Thanks to a lung function meter and a simple configuration between two digital services, asthma patients in the Region Jönköping County in Sweden can control their disease better and seek help when they need it via their phone, instead of relying on an annual booked appointment at their GP practice.
In a pilot study, Region Jönköping County is investigating how remote monitoring in combination with digital contact with patients can lead to better and more effective asthma care. The guidelines for optimal asthma care include many more measurements of lung capacity than the healthcare services have managed to handle through physical visits to GP practices. Now, patients have the chance to be more involved in their own care and, hopefully, disease-related problems can be prevented, thanks to patients being able to test themselves anytime and anywhere and get help straight away if necessary.
Benefits this new way of working can create:
- Better control over asthma
- Increased patient participation and involvement
- Reduced administration of healthcare services
- Clearer identification of which patients need help
- Possibility to analyse data over time
Can be offered to all asthma patients in the county
The pilot study comprises five GP practices, where 4,000 of Region Jönköping’s 37,000 asthma patients are listed. The pilot study will last for 1½ years. After that, an evaluation will be made to see if all asthma patients in the county are to be offered the same possibility. However, even now, after only a few months, it is clear there are huge benefits for both healthcare services and patients.
The equipment
The asthma patients in the pilot study are equipped with the Region’s own digital GP practice, Bra Liv nära, delivered by Visiba Care, the AsthmaTuner app and a spirometer that is connected to it. To introduce an asthma patient to the digital treatment, the GP practice can send a secure message via Bra Liv nära (which as many as 42% of the county’s residents have already downloaded). The patient receives a notification and logs in using BankID. In the message, there is a video that explains how the patient can monitor their asthma plus a link to the app for measuring their lung capacity and recommendations regarding treatment – AsthmaTuner.
Continuous measurements
The GP practice can recommend how often the patient should test their lungs and the patient can set up reminders in AsthmaTuner, for example, every morning and evening or once a week, depending on how much the patient is affected by asthma. The app is a tool which enables the patient to keep an eye on their asthma and avoid problems such as long-term respiratory problems in conjunction with a cold.
Confirmation or warning
When the patient wants to control their asthma, they open AsthmaTuner and blow into the spirometer that is connected to the app. The readings are automatically transferred to the app and the patient is asked to answer some questions about how they are feeling. After that, the result is received immediately. In most cases, the patient receives confirmation that everything looks fine, so they can take exercise, go on a ski trip or go to a party as planned, without having to change their treatment in any way. However, sometimes AsthmaTuner may warn that the patient’s asthma control has deteriorated and then the patient is advised to step up their medication to prevent a deterioration in health. If the patient has uncontrolled asthma for several days in a row, they are advised to contact their GP practice to possibly adjust their medication in consultation with their healthcare professional.
Getting in touch with their GP practice
Because AsthmaTuner and Visiba Care are linked together, the patient can simply press a button in AsthmaTuner to contact their GP practice through a message feed in Visiba Care, without even noticing the change of digital service. This direct and easy form of contact will hopefully lower the threshold for the patient to take action when their disease has deteriorated, compared with being instructed to call their GP practice during set telephone hours.
Benefits for the patient
The greatest benefit of this entire project is, of course, that patients with asthma will have a better life. The fact that they will be more involved in their own care and will perceive the healthcare services as being more accessible is also positive, since they can feel more confident that they can prevent problems with their medical condition and get help quickly when needed. Additional advantages are that they do not have to book an appointment, travel and take time off from work in order to go to their GP practice in person for a check-up.
Benefits for the healthcare services
Asthma patients have been a neglected patient group despite the fact that one in ten Swedes has asthma. There are good guidelines for diagnosis and follow-up, but in practice it has been difficult for GP practices to find the time to do follow-ups as frequently as is recommended.
There have not been enough resources to manage this in the way set out in the documents. I have never heard of any GP practice being able to follow up their asthma patients with spirometry tests as frequent as those stipulated in the recommendations.
– Ulf Österstad, Operations Manager, Bra Liv nära
Streamlining healthcare services
With the help of self-generated health data, it is now hoped that problems for this patient group will be prevented and they will be given more personalised treatment. In addition to patients enjoying improved health, the healthcare organisation will benefit from saving time and resources. Firstly, it will not be necessary to book routine annual check-ups at the GP practices (for 37,000 asthma patients) unless they are really needed. Secondly, it is hoped there will be a reduction in common cold cases which turn out to be asthma that has deteriorated. A third opportunity for improved efficiency is cheaper and more accurate medicine.
Currently, we often have to compensate with rather broad asthma medication because we don’t know exactly how the disease is affecting the patient. Our hypothesis is that we will be able to provide narrower maintenance medication which will be more in line with the patient’s symptoms. This will both improve treatment results and save money.
– Ulf Österstad, Operations Manager, Bra Liv nära
Instead of measuring the patients’ lung capacity once a year, whether they are in a good or bad period, it is now possible to get data from the patient every day. This means, of course, that both the patient and the healthcare professionals will be able to understand this particular patient’s asthma better and treat it more accurately. In a broader perspective, healthcare services will have access to large volumes of data which will help them to develop asthma care in the future.
