Fingers do the walking, but patients, doctors do the talking

The next time the alarm on Leo Zarco’s cell phone rings, it could be a reminder to treat his asthma.

Zarco is part of a highly successful medical trial to help some San Mateo Medical Center patients with severe asthma manage their symptoms through daily tracking using their mobile phones to text-message and call physicians.

Those participating in the study have stayed entirely out of the hospital for six months, a major accomplishment in asthma treatment.

At about 2 p.m. every day, Zarco’s phone alarm sounds and he logs on to answer a series of 20 questions.

Did he remember to take his asthma medicine? Has he experienced shortness of breath?

Patient answers are scored, falling into one of three categories: green for “no problem,” yellow for “elevated concern” and red for “needs immediate attention,” said Dr. Jonathan Mesinger, who oversees the trials at two county clinics in Redwood City.

“If they enter information that is in the ‘danger zone’ it warns them and gives them directions on what they should do,” Mesinger said.

In addition, the patient’s clinical case manager receives the data and can call or text-message the patient.

The survey takes about one minute to answer, Zarco said.

“It’s like having your own personal doctor on that cell phone,” he said.

Logging on not only lets the patient monitor his symptoms more closely, but also allows him to review his health over the past several weeks for comparison.

The cellular software, which operates on a standard mobile phone distributed to patients by the hospital, is also being touted as a way for the taxpayer-funded medical center to save thousands of dollars per patient, by reducing emergency room visits and boosting the number of patients a physician can treat.

With the county subsidizing the medical center to the tune of $65 million this year alone, savings was a high priority, hospital spokesman Dave Hook said.

A typical emergency room visit costs about $700 at the medical center, and patients with severe asthma often have to visit the emergency room two to five times a year.

What is more, the savings is expected to climb as the technology becomes more popular and is used to treat other chronic illness, such as high blood pressure and diabetes, officials said.

So far, Zarco, an 18-year-old resident of Redwood City, is one of about 30 mostly Latino and African-American youths who are participating in the trial, which the project’s

developer hopes to expand to as many as 300.

By regularly entering their symptoms — which are automatically sent to their physician and a database — patients in the first six months of the pilot have significantly reduced their number of trips to the doctor, as well as eliminated emergency room and overnight hospital visits, said Dr. Peter Boland, of BeWell Mobile, the San Francisco-based company that developed the software.

While numbers for the trial are still being crunched, physicians expect to see about 25 hospitalizations a year on average for every 10,000 children with asthma, Mesinger said. That hasn’t happened with the kids in the trial, he said.

Because of the constant monitoring, between 70 percent and 80 percent of patients in the test have adhered to their medical regiments, as compared to 30 percent to 40 percent typically — a “spectacular” success so far, Boland said.

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