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BMC Medical Informatics and Decision Making

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Open Access 01-12-2017 | Research article

Digital health system for personalised COPD long-term management

Authors: Carmelo Velardo, Syed Ahmar Shah, Oliver Gibson, Gari Clifford, Carl Heneghan, Heather Rutter, Andrew Farmer, Lionel Tarassenko, on behalf of the EDGE COPD Team

Published in: BMC Medical Informatics and Decision Making | Issue 1/2017

Abstract

Background

Recent telehealth studies have demonstrated minor impact on patients affected by long-term conditions. The use of technology does not guarantee the compliance required for sustained collection of high-quality symptom and physiological data. Remote monitoring alone is not sufficient for successful disease management. A patient-centred design approach is needed in order to allow the personalisation of interventions and encourage the completion of daily self-management tasks.

Methods

A digital health system was designed to support patients suffering from chronic obstructive pulmonary disease in self-managing their condition. The system includes a mobile application running on a consumer tablet personal computer and a secure backend server accessible to the health professionals in charge of patient management. The patient daily routine included the completion of an adaptive, electronic symptom diary on the tablet, and the measurement of oxygen saturation via a wireless pulse oximeter.

Results

The design of the system was based on a patient-centred design approach, informed by patient workshops. One hundred and ten patients in the intervention arm of a randomised controlled trial were subsequently given the tablet computer and pulse oximeter for a 12-month period. Patients were encouraged, but not mandated, to use the digital health system daily. The average used was 6.0 times a week by all those who participated in the full trial. Three months after enrolment, patients were able to complete their symptom diary and oxygen saturation measurement in less than 1 m 40s (96% of symptom diaries). Custom algorithms, based on the self-monitoring data collected during the first 50 days of use, were developed to personalise alert thresholds.

Conclusions

Strategies and tools aimed at refining a digital health intervention require iterative use to enable convergence on an optimal, usable design. ‘Continuous improvement’ allowed feedback from users to have an immediate impact on the design of the system (e.g., collection of quality data), resulting in high compliance with self-monitoring over a prolonged period of time (12-month). Health professionals were prompted by prioritisation algorithms to review patient data, which led to their regular use of the remote monitoring website throughout the trial.

Trial registration

Trial registration: ISRCTN40367841. Registered 17/10/2012.

Available only for authorised users

http://www.nihr.ac.uk/about-us/CCF/policy-and-standards/research-passports.htm - last accessed: 13 February 2017

The section of the app will record a symptom diary but not an oxygen saturation session in case of problems with the oximeter (low battery, problems with Bluetooth connection, participants deliberately removing their finger).

Low-quality data were not displayed on the website.

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Title: Digital health system for personalised COPD long-term management
Authors: Carmelo Velardo
Syed Ahmar Shah
Oliver Gibson
Gari Clifford
Carl Heneghan
Heather Rutter
Andrew Farmer
Lionel Tarassenko
on behalf of the EDGE COPD Team
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Medical Informatics and Decision Making / Issue 1/2017
Electronic ISSN: 1472-6947
DOI: https://doi.org/10.1186/s12911-017-0414-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Digital health system for personalised COPD long-term management

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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