Dr. Jonathan Tam, Children's Hospital Los Angeles
Aluna representative Charvi Shetty sat down with Dr. Jonathan Tam to discuss the role of digital health solutions and remote patient monitoring as a viable method of care in pediatrics and immunology. Dr. Tam is a medical director at the Gore’s Family Allergy Center at the Children’s Hospital of Ballet. He has attended medical school at the Northwestern University Feinberg School of Medicine, and he’s also completed his fellowship at the Children’s Hospital of Wisconsin. Dr. Tam has board certifications from the American Board of Allergy and Immunology.

Q: “What inspired you to become a doctor, and why did you choose to specialize in allergy and immunology?”

“I actually came to medicine pretty late. I think my parents had no idea that I wanted to be in medicine. I went to the University of Chicago for undergrad, and I was really looking for a passion. I had always been sort of interested in sciences, and my father was a bench researcher so I had been doing a lot of science-based things. So I had that sort of interest in immunology and chemistry. I also wanted to be around people and to help people. I was interested in science, but I wasn’t connected with the work, and so when medicine came up, I ended up going to medical school at Northwestern. I think I was open to everything and all fields. I was thinking about OB, and I was thinking about ER. It was the whole spectrum. If you talk to my medical school classmates, they probably would tell you that they knew that I was going into pediatrics from day one, but I was lying to myself. But over time I found that the problems and patients that interested me most were pediatric patients. I think I connect with them on a very simple level. I like kid things like cartoons, video games, that sort of thing. So I always have someone to talk to in the clinic. The other piece is that you’re getting patients that are interested in getting better and Interested in being well. So you can have an impact on somebody’s health early and have a long-lasting effect.”

Q: “In your opinion, which patient demographics are best suited for using digital health solutions?”

“The holy grail of medicine, in general, is patient-centered care, but also precision medicine. Not only being able to find the right treatment for the individual patient but also tailoring that treatment for that patient. There are lots of ways of approaching that in allergy immunology.  Obviously, there are things like these precision biologic medicines where we’re looking at specific disease processes and targeting precise cytokines. But the other end of that is meeting patients where they are. Going into their homes and using technology to improve their care on an individual level. Things like remote patient monitoring are ways to get at that. So the question is, who is best for it. Ideally, it would be everyone. It’s sort of like reducing friction for use of these sorts of technologies. But I think there are two categories of people that are the best targeted.  One is the difficult-to-treat patients, or difficult to control. Let’s use asthma as an example, where you have a patient where you put them on all the medicines, you’re ramping up their care, you’re teaching them everything that you know, and despite that, you’re still having difficulty controlling their asthma. Something like remote patient monitoring would be ideal for that patient because then you can intervene sooner. Then, you can potentially find where their points of friction are and address the problems that you’re not thinking about. The other case is patients that want to know about themselves so they are interested in their own disease process. This is something that can provide feedback on their self-care. I think there are lots of other patients interested in technology.”

Q: “What advice would you offer a physician that wants to start implementing digital health solutions into their practice?”

“Going back to the last question, the patient selection at this point is still important, and I think you need to find motivated patients, and then patients that understand the use of technology. Everybody has a smartphone, but not everybody interacts with it the same way. When talking to families, you can always get a sense of the kids that would just want to play with a piece of tech or are interested in interacting with the phone in a way outside of texting and gaming. That sort of patient selection, at least, in the beginning, is important. The other thing is understanding how these digital solutions will work in your workflow and improve patient care. Each provider has to look at their workflow and how they interact with technology and how a new piece of technology will improve their flow with the patient. “

Q: “Based on your knowledge and medicine for the last nine years, how do you think the use of digital health solutions will evolve the respiratory healthcare space in the next five years?”

“The pandemic aside, everything’s been moving pretty quickly. I think that respiratory health technologies are about to take a leap. We’ve been sort of stagnant for a very long time with office use of spirometry and these sorts of things. But looking at what Teva did with their Digihaler, and home spirometers like Aluna, or technologies that are sort of trying to take a leap like oscillometry. They are really starting to evolve and move forward. So I think that respiratory issues like the need for more data and more usable data helping delineate patients are the pieces that we need.  For the longest time, everybody’s just had asthma. It’s been just sort of a broad brush. With some of these new technologies and ways to biomark patients and things like that, I think we’re gonna be able to better differentiate patients and patient diseases, and then be able to treat them better. So I think in the next five years we’re going to see an improvement in care because they’re going to be implementing these technologies which will help delineate which patients need what care.”

Q: “What intrigued or interested you about partnering and offering Aluna as an RPM device for your patients?”

The idea of a company that thinks about the user experience. Obviously, nothing is ever perfect, but I think that was really the most important thing. What is the user experience for my patients and are they going to use this device? For the longest time we had things like peak flow meters to look at home lung function, and I personally really haven’t been a fan of peak flows because nobody ever does a peak flow, or they just don’t do it right. You can give out a peak flow in a clinic, but what’s the percentage of patients that will use a peak flow? So how do we incentivize patients to use a piece of technology that we want them to? I think gamification is the answer. It’s what kids and myself are interested in.  That loop of doing something and getting a little reward and then doing it again and getting a little reward is addictive but helpful as a motivation. So when I first saw the Aluna device, I was like, “oh that’s cool, it’s a very small spirometer” but I wasn’t moved. But when I saw the app, I was like okay, well now I understand how we’re gonna make this work. If it’s fun enough and your doctor tells you to do it, and there’s a mini reward system, then we have a chance of getting this information.   The use of RPM in healthcare as a viable means of monitoring patients has become increasingly common. However, many healthcare professionals still have questions. If you want to know more about how RPM could help your healthcare proactive, contact Aluna today!

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