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Big Data and Healthcare Collide in Louisville, Ky.

Louisville outfits inhalers with sensors to track asthma occurrence.

The city of Louisville, Ky., has taken a bold step in an effort to change the role that data plays in creating quality of place.

For decades, Louisville has seen growth in respiratory disorders, such as asthma and chronic obstructive pulmonary disease, and associated visits to emergency rooms. Public health officials have had limited tools to understand this issue and have had to rely heavily on a survey of households, conducted by the federal government every few years.

Louisville decided to challenge that framework by adopting new sensor technology that combines a GPS transponder with a Bluetooth-enabled asthma inhaler. The device, made by Asthmapolis, syncs with patients’ smartphones and makes it possible for patients, their doctors — and, with patient permission, the city — to know when and where episodes of inhaler use occur. This not only represents an innovation in the realm of public health data but also, perhaps more importantly, dramatically improves the quantity and the accuracy of patient diaries, which are the current standard of care.

Collaborating for the Common Good

In a public-private partnership led by the mayor’s office, 500 sensors were offered to Louisville residents free of charge. A public-private partnership is one of the only ways to make this work well, because no stakeholder group has the ability to manage and understand the scope of the data without collaborating with others.

The scope is large: Citizen’s using the inhalers need to know how they're doing individually, but they also serve as a gauge for the Louisville community. Physicians can provide better care when they know how well each patient’s asthma is controlled. Louiville’s public health director knows that access to care and exposure to environmental irritants vary by census tract. The director of the Air Pollution Control District knows that ozone-exceedance events happen, and that notification of those events would be of interest to citizens affected by respiratory disorders. Finally, the mayor and his innovation office should explore where planning and policy changes can reduce suffering and make Louisville a model, data-driven city for the country.

In the Hands of the Patients

Walgreens stores and several specialty medical practices have distributed the sensors since June 2012. This initiative includes big data and near-real-time data that puts health events on space and time coordinates. With more than half of the sensor units in the hands of patients, hot spots in the community are emerging that, for now, inspire the project steering committee to search for other data sets that may correlate and guide deeper discovery of linkages.

The health project has opened the door to connecting asthma events with weather, air pollution, pollen, school attendance and a host of other big data sets.

The health project has opened the door to connecting asthma events with weather, air pollution, pollen, school attendance and a host of other big data sets. Each of those data sets is an independent silo until a catalytic project like this finally joins them together. Each data set would also benefit from more sampling in shorter cycles across the entire geography.

Early results are very promising, with immediate dividends for patients who can see in near real time how well they are controlling their health. What’s more, care providers are now proactively helping the patients think through possible environmental triggers, based on where they live and where hot spots are located.

The first mash-ups of air pollution and asthma events will be shared in June at the national Health Datapalooza conference in Washington, D.C.

Apr 17 2013

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