Introduction

At Nimbus Health, we leverage the latest scientific research to provide leading, evidence-based clinical care.

Engaging patients in their chronic disease management remains one of the most difficult–and vital–challenges in pulmonary medicine. Our approach integrates multiple evidence-based strategies in the domains of telehealth, medication adherence management, remote patient monitoring, and disease-specific exacerbation management. Below we’ve compiled a small sample of the research that informs our approach.

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Remote therapeutic monitoring and chronic disease management

One unique feature of Nimbus Health is our integration of remote therapeutic monitoring and chronic disease management programs into specialty lung care.

Numerous studies demonstrate the benefits of remote monitoring and chronic disease management programs across a wide range of diseases, including chronic respiratory conditions such as COPD.

For example, in a randomized controlled trial of patients with COPD, a telehealth remote monitoring program resulted in significantly fewer hospital readmissions (PMID 27029815). Additional studies demonstrate the potential for chronic COPD management programs to decrease ED visits, hospitalizations, and hospital length of stay (PMID 17389286).

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Employing sleep mats

As a part of our commitment to integrating remote sensor data into our clinical practice, we employ sleep mats to monitor our patients’ resting heart rate, respiratory rate, and sleep quality. These metrics are independent predictors of exacerbation of chronic respiratory disease.

For instance, one study demonstrated that a patient’s resting respiratory rate increased 15-30% in the days prior to an exacerbation of COPD (PMID 22797131). Similar changes in breathing pattern have also been observed in patients on home NIV (PMID 30214176). Similar changes have been observed in heart rate prior to a COPD exacerbation (PMID 35473718, 25475218).

We also use our sleep mats to monitor sleep quality and duration. In COPD patients, derangements in sleep are strongly associated with chronic lung disease severity, as well as risk for exacerbation, hospitalization, and cardiovascular events (PMID 33214924). Poorly controlled OSA has also been implicated in worsening asthma control (PMID 31841642).

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Helping patients with their medication regimen

Another cornerstone of our philosophy at Nimbus is to help our patients stay on top of their medication regimen and out of the hospital. We combine frequent patient outreach and objective adherence monitoring tools to help patients stay on track.

Research demonstrates that adherence to inhaled medications in chronic lung disease is strongly associated with lower exacerbation rates, ED utilization, and hospital admission
(PMID 23643487, 25323234, 19703830).

In a typical practice setting, adherence to inhaled medications is poor, with up to half of all patients not taking their medications as prescribed (PMID 24921985). Although maintaining steady adherence is difficult, digital health interventions such as smart inhaler cap devices and automated reminders help to improve adherence and outcomes for our patients
(PMID 35691614, 33334936, 34277075, 23643487).

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Prompt and aggressive treatment

Inevitably, some patients will eventually experience an exacerbation of their condition. At Nimbus, we recognize the importance of prompt and aggressive treatment of asthma and COPD exacerbations before they lead to hospitalization. Early identification and treatment of exacerbations leads to faster recovery and less hospitalization (PMID 14990395, 23235589, 29504499).

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