Technology
be used to monitor and provide feedback on medication adherence. One such platform includes a CE-marked inhaler sensor to track medication usage, a mobile app or online portal to permit data viewing, and personalised support. The platform can also alert clinicians when patients are at risk of an exacerbation and produces objective insights on medication adherence. The use of smart inhalers in COPD has been associated with improved medication adherence, exacerbation risk and patient outcomes.16 Although not currently used in the
NHS, physiological monitoring devices and smartphone apps, such as purpleDx (electronRx), also hold great promise in the diagnosis and monitoring of COPD. Apps such as these enable the measurement of cardiorespiratory metrics, including heart rate, respiratory rate and oxygen saturation, utilising only the smartphone camera. These metrics can serve as an indicator of respiratory deterioration and aid in the detection of oncoming COPD exacerbations.17
The user
interface also enables trend tracking and the transmission of data to healthcare providers for review.
Barriers to adoption These digital technologies offer the potential to transform COPD health outcomes and the patient experience. However, the uptake and adoption of these have been relatively slow owing to several barriers. These include a lack of funding and resources, staff knowledge and attitudes,
concerns over data security and privacy, and issues relating to equality of access. Significant efforts are required to overcome these challenges if we are to see a shift towards the implementation of technology within the NHS. With regard to funding and resources, the total NHS technology budget for 2022 was estimated to be less than £1 billion after funding was diverted elsewhere.18
This budget was used on
technologies for acute hospitals rather than other healthcare settings, such as general practice.7
However, an additional £3.4 billion in
funding for NHS technology and transformation was recently announced to drive the digital transformation of the NHS.19
This extra funding
will aid in the development and implementation of new technologies within a variety of healthcare settings. Staff knowledge and attitudes towards
technology mean there can be a reluctance to adopt new tools, particularly if they had bad prior experiences, believe it will lead to a change in their role or will make their job more difficult. To overcome these barriers, it is important that staff are fully engaged in the design and onboarding of new technologies, educated on potential benefits and receive training on how to use them effectively. Additionally, there is a need to build patient confidence and trust in these technologies to ensure their successful adoption within clinical practice. The increased use of technology will also lead
to the storage of large amounts of sensitive patient data, making data security and privacy a concern, especially given that in recent years,
the NHS has been the target of numerous cyberattacks. Therefore, it is vital that the NHS make continual efforts to improve cybersecurity to ensure patient data is secure and protected whilst also complying with the general data protection regulation (GDPR) which governs the collection and processing of all personal data. Challenges relating to equality of access
could potentially exacerbate healthcare inequalities among older people, socially excluded groups, disabled individuals, people in socio-economically disadvantaged groups and those living in areas with inadequate broadband and mobile data coverage.20
Within the UK, as
many as 7% of households do not have internet access and 10 million adults lack basic digital skills.20
In order to ensure equality, the NHS must
ensure that digital approaches and technologies are designed and implemented inclusively and are offered complementary to existing services.
Optimising patient outcomes Providing effective care for respiratory diseases, such as COPD, is a challenge for the NHS and one that is set to grow in response to the ageing population and increasing prevalence of chronic diseases. In order to meet these challenges, it is important that the NHS more fully embrace the use of digital technologies within patient care. Digital spirometers and telehealth platforms are already finding utility in the NHS, but numerous other promising digital technologies are also currently in development. The implementation of these technologies offers the potential to improve the quality of care of COPD and relieve the pressure on the NHS; however, their ultimate success will depend on the ability of the NHS to overcome barriers which may be hindering their adoption including prioritisation, problem ownership and resistance to change.
CSJ
References 1 Asthma + Lung UK. DCOPD Survey 2022. (Asthma + Lung, 2022)
www.asthmaandlung.
org.uk/sites/default/files/2023-03/delayed- diagnosis-unequal-care-executive-summary. pdf
2 Diab N, Gershon AS, Sin DD, et al. Underdiagnosis and Overdiagnosis of Chronic Obstructive Pulmonary
Disease.Am J Respir Crit Care Med. 2018;198(9):1130-1139. doi:10.1164/ rccm.201804-0621CI
3 National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease: How common is it? (NICE, 2024)
https://cks.nice.org.uk/topics/chronic- obstructive-pulmonary-disease/background- information/prevalence-incidence/
Apps such as purpleDx enable the measurement of cardiorespiratory metrics, including heart rate, respiratory rate and oxygen saturation, utilising only the smartphone camera.
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4 Office for Health Improvement & Disparities. INteractive Health Atlas of
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