Mar 5 2012
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RWJF Scholar Puts GPS Technology to Work Fighting Asthma

David Van Sickle, PhD, MA, an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program and founder and CEO of Asthmapolis, has created a new device called a Spiroscout. It is an inhaler with a built-in Global-Positioning System (GPS) that sends a signal with the time and location to a remote server every time a patient uses it. Asthmapolis tracks and analyzes the data and sends regular reports to patients and physicians, along with observations and recommendations.

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Last summer, RWJF’s Alumni Network talked with Van Sickle, an epidemiologist and medical anthropologist, and then this month, the RWJF Human Capital Blog followed up with a few more questions. The combined results of those conversations follow:

RWJF Alumni Network (AN): Have you always been working on asthma?

David Van Sickle: My whole career has been focused on asthma. I did my dissertation research on asthma in India and worked at the respiratory center in Arizona during grad school. When I was at the Centers for Disease Control and Prevention (CDC), I was working in outbreak investigations, trying to figure out where and when asthma was happening, so we could better target our public health activities.

AN: How did you get the idea for your company?

Van Sickle: At the national level, we suffer from a lack of data about the day-to-day burden of asthma. When I went to the University of Wisconsin with the RWJF fellowship, and began to look more closely at the clinical management of asthma, I realized that physicians also suffered from a lack of information on how their patients were doing. I thought we could solve these two problems with one new technology that tracked where and when people are using their inhalers, which provides an important signal of how well the disease is being managed.

AN: And did the Health & Society Scholars program help with that at all?

Van Sickle: Absolutely. Not only did the program provide me access to research funds, but I felt that because RWJF had invested in me, these funds came with the responsibility to try something that was high-risk but also potentially very rewarding. At our initial meeting, I raised the idea with the program directors, who recognized and supported my effort even though on the surface it was kind of a crazy adventure for an anthropologist with no engineering training. Even after we moved the technology off campus, colleagues and directors from the Health & Society Scholars program continued to play an important role in our success, by helping to encourage interest from the network and with ongoing mentorship.

RWJF Human Capital Blog (HCB): And how are things going now?

Van Sickle: Things are going very well. We finished two CDC-funded pilot studies, both of which showed major improvements in asthma control and provided valuable new epidemiological data. In 2010, I teamed up with two others to set up a company to build and market a disease management solution for asthma and chronic obstructive pulmonary disease (COPD) to health plans, insurers and employers. We just recently reached an agreement with Dignity Health Systems in Sacramento, California to provide asthma management, using the device, for 500 asthma patients in that community. With the support of the California HealthCare Foundation, we also plan to evaluate how well the system works at improving asthma control, and carry out an evaluation of the economic impact.

We’re also working on an exciting project in Louisville, Kentucky where, in partnership with the city and a retail pharmacy chain, we plan to integrate disease management into the community in a way that makes it more convenient while providing vital information to the city about where and when asthma incidents are occurring, so that they can look at the environmental factors that might be at work.

HCB: What sorts of economic impact do you expect to see?

Van Sickle: The impact of asthma goes far beyond the economic costs, of course, because a day with asthma symptoms is pretty miserable for the patient. Since most asthma morbidity can be averted with appropriate treatment, there’s a sizable opportunity for better disease management to generate significant savings for the patient as well as for the provider and payer. In fact, annual health care costs for patients with uncontrolled asthma can be as much as $4,000 higher compared to someone with controlled disease. By tracking how often someone is using their inhaler, you can identify patients who are worsening and provide them with personalized guidance and education to help them do a better job of managing their asthma. In addition, you give providers the ability to see which of their patients need more help to bring their asthma under control. That’ll save the patients considerable agony, and it’ll save everyone concerned considerable expense.

HCB: So what happens now?

Van Sickle: We’re working hard to identify more health plans and hospital systems to partner with. More and more institutions recognize the importance of proactively managing chronic conditions, and are positioning themselves to take advantage of prevention-minded health care reforms. Chronic conditions are very expensive, and one thing we have working for us on this is that the economic benefits for the payers accrue relatively quickly. While the benefits of better diabetes management, for example, may take years to materialize, improvements in asthma control immediately lower the risk of acute care episodes.

We’ve shown that we can bring about a significant reduction in asthma morbidity and an overall improvement in asthma control in ways that we expect to translate directly into lower health care utilization in the near term. That economic impact is an important part of the case we’re making to potential partners. Many of the health plans who contact us about a program have recognized that they cannot continue to afford the high costs of uncontrolled asthma and COPD. As a result, we expect to add at least another 10 plans this year. So we’ve got our work cut out for us, but we know what we’re offering them will be good for their patients as well as their bottom line.

Read more about Van Sickle’s research and Asthmapolis.

Read a post Van Sickle wrote for the Human Capital Blog.

Tags: Disease Prevention and Health Promotion, Grant Awards, Health & Health Care Policy, Health & Society Scholars, Research & Analysis, Voices from the Field