OBJECTIVES : Digital technologies are increasingly being used to optimize chronic disease management, however, applications to improve asthma management are limited. Suboptimal management contributes to $56 billion annual costs (direct healthcare costs plus lost school and work days) and causes ~3000 deaths/year. We created a tool that can improve health outcomes and reduce costs for patients, providers and payers by engaging patients in their own environments, enabling patients to self-manage, and extending physician reach beyond traditional office visits.

METHODS : The mobile app-based solution, driven by a decision support engine, was custom-developed as a generic disease management platform, and prototype was populated with a set of evidence-based asthma-specific rules vetted by domain experts and tested with a QC process. The automated solution pushes notifications reminding patients to track their symptoms and peak flow measurements, take medications, and complete health care maintenance and educational tasks. Clinician surveys, patient focus groups, and real world patient testing were conducted to validate the app, collect feedback, and measure engagement.

RESULTS : Of the 50 clinicians surveyed, 86% said ‘Improving adherence could reduce costs’ and 94% said ‘I would recommend such an app to my patients’. Patient focus groups resulted in adding improvements including a feature for patients in duress. Real world patient testing showed high levels of initial engagement. Engagement appropriately dropped off once symptoms were controlled and preventative tasks on to-do lists were completed. Patients re-engaged right away when symptoms flared, enabling early, proactive steps to be taken to avoid further deterioration.

CONCLUSIONS : We created a digital app with a simple interface to engage patients, providing 24/7 physician support, and real time clinical guidance to resolve routine issues independently. Digital health solutions can help with patient engagement, product launch and commercialization. Future work will aim for interventions and applications in various therapeutic areas for outcomes research, PRO and RWE assessment