Yuying Zhang, Lead Developer of BreathEasy Android Application and Brian Olive, Lead Developer of BreathEasy Web Dashboard, RTI International
The BreathEasy Android application is designed to be an easy-to-use tool that allows study participants to enter observations of daily living (ODLs) such as peak flow readings, asthma triggers, stress and activity levels, sleep patterns, symptoms and medication use. Data are collected through a few self-guided questions in a way that is similar to traditional survey data collection. With built-in data validation and smart logic design, most users will require fewer than five minutes each day to record their ODL entries. The main menu of the BreathEasy app offers three options: “enter daily data,” “enter rescue data” and “review partial data.” “Enter rescue data” allows participants to quickly enter rescue medication usage information for that day. Patients can review their partial ODL entries and make edits to them before the data are automatically sent to our RTI central server for analysis and storage.
In order to track our patients’ ODL reporting over a several-month period, a reminder system is a must. We developed a notification mechanism in the app that reminds the patient to enter their data at a predetermined time (set by each patient) every day. The app also automatically sends real time ODL data to the RTI central server. The monitoring system on the back-end server gathers all data and analyzes them. If a patient fails to enter her ODL data for more than 36 hours, then a text message, which reminds her to record her ODLs, is instantly sent to her phone. If the patient still doesn’t respond once the message is sent, a different set of text message reminders is then triggered.
Based on the results of our focus group study, we designed the web dashboard to give clinicians a quick overview of their patient’s status between office visits so that they can provide feedback to the patient if needed. The web dashboard provides graphs of peak flow measures for each individual patient for a given time period; symptoms, activity levels, mood and anxiety levels as well as other ODLs are plotted on the same graph for a comprehensive view of the patient’s overall health status. Clinicians can select areas where they want to see more detailed information on the patient’s graphical display. The web dashboard allows easy navigation from one patient to the next. It is very secure and uses industry standard 256-bit encryption and user authentication.
The BreathEasy Android app is developed on an open source system called Open Data Kit (ODK), which is a native Android application targeted for Android OS 2.1 or higher. The BreathEasy website is an ASP.Net and SQL server-based application. These two very distinct systems communicate via standard http protocols over the Internet. We’re finishing up development in anticipation of laboratory-based user testing, which will begin soon.