How Technology is Supporting People with Chronic Obstructive Pulmonary Disease

The abandoned

Cornwall is recognised as an area with great disparity amongst care service provision (Public Health England, 2017), suffering from increasing pressure combined with reduced healthcare resources (The Queens Institute, 2017). A victim of its geographical location in the coastal and rural South West of England and ageing population, innovative solutions to healthcare are urgently needed.

This is particularly true for patients with Chronic Obstructive Pulmonary Disease or COPD – the name given to a group of lung conditions that cause long-term breathing difficulties. COPD in some of its more severe forms, can greatly limit a person’s ability to undertake everyday tasks such as walking and can include a loss of appetite and subsequent weight loss. A chronic condition, symptoms get progressively worse – there is no cure and the condition cannot be reversed. A 2020 study by The Breathers Group – a specialist support group for COPD patients – found that patients often feel abandoned.

The gold standard of care

The National Institute for Health and Care Excellence (NICE) mandated in 2019 that people with COPD should receive an individualised and comprehensive self-management plan. The gold standard care for COPD is pulmonary rehabilitation - a specialised programme of exercise and education – but there are many other issues that COPD patients can experience in self-managing their care. Patients have to learn a host of new information on their condition including how to use emergency antibiotic kits for repeat chest infections, inhaler techniques, pulmonary rehab exercises, medications management, mindfulness during breathless and anxiety attacks and more.

myCOPD – an eHealth app developed by UK company, my mHealth – is proven to be as effective as pulmonary rehabilitation. An NHS Approved, comprehensive self-management tool for COPD patients, it empowers them to self-manage their condition with confidence by allowing patients to set achievable goals. Research has demonstrated that it can improve inhaler technique, reduce symptom scores, and reduce the number of exacerbations and hospital admissions.[1]

However, prior to this collaborative project, it was underutilised in some care pathways.

<p>

Derriford Dental Education Facility<br>Dental students, nurses, clinical supervisors and patients using the Derriford Dental Education Facility.

<br></p>
<p>Human lungs anatomy form lines and triangles, point connecting network on blue background. Illustration vector<br></p>
<p>Getty image 506200364 elderly patient with nurse</p>

The missing piece

As a second-year nursing student and digital health champion at the University of Plymouth, Joy O’Gorman saw the potential for change during her experience with COPD patients in Cornwall:

“In one of my project case studies, I had to focus on a gentleman known as Bob whose condition was deteriorating – he became housebound with increased breathlessness, anxiety and fatigue. Home Oxygen Therapy and nursing care planning was required.  The myCOPD app was part of my person-centred approach for Bob. However, in future placements I realised that a valuable tool such as myCOPD was regularly left out of care pathways for patients in primary and acute settings, despite it being freely accessible across the county.”

As part of her role as digital health champion, Joy works with the University’s Centre for Health Technology which brings together digital health and technology academic expertise to develop, implement and evaluate innovative technologies and services in health and social care. 

Through the eHealth Productivity and Innovation in Cornwall and the Isles of Scilly (EPIC), funded by the European Regional Development Fund (ERDF), they are establishing an ecosystem of organisations and individuals across the South West, including healthcare trusts, charities, social enterprises, patient groups, and students, facilitating a sustainable eHealth sector.

Tapping into the ecosystem

With the support of this ecosystem, Joy engaged key stakeholders in order to implement the myCOPD app within Cornwall’s health and care services, from patients, to GP surgeries to acute hospitals. Joy engaged The Patient Association for the South West, The Breathers Patient Support Group in Cornwall, GP surgeries, the Cornwall County Council Digital Health Team and leading groups within the Royal Cornwall Hospital Trust (RCHT) including the Board of Governors and Quality Improvement Team. my mHealth soon became a new member of this network of innovators and collaborators and the app is now a second-tier quality improvement project for RCHT. Licence user uptake tripled in Cornwall, GP involvement increased significantly and a dedicated digital health referral phone line was launched. As Joy continues her studies, she is taking a leadership role in the quality improvement project for myCOPD in Cornwall:

“Student nurses are just one asset or cog in a wider ecosystem within health and care but we can enable the adoption of new and innovative eHealth solutions that provide person-centred care, reduce the time and resources needed by stretched healthcare professionals, and ultimately benefit patients.”

Utilising student nurses

Laura Falconer, my mhealth Account Manager and EPIC Lead said:

“It was a pleasure to work with Joy on the EPIC project. The aim was to explore novel implementation methods for myCOPD. my mhealth collaborated with student nurses, The Breathers Group, Old Bridge and Oakland GP surgeries. Joy was a key asset in linking these teams together, introducing various stakeholders to maximise the impact of myCOPD. Importantly, the EPIC project provided an opportunity to utilise the skill set of student nurses in registering patients whilst on clinical placements.  We set up a dedicated telephone number so student nurses could call the Digital Health Team to register patients to the myCOPD app. Since the project started, myCOPD uptake in the area has nearly quadrupled. This is great news for patients who are able to self-manage and receive remote clinical support from the safety of their own homes, especially in these uncertain times."

Digital Health Champions

EPIC has recently received a £4 million, three-year extension meaning experts and continue to support businesses in developing technology to address the challenges faced by communities and providers in coastal and rural settings. 

EPIC has enlisted over 20 student nurses as Digital Health Champions, like Joy, to work in local communities to support the implementation of new and existing health technologies to make a difference in patient care.

Read Joy’s thought-provoking piece on the role of student nurses in innovating health and care practice.


The Old Normal: Our Future Health 

The Centre for Health Technology brings together researchers with over 30 years of evidence-based research experience in health and technology. Together, they work to enable innovative healthcare solutions that reduce the pressure on services, support healthy ageing in our communities and stimulate an economy of wellbeing that benefits all. 

In this series, they share their views on the current state of health and care in the UK, and what its future could look like.


eHealth Productivity and Innovation in Cornwall and the Isles of Scilly (EPIC)

A collaborative, three-year project, EPIC helps grow eHealth businesses and improve health, wellbeing and enhance care quality. Funded by a £2.7 million grant from the European Regional Development (ERDF) and the South West Academic Health Science Network (AHSN), EPIC has established an eHealth ecosystem that connects key sectors in Cornwall and the Isles of Scilly with research expertise at the University, led by Dr Arunangsu Chatterjee and Professor Ray Jones. The project enables new technological innovations to be created and adopted and so far has successfully awarded 42 grants to businesses for this purpose. Working together with key partners, the project is helping to improve the quality of life and boost wellbeing.

Learn more about EPIC

References

[1] NorthM,BourneS,GreenB, et alP238: A randomised controlled feasibility trial of an E-health platform supported care vs usualcare after exacerbation of COPD (RESCUECOPD) Thorax2018; 73:A231. BourneS,DeVosR,NorthM, et al: Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial, BMJ 017 Open2017; 7:e014580.doi:10.1136/bmjopen-2016-014580.