Tueo Health is developing a platform technology for passive physiologic monitoring with broad applications in improved chronic disease management. The system will initially be brought to market as a digital health solution that delivers accurate, objective indicators of asthma control integrated with a service to assist patients and their families in managing the disease.
Asthma affects more than 20 million of children and adults in the United States and 300 million around the world. The disease is controllable through appropriate use of existing medical therapies and limiting exposure to known triggers. However, the subjectivity inherent in attempting to monitor signs and symptoms of the disease is problematic, and roughly half of individuals in the United States with asthma are not well controlled. Poor control equates to risk of attack or exacerbation; a large proportion of the billions of dollars spent on costly emergency room visits and hospitalizations as a result of these exacerbations are avoidable.
The solution has four parts: an internet-connected sensor device in the home, personalized analytics, a smartphone application, and target education and coaching. The contactless sensor attaches to the mattress where an individual sleeps and passively measures basic physiologic parameters during sleep. Analysis of changes in the parameters relative to a patient’s baseline reveal early changes in disease control days before the condition becomes severe. The data available in the smartphone app gives patients objective measures to use in following doctor-issued asthma action plans. And in the event of worsening control, the asthma educators will provide guidance to obtain optimal results. The solution could be deployed as a consumer health product or readily integrated with existing asthma management programs within health systems. As such, there is a benefit for patients, providers, and payers to adopt the system and improve the outcomes while reducing cost of asthma care.
A prototype of the system has been deployed in an observational clinical study through the Stanford University hospital system for over a year. Participants in the study are monitored nightly and complete a validated asthma control test (ACT) survey bi-weekly. The monitoring device is a ballistocardiogram sensor manufactured by a global electronics component supplier. The device reports heart rate, heart rate variability, respiratory rate, stroke volume, and bed occupancy status every second. These parameters are combined with patient-specific data (age, height, weight, etc) to compute a personalized baseline and an assessment of current status.
More than 2000 nights of data -- over 100 million data points -- have been collected from twenty children with asthma. The data collected in the study clearly shows the tremendous utility of the physiologic data for understanding deviations from baseline -- including the development of exacerbations -- and informing asthma care. Next steps will include adaptation of the many excellent asthma education materials publicly available so that it integrates well with the physiologic indicators that will be used to trigger delivery of these materials through a digital coaching platform.
We have only begun to scratch the surface of this data as it pertains to asthma management, and there are many other exciting applications as the data we're gathering is not specific to asthma. Management for other conditions such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) could benefit from the same monitoring. The solution could also be deployed as a diagnostic tool as well as for episodic monitoring for high-risk populations.
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