Indiana University and patientMpower launch new project to improve care access for rural ILD patients

Indiana University (IU) and patientMpower are set to launch a new project monitoring rural Interstitial Lung Disease (ILD) patients remotely. The two-phase project, headed by IU’s Dr Ryan Boente, will see the patientMpower remote patient monitoring (RPM) platform be used to track changes in patient lung function and patient reported outcomes, key indicators of ILD progression.

Phase One of the project, which is due to begin in early December 2022, will assess feasibility of RPM in a small cohort of rural ILD patients at IU. Pending the success of Phase one, the project’s second phase will expand the patient cohort and also aim to assess additional metrics related to disease progression and health economics.

Discussing the project, Dr Ryan Boente, Assistant Professor of Clinical Medicine in the Division of Pulmonary, Critical Care, Sleep & Occupational Medicine at IU and Clinical co-director of the IU Interstitial Lung Disease Program, stated:

“My primary interest in RPM is to better serve rural patients in Indiana who have barriers to care such as distance to our center.  We are the only center in the state that is part of the Pulmonary Fibrosis Foundation Care Center Network, and often get referrals for patients that live well over 50 miles from Indianapolis. I see RPM as a way to expand access and overcome barriers to routine care such as distance, transportation with oxygen, and other logistical concerns that individuals living with pulmonary fibrosis face in seeking care"

Standard of Care for ILD

Interstitial lung diseases (ILDs) are a group of chronic lung diseases characterized by inflammation or scarring of the lung tissue. ILDs are often progressive diseases, with exacerbations resulting in the loss of lung function - which may not be regained. Without rapid intervention, an acute exacerbation of ILD may result in hospitalization, coming at a high cost for patients and healthcare systems. The typical model for identifying acute exacerbations and disease progression are through the use of in-clinic pulmonary function tests (PFTs) which, among other parameters, measure forced vital capacity (FVC) of the lungs. While effective, the low frequency of in-clinic PFTs (typically 2-3 per year) may be insufficient to enable identification of acute exacerbation or progression in a timely enough manner for intervention and/or treatment.

Addressing Geographical Disparity in Access to Healthcare  

This concern is amplified for those patients in rural settings. Due to their distance from the clinic, they are even less likely to access frequent PFTs. For those rural patients who are able to attend scheduled clinic visits, they may suffer the burdens of increased travel, including higher costs. Reduced access to care can lead to worse health outcomes for rural patients. For example, a multi-centre analysis of patient access to ILD centres in Canada found that whilst patients with fibrotic ILD who had a longer travel distance to their ILD clinic had better prognostic indices at baseline they had significantly worse outcomes, with a higher risk of death or lung transplant.

Expected Outcomes

IU’s project hypothesizes that remote patient monitoring, including the use of home spirometry may be an acceptable replacement for many in-clinic visits. It is hoped that this will improve care access for rural patients. Additionally, the increased availability of patient data may enable earlier identification of acute exacerbations and disease progression than through the standard care pathways alone.