How will telemedicine change clinical practice in chronic obstructive pulmonary disease?

Abstract

Within telehealth there are a number of domains relevant to pulmonary care: telemonitoring, teleassistance, telerehabilitation, teleconsultation and second opinion calls. In the last decade, several studies focusing on the effects of various telemanagement programs for patients with chronic obstructive pulmonary disease (COPD) have been published but with contradictory findings. From the literature, the best telemonitoring outcomes come from programs dedicated to aged and very sick patients, frequent exacerbators with multimorbidity and limited community support; programs using third-generation telemonitoring systems providing constant analytical and decisionmaking support (24 h/day, 7 days/week); countries where strong community links are not available; and zones where telemonitoring and rehabilitation can be delivered directly to the patient’s location. In the near future, it is expected that telemedicine will produce changes in work practices, cultural attitudes and organization, which will affect all professional figures involved in the provision of care. The key to optimizing the use of telemonitoring is to correctly identify who the ideal candidates are, at what time they need it, and for how long. The time course of disease progression varies from patient to patient; hence identifying for each patient a ‘correct window’ for initiating telemonitoring could be the correct solution.In conclusion, as clinicians, we need to identify the specific challenges we face in delivering care, and implement flexible systems that can be customized to individual patients’ requirements and adapted to our diverse healthcare contexts.

A sense of belonging: A meta‐ethnography of the experience of patients with chronic obstructive pulmonary disease receiving care through telemedicine

“…Consequently, the need for connectedness and the requirement to belong increase with the progression of illness burden and severity. This is an important contribution to the existing evidence base that shows contradictory results (Brunton et al, ; Cruz et al, ; Gregersen et al, ; Pedone & Lelli, ) and a lack of understanding of who would benefit the most from TM, including their preferences (Vitacca, Montini, & Comini, ). Pinnock and McKinstry () suggest that these contradictions may be influenced by the complexity and the large symptom burden of the disease.…”

GOLD Reports on Chronic Obstructive Pulmonary Disease (COPD): Evolutions, Revolutions and Controversies

“…When the level of detail is insufficient, it makes it difficult to assess these strategies globally. New technologies of information and communication (NTIC) will certainly provide new avenues for patient support 63,64 . Many connected solutions are currently developed to improve device use, adherence to care and, more globally, health behaviours.…”

Developing a strategic understanding of telehealth service adoption for COPD care management: A causal loop analysis of healthcare professionals

“…Telehealth (TH) is defined as the ongoing and remote exchange of data between patients at home and HCPs as part of disease management [10]. Despite the many beneficial patient and organizational outcomes reported in COPD care management, [11] TH is currently not being implemented at a large scale in routine clinical care [12].…”