I-Corps: A Home-based Solution for Remote Lung Function Monitoring for Patients with Chronic Lung Disease

该I-Corps项目的更广泛影响/商业潜力是开发用于远程肺功能监测的改进测量工具。慢性肺部疾病影响了10%的美国人口，近80%的农村居民生活在“医疗沙漠”中，整体医疗保健提供者数量有限，难以获得专科护理，居民和医院之间的地理距离很大，以及社会经济挑战，这些挑战为获得频繁护理提供了障碍。城市人口和美国退伍军人面临许多这些挑战。目前的远程肺部监测技术缺乏灵敏度、有效的报告选项和易用性。在肺部健康领域利用远程医疗的工具沿着更高灵敏度的肺部监测工具有可能解决这些挑战。所提出的技术可以提供基于家庭的气体冲洗技术的首次头对头比较，该技术在临床环境中上级标准护理家庭诊断，并为这些技术的未来发展提供依据。潜在影响很大，因为有大量的人可能受益于改善的家庭监测，医生对目前基于家庭的解决方案不满意，以及目前服务不足的患者数量，包括儿科人群，农村人群和服务不足的城市人群。这个I-Corps项目是基于远程肺部健康监测解决方案的开发。在当前的医疗保健模式中，大多数肺部诊断测量是在诊所或医院进行的。因此，它们通常不经常或对症状恶化作出反应。肺活量计和峰值流量计广泛用于家庭使用，但是使用高度依赖于患者努力并且可能高度可变的强制呼气操作。气体冲洗方法灵敏而准确地测量了肺部疾病恶化的关键因素-气道容积、气道均匀性和肺容积-这些因素被认为上级基于强制呼气的测量。到目前为止，气体冲洗测量仅在大型医疗中心可用，因为它们需要庞大的设备和外部供应的气体。为了解决这些缺点，所提出的技术将基于临床的气体冲洗的基本原理转化为基于家庭的系统，而不需要供应的气罐，并且其中测量数据可以报告回临床医生的办公室。目前，基于家庭的诊断是一个不足的补充，因为基于家庭的诊断包括敏感性差的方法，要求患者保持纸质记录，以及缺乏信息整合到医疗记录。这项技术可以克服这些限制，提供一个上级诊断测试，纵向记录数据，并将这些数据传输给临床医生进行审查。这个奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。

The broader impact/commercial potential of this I-Corps project is the development of an improved measurement tool for remote lung function monitoring. Chronic lung disease impacts 10% of the United States population and nearly 80% of rural residents live in a "healthcare desert," with a limited number of overall healthcare providers, poor access to specialty care, large geographic distances between residents and hospitals, and socioeconomic challenges that provide barriers to accessing frequent care. Urban populations and U.S. veterans share many of these challenges. Current remote lung monitoring technologies lack sensitivity, effective reporting options and ease of use. Tools that leverage telemedicine in the lung health space along with higher-sensitivity lung monitoring tools have the potential to address these challenges. The proposed technology may provide the first head-to-head comparison of home-based gas washout technology, which is superior in the clinical setting, to standard-of-care home diagnostics and provide the rationale for future development of these technologies. The potential impact is high, given the large number of individuals that may benefit from improved home monitoring, physician dissatisfaction with current home-based solutions, and the number of patients that are currently underserved, including pediatric populations, rural populations, and underserved urban populations. This I-Corps project is based on the development of a solution for remote lung health monitoring. In the current healthcare model, most lung diagnostic measurements are made in the clinic or hospital. As a result, they are often made infrequently or in reaction to worsening symptoms. Spirometers and peak flow meters are widely available for home use but use forced exhalation maneuvers that are highly dependent on a patient's effort and can be highly variable. Gas washout methods sensitively and accurately measure the key elements of worsening lung disease - airway volume, airway homogeneity, and lung volume - that are recognized as superior to measurements based on forced exhalations. Until now, gas washout measurements have only been available in large medical centers because they require bulky equipment and externally supplied gases. To address these shortcomings, the proposed technology translates the principles underlying clinic-based gas washout to a home-based system, without the need for supplied gas tanks, and where measurement data can be reported back to a clinician’s office. Currently, home-based diagnostics are an insufficient supplement because home-based diagnostics include poorly sensitive methods, the requirement that patients keep a paper record, and the lack of integration of the information into the medical record. This technology may overcome these limitations by offering a superior diagnostic test that records data longitudinally and transmits these data to a clinician for review.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.