JMIR Publications

ABSTRACT

Background:

Chronic Obstructive Pulmonary Disease (COPD) is characterized by acute exacerbations that frequently result in hospitalization, highlighting the need for improved follow-up care. Hybrid care incorporates digital health strategies such as remote patient monitoring (RPM). This offers the opportunity to early detect signs of disease worsening by continuously tracking the patients’ health status. However, it is unknown how RPM can effectively be integrated into current practice.

Objective:

Co-create a hybrid COPD care pathway integrating RPM into the existing care trajectory, considering the expertise of all involved care pathway stakeholders.

Methods:

At first, semi-structured interviews were conducted with stakeholders (i.e., patients and health care professionals) involved in COPD care to map the existing care pathway in a tertiary care hospital in Belgium. Secondly, interactive workshops with patient representatives and healthcare professionals informed the development of a theoretical hybrid care pathway integrating RPM.

Results:

The existing COPD care pathway involves multiple stakeholders whose activities can be organized into five functional domains: support, treatment, medical advice, patient education, and monitoring. Stakeholders can be divided into in-hospital, out-hospital, or mixed setting. Stakeholders deemed the introduction of an RPM dedicated stakeholder necessary for effective integration of RPM strategies into the care. This individual will be responsible for all RPM-related activities (i.e., RPM device installation, providing RPM-related education, data review, alert management, and RPM discontinuation) and in close contact with both patients and physicians

Conclusions:

The introduction of a RPM dedicated stakeholder into the COPD care pathway is deemed necessary for the successful implementation of RPM strategies.