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ASTHMATUNER

AsthmaTuner Triggered by Multiple Factors

General

Introduction
Welcome as a user of AsthmaTuner! Read this user manual carefully for important information and the best possible experience of AsthmaTuner.

Intended Use
The intended use of AsthmaTuner is to improve asthma control. This is mainly done by providing information and treatment recommendations which is generated based on a patient’s lung function, symptoms and physician prescribed treatment plan. Furthermore, AsthmaTuner facilitates management of respiratory diseases by processing lung function and user reported data and by providing information. The actual diagnosis shall be done by a healthcare professional so home use is only for indicative purpose.

Intended Users
Mainly indicated for asthma, Chronic obstructive pulmonary disease (COPD), Interstitial pulmonary fibrosis (IPF) and cystic fibrosis.
For use by trained users, healthcare providers and researchers. AsthmaTuner is intended for use from the age of 6 onwards. All use by children and adolescents under the age of 18 must be under the supervision of their guardians. This means that children and adolescents must receive support, advice and information from guardians when needed while using AsthmaTuner.
Entering a treatment plan in AsthmaTuner must be done by qualified healthcare personnel. AsthmaTuner is currently available in Swedish, English, Danish and Norwegian and should be used by people who are fluent in these languages.

AsthmaTuner Components

  1. Wireless spirometer
  2. Smartphone app for iOS and Android
  3. Careportal – web interface for caregiversAsthmaTuner Triggered by Multiple Factors-1

NOTE! The iOS and Android apps are very similar but may differ. Pictures in the manual illustrate the iOS app.

System requirements
To use the AsthmaTuner app, a smartphone with following requirements is needed:

  • Bluetooth 4.0 or above
  • iOS 10 or above
  • Android 6 or above.
  • In Sweden and Norway you need Mobile BankID or a relative with Mobile BankID to create an account

The AsthmaTuner Careportal is a web application than can be reached through a web browser on a computer. The approved browsers to reach the application include:

  • Safari
  • Internet Explorer IE11+
  • Edge
  • Firefox
  • Google Chrome

The recommendation is to always use the latest version of the browser since functionality on older browsers might be affected. Unless stated otherwise the two latest major versions of the above listed browsers are supported.

Important information for healthcare professionals when using AsthmaTuner
Make sure to educate all users on how to use AsthmaTuner and make sure the patient knows how to measure their lung function.

  • Warning! Make sure that medicines included in the patient’s treatment plan in AsthmaTuner are in accordance with drugs prescribed in the medical record system used at the clinic.
  • Warning! Make sure the patient is not using medicines that should not be taken with certain asthma drugs, such as beta blockers.
  • Note! AsthmaTuner is not a surveillance / monitoring system. You must inform the patient that he/she is responsible for seeking healthcare when needed.

Contraindications and complications of spirometry examination
Lung function tests should not be performed if the patient has recently undergone surgery or myocardial infarction and aortic aneurysm. The assessment should be made individually by the responsible physician. Otherwise, complications are rare in spirometry examination. Very rare are dizziness and various types of chest pain. In case of acute dizziness, terminate the examination and rest before a new examination is done.

Introduction to Careportal

The purpose of Careportal is to support the evaluation of patients’ asthma and support them in treatment and self-care, both for physical and digital health care visits.
To get started, the clinic you are working on must be connected to AsthmaTuner. Contact [email protected] to connect to AsthmaTuner. The clinic appoints local AsthmaTuner administrators. These administrators are set up as admin users by the company MediTuner, which provides the service, and can then set up which of the clinic’s healthcare personnel can log in and use the system.

Login and logout
To log in, visit the careportal.asthmatuner.com page. You can identify yourself with either SITHS card or Bank ID. If you use AsthmaTuner at multiple clinics, choose which one you want to log into. Log out by clicking on the symbol with an arrow out through a door.
For countries without BankID, healthcare providers are invited to create an account by an administrator at the clinic. After the account has been created, the healthcare provider logs in with Personal ID, password and SMS code.

Overview of Careportal

The appearance and functionality of the Careportal interface differs depending on whether the user is registered as an “administrator” or not. The task of the admin staff includes managing access for those who have access to the interface for each clinic. The Careportal admin menu includes:

  1. Treatment Templates
  2. Caregivers
  3. Your Clinic
  4. Log

If you want to change the language, click on the globe icon and the existing language in the bottom right corner.

