Putting the ‘technology horse’ before the cart was our aim in developing the asthma ‘web app’ (AWA). It is, regrettably, so often the other way round. I work as a GP in an inner city area and was acutely aware of the needs of patients with asthma and the shortcomings in provision of asthma care. I also have an interest in I.T. so it wasn’t long before I wondered how we could use I.T. to address these clinical needs. Making use of Web 2.0 we developed an ‘app’ which tackles the major issues contributing to poor asthma control: inhaler technique, patient education and provision of a care plan.
The provision of a care plan in particular is one area which needs improvement. The AWA control plan is the key component in the application. Patients without a care plan are four times more likely to need an acute admission with poorly controlled asthma. Yet, only one third of asthmatics have a plan. The AWA makes it much easier for a GP or asthma nurse to provide a personalised plan for a patient during a consultation. Subsequently, patients have access to a web-based version of their care plan either through PC or mobile devices. But it goes one step further. The AWA care plan, unlike a paper-based version, adapts dependent on the patients asthma control, prompting an increase in treatment with poor control or allowing a ‘step-down’ with good control. In other words it promotes self-care.
The AWA also provides an alternative healthcare pathway to the traditional model where patient care takes place in GP surgeries or hospitals. The AWA allows the healthcare professional and patients to interact remotely. This is particularly valuable for the ‘difficult to engage’ patient. In asthma care this translates into teenagers. This is a group who are always resistant to invitations to asthma clinics but for who the use of a mobile phone or tablet is second nature.
I think the success of an ‘app’ depends on two simple principles based on need and data handling. First, there has to be a clear clinical need for an ‘app’. Secondly, collecting data is not in itself sufficient. Doing something useful with the data for the benefit of patients is the crucial step. I believe the AWA passes these tests. Whether it is innovative, I will leave you to decide.
Howard is happy to be contacted if anyone would like more information about the AWA.