Digital Innovation With Remote Management and Predictive Modelling to Integrate COPD Care With Artificial Intelligence-based Insights: An Acceptability, Feasibility and Safety Study

Background: COPD need, challenge and opportunity.

Chronic obstructive pulmonary disease (COPD) is a global healthcare challenge. Whilst care-quality gaps exist across the continuum of patient's with COPD's presentation, COPD exacerbations are responsible for a large proportion of the disease-burden, adverse outcomes and healthcare costs. People with COPD prioritise the avoidance of exacerbations and resultant hospitalisations. The Patient Charter for COPD (March 2021), called for proactive, preventative management to reduce the risk of exacerbations and premature death1. Digital transformation with co-designed digital tools and emerging innovations such as wearable sensors and AI-based predictive modelling offers the opportunity to address these COPD care-quality gaps and achieve this care re-orientation.

DYNAMIC: NHS GG&C COPD digital service transformation, implementation and evidence.

'DYNAMIC' (Digital Innovation with Remote Management and Predictive Modelling to Integrate COPD Care) program commenced in 2018. This was based on an innovation partnership between NHS GG&C respiratory medicine and West of Scotland innovation teams and with LenusHealth (then StormID). Initial funding was from a digital health technology catalyst award from InnovateUK. Subsequent Scottish Government Technology Enabled Care (TEC) Program funding has continued the service and allowed scale-up provision.

Our vision was to initiate digital transformation of a COPD service with the development, implementation, and evaluation of co-designed digital tools. We co-designed the "LenusCOPD' patient and clinician web applications and support website based on cycles of user experience testing. We aimed to establish tools which would be sustainably used by patients during follow-up, and support COPD co-management with an anticipation of achieving reduction in respiratory-related admissions and occupied bed days in a high-risk COPD cohort. Evidence was gathered in the 'RECEIVER' observational cohort study and subsequently in the scale-up 'DYNAMIC-SCOT' service evaluation.