COVID 19 pandemic. In this pilot study we introduced a novel platform that remotely monitors patients with chronic respiratory illnesses using CDC guidelines to reduce hospitalizations and emergency room visits. As a new virtual care solution, the goal of the pilot was to understand patient and physician engagement with the platform, as well as understand the value, for both patients and providers, of using a remote patient monitoring tool.

Objective:

The goal of the study was to understand patient and physician engagement with a new virtual care solution (Keva365 platform), as well as understand the value, for both patients and providers, of using a remote patient monitoring tool. We assessed real-world usage of the platform both from physician and patient perspectives (specific features, frequency of use, what could be improved) and the impact of devices on engagement and monitoring

Methods:

Participants with a history of moderate-severe persistent asthma were included in the study. Other inclusion criteria were being 18 years of age or over, having access to an android/iOS mobile device with internet connectivity . In addition, the participants should have no visual, cognitive, or other impairments that may prevent the patient from being able to participate. Patients were also required to have the English language proficiency and literacy (6th-grade reading level). Patients were excluded from the pilot for any conditions that would prevent them from using the platform during the duration of the pilot at the physician's discretion.​​We provided patient questionnaires to assess the usefulness and evaluate the app features. We monitored remote spirometry and oximetry data, application check-ins, alerts, and escalations during the study time window. Data was reviewed daily by nurses. Predetermined criteria were set to escalate for physician review based on the patient's symptoms and objective data.

Results:

A total of 25 patients were included in this pilot. Mean age was 57 and the majority (23) were female. A baseline questionnaire rating the app, indicated that ease of check-in and ease of modification to the patient’s asthma plan were the two highest rated features. 2066 total check ins (1550 green, 506 yellow and 10 red check ins) and 1155 spirometry sessions were recorded during this 3 month period. 60.9% of patients were found to have peak flows in their respective red zones at least once and 87% were found to have peak flows in their yellow zone at least once, during the course of the study 484 alerts were recorded and evaluated by the monitoring team, of which 37% required an escalation to the physician requiring an intervention which included transfer to a medical facility, change in respiratory medication or further education.

Conclusions:

In this pilot study we demonstrated the feasibility of implementing a novel remote patient monitoring platform in patients with asthma. Our platform showed high patient engagement and satisfaction as well as providing physicians with real-time subjective data to evaluate patients remotely that aids in their clinical decision-making.