BWH Asthma App Sustains Patient-Provider Communication Between Visits

For patients with moderate to severe asthma, it’s not uncommon to see a pulmonologist or allergist for routine follow-up appointments at three- to six-month intervals. But a lot can happen in between those visits, and patients don’t always call their provider when their symptoms worsen – sometimes misjudging a significant deterioration of breathing as allergies, a cold or simply not bad enough to merit the hassle of trying to book another appointment.

Because of this, patients may not seek treatment until their symptoms escalate into an asthma attack, which can potentially become a life-threatening emergency.

But this cycle doesn’t have to be inevitable, contends Christopher Fanta, MD, director of the Partners Asthma Center and a pulmonologist in BWH’s Division of Pulmonary and Critical Care Medicine. In fact, it is often preventable.

Two innovators are confident that window of opportunity could be pried open with digital health tools. David Bates, MD, chief of General Internal Medicine and Primary Care and medical director of the Partners HealthCare Center for Clinical and Quality Analysis, and Bob Rudin, information scientist at the RAND Corporation, have teamed up to create an app that can help patients track their symptoms between appointments.

Following a conversation about how to best overcome the challenges of integrating patient-reported outcomes into routine clinical care, Bates and Rudin began collaborating on what would become the BWH Asthma App, a mobile application for patients to regularly track and report their asthma symptoms.

Interested in conducting a six-month feasibility study with Partners Asthma Center patients, Bates and Rudin approached Fanta with the idea for the pilot. An enthusiastic proponent of digital health innovation, Fanta happily came on board to support the clinical side of the study, which enrolled 26 patients with moderate to severe asthma and concluded earlier this year.

Created by Rudin, the app was designed for simplicity and ease of use – an approach that was influenced largely by interviews the team conducted with providers and patients before building the software.

The research team also engaged the Brigham Digital Innovation Hub (iHub). Using iHub’s Brigham Mobile Research Platform, they were able to ensure the app met stringent security and Institutional Review Board requirements while integrating patient-generated data with electronic medical records in Partners eCare.