Effective deployment of technology-supported management of chronic respiratory conditions: a call for stakeholder engagement
Received 13 January 2017
Accepted for publication 4 May 2017
Published 5 July 2017 Volume 2017:8 Pages 119—128
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Dr John Haughney
Richard W Costello,1 Alexandra L Dima,2 Dermot Ryan,3 R Andrew McIvor,4 Kay Boycott,5 Alison Chisholm,6 David Price,7,8 John D Blakey9,10
1Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Amsterdam School of Communication Research ASCoR, University of Amsterdam, Amsterdam, the Netherlands; 3Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK; 4Firestone Institute for Respiratory Health, McMaster University, Hamilton, ON, Canada; 5Asthma UK, London, 6Respiratory Effectiveness Group, Cambridge, 7Observational and Pragmatic Research Institute, Singapore; 8Academic Centre of Primary Care, University of Aberdeen, Aberdeen, 9Health Services Research, University of Liverpool, 10Respiratory Medicine, Royal Liverpool Hospital, Liverpool, UK
Background: Healthcare systems are under increasing strain, predominantly due to chronic non-communicable diseases. Connected healthcare technologies are becoming ever more capable and their components cheaper. These innovations could facilitate both self-management and more efficient use of healthcare resources for common respiratory diseases such as asthma and chronic obstructive pulmonary disease. However, newer technologies can only facilitate major changes in practice, and cannot accomplish them in isolation.
Focus of review: There are now large numbers of devices and software offerings available. However, the potential of such technologies is not being realised due to limited engagement with the public, clinicians and providers, and a relative paucity of evidence describing elements of best practice in this complex and evolving environment. Indeed, there are clear examples of wasted resources and potential harm. We therefore call on interested parties to work collaboratively to begin to realize the potential benefits and reduce the risks of connected technologies through change in practice. We highlight key areas where such partnership can facilitate the effective and safe use of technology in chronic respiratory care: developing data standards and fostering inter-operability, making collaborative testing facilities available at scale for small to medium enterprises, developing and promoting new adaptive trial designs, developing robust health economic models, agreeing expedited approval pathways, and detailed planning of dissemination to use.
Conclusion: The increasing capability and availability of connected technologies in respiratory care offers great opportunities and significant risks. A co-ordinated collaborative approach is needed to realize these benefits at scale. Using newer technologies to revolutionize practice relies on widespread engagement and cannot be delivered by a minority of interested specialists. Failure to engage risks a costly and inefficient chapter in respiratory care.
Keywords: apps, smart inhaler, connected devices, remote monitoring, co-creation, standards, guidelines, health economics
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