5 simple technologies to bridge the COPD care gap virtually

One of the challenges that many institutions face is that the PCPs may not be affiliated with the emergency room that the patient has gone to. So, we generated an automatic messaging prompt through our electronic health record, which sends that primary care provider a message that simply says: ‘Your patient was seen and discharged from the emergency department. We know that these patients with COPD have high mortality in the next year. They should be on full maximal inhaled therapies. They should be educated about the appropriate use of their inhalers, and here is some contact and resource information if you think they need to see a pulmonologist.’ We often get replies back that the PCP, especially when they're outside of our system, had no idea the patient was even in the emergency room.” 

Let's stop rewarding touch time. Providers should be able to do e-consults with each other and say, ‘I'm worried about this patient. Can you look at their spirometry? I've got him on all this, what would you suggest?’ And we should be able to look at it and say, ‘I would try this and this and this,’ without actually seeing the patient, because there are so many barriers to coming into the clinic.”

One of the concepts I'm toying with now is a virtual respiratory therapist. It may not be cost-effective to have a respiratory therapist on staff, but we can engage a trained RT to virtually spend 15 minutes of time with a patient while they’re in their own home, through whatever technology makes the most sense. It might be a simple phone call, but Skype or FaceTime or another visual technology would be much better. I'd be curious if, in the pulmonary practice or family practice, there would be value for having that expert who could beam in literally only on an as-needed basis [and] at no cost to the practice?”

We've spent a lot of time developing a COPD resource website that has easy links to how-to videos, so that when you don't have the opportunity to engage a certified trainer with a patient, you can at least show the patient, in a standardized way, how that inhaler is supposed to be used. I think the wealth of patient champions moving things forward is great in some places, but in some settings, those people or resources may not be available. In those cases, we have to decentralize those resources a little bit and find new ways to educate patients.”

We’re currently developing an artificial intelligence navigator in the form of an app. The idea is to check in with patients and ask questions like, ‘Have you taken your medications today? Did you go to your follow-up, etc.?’ And if  the patient describes that they're exhibiting symptoms, or if they are having problems with their medications, those concerns are routed to a real COPD navigator who can help answer those questions. Education can be provided and we can ensure that patients’ questions are being answered. But the tool can also take that information back to the primary care team to let them know that a question was asked, this was what was done, and this is how we should go forward.”