Help Page
If you need help with anything and want to get in touch with customer support, you can always contact us by pressing the question mark button on the bottom right corner (available in all views) and filling in the form. We will get back to you as soon as we can.
You may also look for answers under the top menu section called “Help”. Here, you can read about frequently asked questions (FAQ) as well as reach us using the form on the right side.

Patient list
After logging in, you land directly in the “Patient list”. Here, you quickly get an overview of which patients are connected to your clinic and key information about the patient

Add patient 
Click on “Add patient”, a box will open where you fill in the patient’s social security number. After clicking add, a request is sent to the patient that they must approve in the AsthmaTuner app before you can see the data.
For some markets, this feature is also used to make an invitation to the patient to create an account. Then fill in the social security number and telephone number of the patient and any relatives. They will then receive an SMS with code and a link to create an account and an invitation to the clinic.

Configure Patient App Experience
Once you have added a patient, you can configure the types of tests (tools) you would like them to complete in their app. There are three main parts of the configuration step, Careportal will recommend certain tools depending on whether or not the patient has an asthma diagnosis. However, you can tailor these tools to best fit your patient’s needs:

  1. Does the patient have a diagnosis yet? – Choose ‘yes’ or ‘no’
  2. Select patient’s primary asthma tool
  3. Configure spirometry tool

When you are satisfied with the configuration, press the ‘Send to Patient’ button and your patient will receive your instructions and the app will be configured according to your specifications.
NOTE! When ordering a patient to perform a reversibility test, it is important that you inform them about which medication they should take for the test and how to take it correctly. The AsthmaTuner app will not provide any specific information about inhalers for reversibility tests, only that they should take what their caregiver recommends.

Remove patient
If a patient should no longer use AsthmaTuner, you can remove the patient from the clinic. Click ‘Edit List’ and select the patient using the checkbox box and then press delete. You will no longer be able to see the patient’s information, so it is important that you record the information before.

Sort, Search and Filter
It is possible to sort the patient list by clicking on the different headings in the table.
You can search for a specific patient by entering the patient’s name or social security number in the search field and clicking search.
You can also filter the list, so that only the patients relevant to the filter you selected are visible. You can, for example, filter b to only show your own patients. Otherwise, ‘All patients in this clinic’ is the default setting. .

Show patient-specific information
To get more information about a patient, click anywhere on the line in the table. For each patient, information is divided into four sub-tabs; “Patient information”, “Treatment and Trend Graph”, “Evaluation Graph” and “Spirometry”.

Patient information
“Patient information” contains contact information and specific information about the patient. On the left side of the view, you can see the latest (and current) instructions that have been sent to the patient as well as edit and send new instructions.
The rest of the patient information view includes a dropdown for assigning a specific healthcare professional to the patient, for example to facilitate follow-up and sorting. The information fields to the right are filled in by the patient themselves in the AsthmaTuner app and cannot be changed in the Caregiver interface.

Treatment and Trend Graph
Under the tab “Treatment and Trend Graph” you can track how the patient’s measured lung function, reported symptoms and asthma control have developed over time. Data is collected here when patients use the treatment check tool in the app.
Data can be reviewed by month or year. To move forward or backward in time, click on the left and right arrows that indicate the time periods that will be reviewed instead. If you wish to view a specific time period, click on the button between the arrows and select the time period’s start and end. By moving the cursor over the various points in the graph, detailed data on the lung function value and number of symptoms can be read.

Asthma control is calculated by the following algorithm:

Asthma control Green – Controlled Yellow – Partly controlled Red – Uncontrolled
Markers 0 markers 1-2 markers* 3-5 markers*

Lung function <80% of personal best FEV1 is counted as a marker. Registration of symptoms for each symptom issue is counted as a marker 0-4

Treatment plan
The patient’s treatment plan can be found at the bottom of this view in a tab called ‘Treatment Plan’. Here, you can create a new treatment plan for the patient or edit the existing one. The treatment plan is color coded and divided into three stages, green for controlled asthma, yellow for partially controlled asthma and red for uncontrolled asthma.

