Internet-based home asthma telemonitoring: can patients handle the technology?
OBJECTIVE
To evaluate the validity of spirometry self-testing during home telemonitoring and to assess the acceptance of an Internet-based home asthma telemonitoring system by asthma patients.


METHODS
We studied an Internet-based telemonitoring system that collected spirometry data and symptom reports from asthma patients' homes for review by physicians in the medical center's clinical information system. After a 40-min training session, patients completed an electronic diary and performed spirometry testing twice daily on their own from their homes for 3 weeks. A medical professional visited each patient by the end of the third week of monitoring, 10 to 40 min after the patient had performed self-testing, and asked the patient to perform the spirometry test again under his supervision. We evaluated the validity of self-testing and surveyed the patients attitude toward the technology using a standardized questionnaire.


METHODS
Telemonitoring was conducted in patients' homes in a low-income inner city area.


METHODS
Thirty-one consecutive asthma patients without regard to computer experience.


RESULTS
Thirty-one asthma patients completed 3 weeks of monitoring. A paired t test showed no difference between unsupervised and supervised home spirometry self-testing. The variability of FVC (4.1%), FEV(1) (3. 7%), peak expiratory flow (7.9%), and other spirometric indexes in our study was similar to the within-subject variability reported by other researchers. Despite the fact that the majority of the patients (71%) had no computer experience, they indicated that the self-testing was "not complicated at all" or only "slightly complicated." The majority of patients (87.1%) were strongly interested in using home asthma telemonitoring in the future.


CONCLUSIONS
Spirometry self-testing by asthma patients during telemonitoring is valid and comparable to those tests collected under the supervision of a trained medical professional. Internet-based home asthma telemonitoring can be successfully implemented in a group of patients with no computer background.
Finkelstein
J
J
Department of Medical Informatics, Columbia University, New York, NY, USA. finkelj@bu.edu
Cabrera
M R
MR
Hripcsak
G
G
D000328:Adult; D000368:Aged; D001249:Asthma / Q000503:physiopathology*; D003362:Cost-Benefit Analysis; D005260:Female; D006699:Home Care Services; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010366:Peak Expiratory Flow Rate; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013147:Spirometry / Q000379:methods*; D011795:Surveys and Questionnaires; D013686:Telemetry / Q000191:economics / Q000379:methods*; D014505:Urban Population