Protecting, Engaging, and Monitoring Lung Transplant Patients
To prevent chronic rejection, lung transplant recipients are screened for lung function using pulmonary function testing (PFT) in a laboratory at regular intervals. When the pandemic hit last year, it put the health and safety of more than 500 lung transplant recipients at UCSF Health at risk. Pulmonary laboratories were forced to close as a result of the pandemic, and as patients were immunocompromised, their travel and exposure to risk had to be limited.
Anobel Odisho, MD, MPH, Clinical Product Manager at UCSF’s Center for Digital Health Innovation (CDHI) and Assistant Professor of Urology, discusses the development and implementation of the Digital Health Chatbot with Remote Home Spirometry Monitoring for Lung Transplant at the
2021 UCSF Health Improvement Poster Symposium.
In May 2020, the UCSF Lung Transplant Program enrolled patients and mailed them Bluetooth-enabled home spirometry kits. The kit included instructions to enroll in a personalized digital health chatbot developed in collaboration between CDHI and Conversa Health. Patients were able to use a personal spirometer at home and enter their results into the chat. An integration with Epic (Electronic Health Record) ensured that any results of concern were flagged and forwarded to the providers’ in-basket. Weekly patient summary reports were then sent to providers.
According to Dr. Odisho, 479 patients have enrolled, 73% have engaged with the chat, and two-thirds have submitted remote monitoring data at least once. Since its launch, the Lung Transplant program has replaced three in-person clinics and laboratory visits with home spirometry and video visits.
In his presentation, Dr. Odisho shares some lessons learned:
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Patients are able to engage in digital health solutions at high rates
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Men were about half as likely to engage in chat than women
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Those who were less likely to engage in chat included non-English speaking patients and those whose transplant was more than a year from enrollment into the chat
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Some in-person measurements are able to be replaced with home spirometry and video chats
Learn more about the remote home spirometry and chatbot, and what the team* is working on next:
*Home Spirometry Kit Balanced Product Team: Anobel Y. Odisho, MD, MPH, Steven Hays, MD, Olivia Bigazzi, Eli Medina, Jerry Young, Ali Maiorano, Sondra Renly, Andrew Liu, Chris Sorric, Chris Miller, Ed Wise, Aaron B. Neinstein, MD