"There's an app for that." When Apple trademarked that phrase in 2010, Dr. Sunit Jariwala was just about to begin his fellowship at Montefiore where he would soon take health education to the next level by leveraging technology to put information in patients' hands -- literally.
In 2013, he and his colleagues built two smartphone apps: ASTHMAXcel for adults and ASTHMAXcel Adventures for pediatric patients, which educates patients on the proper use of inhalers and other medications, how to recognize asthma triggers, and action steps to prevent asthma attacks. Both combine asthma education with games that test a user's asthma knowledge and encourage healthier behaviors. After two months using the app, there was a dramatic increase in asthma control and decrease in emergency room visits and hospitalizations by six months. Fewer patients needed to take steroids to control asthma symptoms.
For a lung disease that disproportionately affects Bronx residents, who have one of the highest asthma prevalence and mortality rates in New York City, the app could be a gamechanger.
"We needed to address the asthma epidemic in a sustainable way that would empower our patients to be self-reliant when it comes to their health," says Jariwala who is an associate professor of medicine (allergy & immunology) at Einstein, director of clinical & research innovation, and medical director of digital transformation at Montefiore.
It all started with a PowerPoint presentation. During his fellowship in 2011, Jariwala, along with Drs. David Rosenstreich, Sumita Sinha, and Simon Spivak, established the Montefiore Asthma Center, which offers resources for patients to better understand, manage, and control their asthma symptoms. Patients liked the PowerPoint presentations so much that they wanted to download them.
That was the impetus for the creation of the asthma app, based on the National Asthma Education and Prevention Program guidelines, and with input from patients, clinicians and experts in psychology and pediatrics. And of course, grant funding, which initially came from the American Lung Association, American Academy of Allergy, Asthma & Immunology, the federal government, and other public and private sources.
The success of the asthma app model spurred Jariwala to create a program to train the next generation of physician innovators who could invent new technological modalities that would benefit patients with other medical needs and conditions.
One of only six such programs in the country, the Einstein Montefiore Innovation Biodesign Training Program is a one-year experience for residents and fellows to build, validate, implement, and evaluate innovative health technologies (devices, digital tools) that improve outcomes (clinical, process) for patients, providers, and the Einstein and Montefiore health system.
Since its inception in 2020, there have been 18 participants from a wide range of specialties, including anesthesiology, critical care medicine, dentistry, emergency medicine, endocrinology, hospital medicine, obstetrics and gynecology, pulmonary medicine, and neurosurgery.
Creation of 12 Patient-Facing Mobile Health Apps to Improve Clinical Care, including:
TOTAL USERS: 4,000 (approx.)
25 Seminars with 57 Seminar Presenters
9 Health Technology Podcasts
16 Grants ($2.4M)
- American Academy of Allergy, Asthma & Immunology
- American Lung Association
- American Medical Association
- Chest Foundation
- Sonde Health
- Stony Wold-Herbert Foundation
Plus, federal funding and Einstein Montefiore Department of Medicine.
10 peer reviewed publications
This is a brief snapshot and there is a lot more to come.
For Jariwala, who has always been fascinated by the intersection of clinical care, research, and health technology, the program has been a dream come true. With a background that also includes clinical informatics and soon, business (in his spare time he is getting his MBA focusing on entrepreneurship), the future for the Innovation Biodesign Program remains bright.
"I am excited and awed by the ideas our team comes up with," says Jariwala. "I look forward to seeing what comes next." So do we.
Posted on: Tuesday, September 13, 2022