Windsor therapist pioneers new asthma treatment app

Friday, November 1, 2013

The Windsor Star/Don Lajoie

Madonna Ferrone has a personal stake in her own research.

That’s because the Windsor respiratory therapist, who is part of a team pioneering a new digital health care tool to help asthma patients better control their condition, is herself a long-time asthma sufferer.

Ferrone, an instructor at St. Clair College who also works for the Windsor-Essex Primary Care Lung Health Program, said Thursday she became involved in the research to see if it might help her cope with the condition. She described her symptoms as severe and chronic, and added that difficulty controlling the symptoms in the past often left her gasping for breath and forced her to seek medical attention for particularly bad attacks.

But, experimenting with the new computer app she helped develop along with a team that also included Dr. Christopher Licskai – pulmonologist at St. Joseph’s Hospital in London, Ferrone determined, over the course of a year’s usage, that she was able to virtually eliminate such episodes simply by following the application’s program on her computer.

“I’m coming up to one year using the app,” she said. “And I’ve really improved. I used to have to go on prednisone (medication) at least twice a year. For this past year I’ve not been on it at all. Because this allows me to deal with symptoms quickly, using my puffer.”

Essentially, Ferrone explained, the app acts as a diagnostic tool. The patient inputs the monitoring parameters, such as the individual’s symptoms, peak flows of condition activity, exercise tolerance, night symptoms and known attack triggers. Based on the data, the applications is then able to determine what threat level the patient may be facing given the symptoms.

A green zone reading means the patient is in control of the condition, A yellow zone means the user’s “control” of the condition has dropped. Some intervention may be necessary, perhaps different medication or dosages are required or other changes may have to be made in prescribed treatment. A red zone reading indicates that the patient’s condition is “out of control” and the patient should seek immediate medical treatment, perhaps requiring a visit to the emergency ward.

Ferrone cautioned that all data has to be input according to a doctor’s instructions so that the plan is based on their actual needs.

“So, essentially, if you drop into the yellow zone, the information tells you what, according to your doctor, you may need to do,” she said. “It’s self-management that gives patients control over their own care.”

She added that is how the use of the application differs from other medical apps currently available on the Internet, which function basically as a diary. She said the plan is to eventually offer the application at no cost to the user.

“It was like a light bulb went off,” said Ferrone, in describing her own testing of the app. “If you have asthma for a long time, after a while, you don’t know what normal should be anymore. Take coughing. You don’t think about it but if you’re coughing every day, that’s not normal. You should do something about it. I wasn’t in control in the way I thought I was and this was a big eye opener.”

But, she said, the asthma app is not yet available for download. She explained that testing is continuing, with 150 Ontario asthmatics currently part of a study.  She added that the basic premise may one day be applicable to other chronic conditions and illnesses, such as diabetes. “But we’re not there yet.”

A side benefit, Ferrone noted, is that giving patients more control over their health, focusing on management and prevention, could save government health care programs a lot of money.

In fact, a survey released by the Canada Health Infoway advocacy group recently showed that 96 per cent of Canadians who responded agree that it is important the Canadian health care system make better and more use of such “digital health tools” and their capabilities. A further 89 per cent expressed an opinion that they “personally” feel it is important that they be able to access digital health tools, according to the Harris/Decima poll.

“We’re hoping for a whole range of applications leading to better health care for all Canadians,” said Jennifer Zelmer, executive vice-president of Canada Health Infoway, a not-for-profit group funded by the federal government, advocating for more access to digital health initiatives. “It’s an important issue … to use digital capabilities to advance the health care system.”

She said the group’s research, as part of its Better Health for Canada initiative, indicates that Canadians support more access to digital advances that would, among other things, allow them to book medical appointments online, be able to communicate directly with their own doctors online, give them access to their own medical records and allow them to renew their own subscriptions.

She added that such initiatives have already gained the support of the Canadian Medical Association and Canadian nurses associations.

She said the new technology is capable of “changing the way doctors and patients interact.”