- By incorporating connected devices and sensor applications into a community wide wellness program, the city of Louisville, KY, doubled the amount of symptom-free days for patients with asthma and chronic obstructive pulmonary disorder (COPD).
The Air Louisville program took place over a two-year period from 2015 to June 2017. The project was a collaboration between Propeller Health, who provided the mHealth sensor, the Louisville Metro office of Civic Innovation, and the Institute for Health Air Water and Soil.
The program enrolled 1,147 participants, collected 570 patient years of data, 251,000 medication puffs, and over 5.4 million environmental data points from Propeller Health’s asthma medication sensor.
The sensor, which attaches directly to a patient’s normal inhaler, collects data on the number of puffs used per day, how many times a patient experienced symptoms, and where they experienced those symptoms.
In conjunction with the sensor, a smartphone app provides a personal asthma management system that alerts a user to track their symptoms and take medication.
Over the course of the program, data points were matched with environmental conditions like nitrogen dioxide, particulate matter, ozone, sulfur dioxide, pollen levels, temperature, humidity, and wind speed across Louisville to identify the most significant triggers of asthma and COPD.
By combining the data from connected devices and Air Louisville sponsored education on asthma management, the program’s participants saw significant improvements in their health.
Around 82 percent saw a reduction in inhaler use, as they incorporated preventative care before needing the inhaler. Twenty-nine percent improved their overall control of their asthma, and 19 percent decreased their night-time symptoms, increasing the quality of their sleep.
This approach allowed the City of Louisville to identify environmental and socioeconomic factors that can adversely affect the quality of life for asthma and COPD patients.
Air Louisville program coordinators used the data to build a map that shows the most at-risk asthma patients in Jefferson County.
Source: Air Louisville
After analyzing the map, the team found that if ozone exceeds the EPA limit of 70 parts per billion (ppb), a community could expect to see more than 65,000 asthma rescue inhaler uses among all persons with asthma throughout Jefferson County.
This level of medication usage equated to healthcare costs of $129,000 in a single day. In 2016, ozone exceeded the 70 ppb limit on 19 days, which translated to roughly $2.4 million in healthcare costs, Air Louisville estimated.
Based on these findings, the city now plans to increase tree coverage in high risk asthma areas, identify alternative truck routes to keep them away from high risk neighborhoods, provide asthma risk forecasts through mHealth to all citizens of Louisville, and consider zoning policies through the city to address health impacts of highways and industrial admissions.
"The health of our residents is critical to the overall health of our community, and Louisville's location within the Ohio River Valley provides particular challenges for residents with asthma," Mayor Greg Fischer said.
"Data and research show that asthma can become more severe on days of extreme heat and poor air quality. As the city and our many partners, including Air Louisville, work to plant trees, and improve air quality, I look forward to seeing asthma sufferers enjoy cleaner air and easier breathing,” he said.
Other regions have also employed connected devices and patient education to identify asthma risks and improve chronic disease management.
Earlier this year, Mount Sinai Hospital effectively used connected devices to improve asthma care and enhance clinical research on new ways to treat and manage asthma patients. Researchers connected thousands of asthma patients across the country and record the day-to-day activities affected by asthma.
At Ellis Hospital in Schnectady, NY, a team was able to reduce ED admissions related to asthma attacks simply by setting up a comprehensive asthma education program for patients. Ellis Hospital decreased ED charges by $600,000 and inpatient costs by another $230,000 just by informing patients about preventive care.
Comprehensive care strategies that maximize the use of connected devices and patient education can allow stakeholders at multiple levels of healthcare and wellness to significantly improve community health for asthma patients.
"Our ambitious goal is only achievable if we work together with organizations like Air Louisville,” said Rae Godsey, MD, and Corporate Medical Director at Humana. “Our research indicated that asthma, allergies, smoking and other respiratory illnesses are significant barriers to Kentucky's health. Air Louisville is helping us develop and implement collaborative strategies to remove these barriers and assist us all in breathing easier.”