Sometimes our work life and home life collide…or at least it would be good if they did…

The Center for Information Therapy (IxCenter) has just submitted a grant proposal to NIH — part of the stimulus bill funding for comparative effectiveness research included requests for “information prescriptions” evaluations — in collaboration with Ix evangelist Kate Burke (an emergency physician) and some very progressive physical therapy (PT) practices in Massachusetts. The basic premise — and any athlete that has done PT to rehabilitate an orthopedic injury knows — is that physical therapists do great work, but ongoing improvement in orthopedic function often comes from the home exercise that the patient does on his/her own. And, equally importantly, it can be really hard to recreate those exercises at home based on oral instructions received or even text or a single picture.

The main Ix intervention in the proposal involves using Flip Video information prescriptions. The physical therapist uses the simple Flip camera to record that patient doing the PT exercise in the clinic and emails the video to the patient that day. I have grown fond of saying about this project: If a picture is worth a thousand words, a video is worth 10,000.

So that brings me home…  We’ve been monitoring my 5-year-old son, Ryan’s, asthma. Last spring (exactly this week), the spring pollen season triggered a reasonably severe asthmatic reaction (see Ix Gets Personal (Again)). He has since had one other bad asthmatic event, and a few consultations and allergy testing with a pediatric allergist. We developed a game plan for trying to prevent another April flare-up.

In many ways, we think our pediatric practice is great, but there are some things that it does not do well. For example, there’s no written (not to mention electronic) asthma action plan, so my wife and I sometimes have slightly different expectations of next steps.

In this case, most importantly, neither of us is a skilled practitioner in the use of an asthma inhaler. As a four-year-old, Ryan used a nebulizer (a clunky device, but one which is fairly straightforward to use), but the allergist trained us once (more than two months ago) in use of the asthma inhaler with spacer. We have no information beyond the package insert. I honestly don’t have a good recollection of the exact steps involved and — when I asked my wife how she did it last week when I was out of town — she confessed to not being too sure herself. And, little Ryan — despite his many talents — isn’t quite ready to teach his parents what to do.

Ryan’s breathing was strained this evening, and we eventually returned to the nebulizer to deliver his albuterol (rescue medication), but it’s not a very good solution. All I could think about was how perfect it would be if my pediatric allergist (or the medical assistant in his office) could have videotaped when he walked us through it step by step a couple of months ago. If he had then sent us this video information prescription via email, I’d be empowered to help my son manage his asthma effectively and efficiently.

It seems so easy, yet so far away…

This entry was posted on Wednesday, April 29th, 2009 at 9:55 pm and is filed under Ix Strategies, Patient Stories, Video Ix. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.