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测量工具，用于远程肺功能监测。慢性肺病影响了美国10%的人口，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，获得专科护理的机会很少，居民和医院之间的地理距离很远，社会经济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着许多这样的挑战。目前的远程肺部监测技术缺乏敏感性、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以及灵敏度更高的肺部监测工具有可能应对这些挑战。拟议的技术可能会首次对在临床环境中优于标准护理家庭诊断的基于家庭的气体冲洗技术进行面对面的比较，并为这些技术的未来发展提供理论基础。考虑到可能受益于改善家庭监测的大量个人、医生对当前以家庭为基础的解决方案的不满以及目前未得到充分服务的患者数量，包括儿科人口、农村人口和未得到充分服务的城市人口，潜在影响是很大的。这个i-Corps项目是基于远程肺部健康监测解决方案的开发。在目前的医疗模式中，大多数肺部诊断测量是在诊所或医院进行的。因此，这些症状通常很少见，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，但使用强制呼气动作，这高度依赖于患者的努力，并且可能高度可变。气体冲洗法灵敏而准确地测量加重肺部疾病的关键因素--气道容量、气道均匀度和肺容量--这些被公认为优于基于用力呼气的测量。到目前为止，气体洗出测量只在大型医疗中心才能使用，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，拟议的技术将基于临床的气体清洗的基本原理转换为基于家庭的系统，不需要提供气罐，并且可以将测量数据报告给临床医生的办公室。目前，基于家庭的诊断是不够的补充，因为基于家庭的诊断包括敏感度低的方法，要求患者保留纸质记录，以及缺乏将信息整合到医疗记录中。这项技术可以通过提供一种卓越的诊断测试来克服这些限制，该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。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势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.