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

I-Corps项目更广泛的影响/商业潜力是开发一种改进的远程肺功能监测测量工具。慢性肺病影响了10%的美国人口，近80%的农村居民生活在“医疗沙漠”中，总体医疗服务提供者数量有限，专科护理机会较少，居民和医院之间的地理距离较远，以及社会经济挑战为获得频繁护理提供了障碍。城市居民和美国退伍军人都面临着许多这样的挑战。目前的远程肺监测技术缺乏灵敏度、有效的报告选择和易用性。在肺部健康领域利用远程医疗的工具以及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家庭气体冲洗技术的首次正面比较，该技术在临床环境中优于标准护理家庭诊断，并为这些技术的未来发展提供基础。潜在的影响是很高的，因为大量个人可能从改进的家庭监测中受益，医生对目前以家庭为基础的解决方案不满意，以及目前服务不足的患者数量，包括儿科人口、农村人口和服务不足的城市人口。I-Corps项目的基础是开发远程肺部健康监测解决方案。在目前的医疗模式中，大多数肺部诊断测量都是在诊所或医院进行的。因此，它们通常很少发生，或者是对症状恶化的反应。肺活量计和峰值流量计广泛用于家庭使用，但使用的强制呼气操作高度依赖于患者的努力，并且可以高度可变。气体冲洗法灵敏而准确地测量肺部疾病恶化的关键因素——气道体积、气道均匀性和肺体积——被认为优于基于强迫呼气的测量。到目前为止，气体冲洗测量只能在大型医疗中心进行，因为它们需要笨重的设备和外部供应的气体。为了解决这些缺点，该技术将基于临床的气体冲洗原理转化为基于家庭的系统，不需要供应气罐，并且可以将测量数据报告给临床医生办公室。目前，家庭诊断是一种不足的补充，因为家庭诊断包括灵敏度较低的方法，要求患者保留纸质记录，以及缺乏将信息整合到病历中。这项技术可以通过提供一种纵向记录数据并将这些数据传输给临床医生进行审查的优越诊断测试来克服这些限制。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

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.