Chronic rejection remains the main obstacle to long-term survival for people who have had a lung transplant. Patients often express anxiety about the ever-present risk of this complication. But screening for chronic rejection requires frequent spirometry testing, which has typically been done in hospital-based pulmonary function laboratories – many of which are off limits during the COVID-19 pandemic.
The Lung Transplant team at UCSF Health sought a method to safely track patients from their homes no matter where they lived, to eliminate the need to travel and to assure their safety. A home spirometry kit was created for this purpose, driven by a collaboration between lung transplant clinicians and the Center for Digital Health Innovation at UCSF.
The home spirometry kit saves data digitally for use during periodic telehealth visits with the transplant physician. Though home spirometry has been available for years, this new technology transmits data collected on a home spirometry device to an individual’s mobile phone or tablet. Then, it provides a chat box or text-based messaging system so the patient can transmit the data to his or her physician.
This platform allows the Lung Transplant team to remotely track patients with the goal of identifying both symptomatic and, even more importantly, asymptomatic changes in lung function that may be the first sign of early chronic rejection.
Education and outreach efforts have resulted in a 65 percent adoption rate by lung transplant patients receiving follow up care at UCSF Health. Patients like it so much it will likely continue as the method of choice for long-term management, even after the pandemic is over.
The Lung Transplant team hopes to build on this platform to provide a comprehensive health monitoring program that would allow patients to track other metrics that are important for good transplant outcomes. This could include medication adherence, lab monitoring, exercise and nutrition.
For more information, contact the Lung Transplant Program at (415) 353-4145.
