The program's long term objective is to improve the health status of lung transplant recipients by providing a means for the early detection of acute bronchopulmonary events, resulting in earlier and more timely intervention and improved outcome. We have developed and tested a telehealth home monitoring system in which recipients do daily lung function measurements and record respiratory symptoms; these measurements are transmitted from the recipient's home to our data center over the recipient's telephone. This information is currently used by nurses to identify those recipients who show the earliest indications of an acute bronchopulmonary event. This is a laborious process, especially when large numbers of patients are doing home monitoring on a regular daily schedule. We have developed a computerized triage system to interpret the home monitoring data using appropriate probability measures. The computer systems are necessary to evaluate the large amount of data generated from home monitoring. These systems can identify early indications of a problem, but it is not known if this results in improved health outcome for the patient doing home monitoring. The first part of the study will evaluate a new telehealth enhanced home spirometer/diary device which should make it easier for patients to do home monitoring, for nurses to review and assess their patient's home monitoring data, and to provide automated feedback messages to patients to help them maintain home monitoring adherence. The next part of the study will be a randomized controlled trial to evaluate and compare manual nurse triage with the computerized triage system in terms of patient's health and quality of life, and the time required to fully utilize each triage system. ? ?
