By Tom Stibolt, MD, Mobile Musings Column Editor

Lung Function

Developers of the spirometry app SpiroSmart, designed at the University of Washington, are now providing a service called SpiroCall. This solution builds upon earlier work by the team and uses a central server to process data collected by the microphone on the phone. It does not require downloading an app, which greatly increases the number of phones that can be used. For instance, the system can be used with any phone, from a shared landline to a 10-year old mobile phone.

SpiroCall transmits the collected audio using a standard phone channel, as opposed to a sound file that is transferred by a smartphone app over the Internet. The team combined multiple regression algorithms to provide reliable lung function estimates, despite the degraded audio quality. The system is currently in use in a number of third-world countries.

Over the last four years, the team has collected data from more than 4,000 patients, where clinicians have measured lung function using both SpiroSmart and a commercial spirometer. That comparative data has improved the performance of the machine learning algorithms and have laid the groundwork for the team’s current Food and Drug Administration clearance process. A paper presented in May at the Association for Computing Machinery’s CHI 2016 conference in San Jose, California, shows that SpiroCall’s results came within 6.2 percent of those from clinical spirometers used in hospitals and doctors’ offices, meeting the ATS standards for accuracy.

Transplants

The Seattle team hopes to improve access to home-based spirometry and lung function monitoring, and in turn, improve the way care is administered to patients around the world. Future steps for the research team include looking at additional data collection and figuring out how best to communicate test results in a way that will make sense to patients.

Another project from Seattle Children’s Hospital has resulted in an app for transplant patients. The app, called Tonic, was originally for liver transplant patients. It started as post-operation education while the patient is still recovering in the hospital.

The program consists of a 14-chapter curriculum for a patient, with information from pharmacists and transplant teams on the medications they must take and how often they must take them. The app was originally intended for patient surveys, but the digital team built it out to include a broader range of services. The next generation of the app will include information for patients who are on the waiting list for an organ, as well as their families. It will also provide information once they are discharged from the hospital. The app has been adapted for kidney transplant patients now, and a version for cardiac transplant patients should be available this year. At present, the app does not appear to be available outside of Seattle Children’s Hospital.

Wearables

An article just published on MedCity Newsdetails a number of issues that limit the adoption of wearables in medicine. The article quotes Arun Villivalam, MD, a family physician in Los Gatos, California, who spoke at the Health Technology Forum’s Innovation Conference in Palo Alto, California. He notes that the adopters may not be the right people who need the devices. The patients he encounters using wearables usually are the ones who are healthy. It is apparent that there is a difference between fitness and medical uses.

He identifies three major barriers to wider use of wearables in clinical practice. First, there must be a system around it. These devices have to produce accurate, actionable data on health that is easy to interpret. Second, clinicians don’t want extra work, including extra clicks, within their electronic health records. Finally, the question of who pays doctors for their time managing wearables data remains an open question.

Editor’s note: The ATS does not endorse any of the programs or products mentioned in this column.