Create or change a treatment plan
Click “Create Treatment Plan” To create a new one, or make adjustments to an existing treatment plan, click “Change”.

  1. Select the drug in the drop-down menu on the left.
  2. Specify if the selected drug is a “Regular” or “As needed” type For Regular medications, set the dose morning / noon / evening
    As needed, set number per time and maximum number per day
  3. Add the treatment to the correct treatment step in the treatment plan by pressing the “+ button”. One click on the green button adds the treatment to the green level, yellow on partially controlled and red on uncontrolled.
  4. Repeat steps 1-3 until the treatment plan is complete, and then click save. The patient will receive a notification in their app that the treatment plan has been updated.

You can create an entire treatment plan by using a treatment template. To do this, select the treatment plan in the upper left corner. The entire treatment plan is then populated.

Save as a favorite
You can save a treatment plan as a “Favorite” and name it by typing a name for it in the box at the bottom and click “Add”. The current treatment plan will be saved as one of your personal favorites. It can then be found under the tab “Treatment templates”, read more there.

Other
Under the current treatment plan, there is a table with a patient-specific log showing which staff have looked at or made changes to the patient’s treatment plan.

Summary

The ‘Summary’ tab next to ‘Treatment Plan’ includes additional data about the patient’s treatment checks for the selected time period. You can see data such as distribution of reported symptoms, Lung function FEV1 and % of person best
Warning! Make sure that you have the right medication and strength by reviewing the treatment plan before leaving the tab “Treatment plan”.
Warning! Ensure that the prescribed drugs are included in the Medicines Compendium (e.g. FASS) and that the dose does not exceed the Medicines Compendium recommended maximum dose for the drug by reviewing the treatment plan before leaving the tab “Treatment plan”.
Warning! Ensure that the treatment plan is posted to the correct patient by reviewing the name and social security number before leaving the tab “Treatment plan”
Warning! Inform the patient to always seek contact with the healthcare provider if he / she feels that AsthmaTuner recommends a dose that is too low or too high based on asthma status.
NOTE! Inform the patient to familiarize themselves with the AsthmaTuner user manual before starting treatment, and that use for children and teens under the age of 18 should be supervised.
NOTE! Also inform the patient that the maximum dose and dosage information for the drug will be indicated on the package when the drug is collected at the pharmacy.

Evaluation

The evaluation graph is used to evaluate variation in lung function over time. Data is collected here if you have chosen the “Evaluation Tool” as the primary asthma tool when configuring the patient instructions.
You can choose whether you want to see information for PEF or FEV1 by using the drop-down menu in the upper left corner. The graph shows actual values in lung function. Below the graph, the daily variability is calculated per day, as well as the average over each measurement week. You can choose to download all metrics as a .csv file by clicking the “Download metrics” button

Treatment templates – Admin only
To simplify the work on treatment plans there is the possibility to create standardized treatment plans in AsthmaTuner (“Treatment templates”)
Here you find the pre-composed treatment templates for the healthcare staff. These are divided into two levels; Clinic-specific treatment templates that can only be set up and changed by administrators at the clinic, but which all clinic staff can access. Under “My treatment templates” you can create personal treatment templates that only you see.
The star on the right of each treatment template is clickable. By clicking on the star, you can activate or deactivate the star; an activated star means that it is a favorite you want to use, it will then be included in the drop-down list when you create or change treatment plans for a specific patient

Caregivers – Admin only
Under the caregiver tab all staff that has access to the clinic is. By using the “Delete” and “Add” buttons, you can manage which healthcare providers at the clinic can use the system.

Your Clinic – Admin only
Under the ‘Your Clinic’ tab, you can add information that will be shown when a patient is connected to your clinic. For example, your clinic’s logo, contact information, visiting address and website.

Log – Admin only
Under the log tab there is a list of the activities registered in the healthcare provider interface for the specific clinic.
It is also possible to search for a specific patient by name, social security number, or a specific healthcare provider at the clinic.

MediTuner AB 2021. All rights reserved.
Instructions For Use AsthmaTuner Careportal Version 3.3.0

Documents / Resources

AsthmaTuner Triggered by Multiple Factors [pdf] Instructions
Triggered by Multiple Factors, Multiple Factors, Triggered, Factors

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