REVIEW

HealthEngage Asthma
by Pocket Press Editor and Dale Shank
Developer: FireLogic, Inc.
Desktop (Windows or Mac OSX) and either Palm or Pocket PC: $49.99 (demo available)
Price: Desktop plus PDA $49.99

Susan's Experience

Two weeks ago, a little cold became bronchitis; the bronchitis got worse; my asthma kicked in; and I was one sick puppy before I visited urgent care to discover that my peak flow was about a third of what it should be. Peak flow is a measurement of how well your lungs are working. To obtain the number, you exhale forcefully into a small plastic meter. People with asthma, emphysema, and other chronic pulmonary disorders often use this device to monitor their conditions. A daily record helps the patient and the patient's doctor make decisions about medications and other forms of treatment. Vague recollections, however, are not particularly helpful when you meet with a busy doctor, and a sheaf of scrawled notes isn't much better.

What the doctor can use is a clear printed record showing daily peak flow variations. A graph, for example, is easy to comprehend at a glance. That's what the asthma monitoring software from HealthEngage provides, along with a quick, easy way to enter the data on the Web, on a desktop computer, or best of all, on a Palm or Pocket PC. Whether you're monitoring diet, exercise, blood sugar, peak flow or any other measure of health, what can be handier than keeping records on the device that is with you all the time?

Computer monitoring of asthma can also be helpful in getting children to become more involved in managing their disease. Asthma is a serious problem for children, causing more days of absence from school than any other condition. Just as children with diabetes are often resistant to monitoring and managing their disease, children with asthma dislike looking and acting different from their peers when they use a peak flow meter and an inhaler. Entering data on a PDA or computer and graphing the information will encourage at least some children to take more responsibility for their health.

I tried the HealthEngage Asthma software for Palm Powered devices. Installation is straight forward, although the program requires several helper files, which are included in the download. I don't really like that because if you decide to delete the main program, chances are you'll not remember the names of the helper files. Years later you'll still have them on your Palm and will be wondering what in the world they are for and whether you dare delete them.

After installing the software, you set it up by providing information about yourself, including a list of medications and the schedule on which they are taken. You are also asked for the date on which the various medications were prescribed. If you don't enter a day, today's date will be used. But if you do enter a date, it must be in the 00/00/0000 format or the medication will not appear on your list. That information is in the read-me file, but no on-screen hints are given. If your doctor has given you the appropriate peak flow numbers, you can enter them. If not, the program will compute them based on your body size.

After entering this information, which doesn't take long, you can begin entering data daily or more or less often. Each time you use the peak flow meter, you enter the number along with the medications you took, the triggers you were exposed to, your level of wheezing and coughing, the quality of your sleep, and the level of exercise that you engaged in. You can also record doctor or emergency room visits, and you can add notes.

Graphing the peak flow data shows the trend and also visually indicates whether the level is acceptable or whether you should seek medical assistance.

I suppose you could hand your PDA over and let your doctor look at the graph, but a paper record is probably more useful, and it can be kept in your chart. To create that paper record requires synching to the desktop application for Windows or for Mac OSX. At the time I was testing the software, I was not using OSX, so I will leave it to Dale to report on the Windows desktop application and the reports that can be generated from it.

Dale's Experience

While Susan has just described a situation where she had a sudden asthma attack, my situation is different. I have persistent asthma and emphysema, so a tool like Engage is perfect for tracking my medications, triggers, and peak flow meter readings and for making any notes about special events or concerns related to managing my condition. Just this past Thursday, I had an appointment with my pulmonologist (lung doctor). I took him samples of the reports out of HealthEngage Asthma, and he was impressed. In fact, he said, "If I could get all of my patients to use such a set of tools, I would be the miracle man." My doctor is a man who firmly believes that health care is a partnership between the patient and the care giver. Having suffered with asthma for ten years now, I have become very aware of how much better I do when I follow a very strict regimen, and my doctor attributes my ability to live "a normal life" to how diligent I am about managing my illness. A tool like HealthEngage Asthma can give you that same advantage.

Not only was I able to show him a graph of all of my peak flow meter readings but also a confirmation that I was taking all of my medications exactly as prescribed. By recording how I slept, along with coughing, wheezing and other symptoms twice each day, I could give him a much clearer picture of how I am progressing. He gladly took all of the papers and put them in my chart after making copies for the front desk to give out to other patients as examples.

Here is a sample of the report that I gave him, printed directly from HealthEngage Asthma:

RECORD NUMBER: 2

Day of the Week Date Time PEF % of Best

Saturday Apr 27, 2003 0:50 PM 390 62%

Symptoms:

Wheezing: End Exhale

Coughing: Occasional

Exposure to Triggers: None

Respiratory Infection: None

Sleep: Slight wheeze or cough

Activity Levels: Fully Active

Medications:

Changes in Medications: No

Listed Current Medications: Albuterol:1 other unit(s), 2 times per day

Prednisone:1 tablet(s), 1 times per day

Theophyline:2 tablet(s), 2 times per day

The best result from the use of a tool like this is the discipline it helps you to maintain. If you are like most people, you are on the computer at least once a day, more likely twice, once in the morning, once in the evening. Simply fire up the HealthEngage Asthma program or Web page and spend at most five minutes recording your progress and actions for the day.

If you are an asthmatic, take a few minutes to check out the HealthEngage Web site, at http://www.healthengage.com and sign up for the free five-day trial of their Web-based program. I actually tested the Web tool, the desktop version, and the Pocket PC application as well. All three of them synchronize with each other so your records are always up to date.

While you might start with the Web version, there are also desktop, Palm, PocketPC, and mobile phone versions available, giving you maximum flexibility. Use any or all of the versions to manage your asthma. Simply connect to the Internet for ten seconds to synchronize your profile from your desktop application, and you can then access your full information from anywhere at anytime. For example, you could use the Web version at work in the morning, the desktop version in the evening, and the Palm-held version on the weekend or when you are on vacation and away from the computer.

Like Susan, I found the installation to the Palm top unit a bit challenging, but I have discussed that with them and they assure me they are working on an installer program. That will move the application from your desktop to the Pocket PC and set up all of the needed files automatically.

HealthEngage Asthma is a worthwhile tool that allows asthma sufferers to collect, store, and chart peak flow, medications, symptoms, and other health information. It can be used by asthmatics to better manage their condition while giving their health care provider better insight into their progress. Check it out; give it a try; give yourself the best chance to enjoy as active and healthy a lifestyle as your doctor, condition and medication regimes will allow.