European Health Data Space [16], and is widely welcomed by professional societies such as the
European Respiratory Society (ERS) as an opportunity for better healthcare, research and
policymaking [17]. With the launch of OpenAI resources such as ChatGPT [18], artificial
intelligence (AI) has become a major talking point for the public and policymakers. AI is
already supporting professionals to make healthcare decisions, but there is evidence that wider
use may be outstripping the trust of patients and professionals [19].
A priority for respiratory healthcare
Digital respiratory care is of interest to both professional and patient respiratory organisations.
The theme of the ERS Presidential Summit 2021 [20], a research seminar and three successive
Congresses [21–23], the creation of the m-Health/e-health ERS Group [24], and the
commissioning of reviews [11], all reflect the significance of digital health to ERS members.
Similarly, the European Lung Foundation (ELF) adopted digital health as the theme for their
Patient Organisation Networking Day 2021 [25] and have run workshops on digital health to
explore the potential benefits and concerns.
Patients report being keen to use apps to monitor and learn about their condition, access timely
advice and reduce travel time for consultations. They are interested in using remote monitoring
and consultations to develop new kinds of relationships with their healthcare team, and to
maintain disease control. They want to understand how their data could be used by others but
have concerns about data privacy and security. Healthcare professionals embraced remote
consulting for reasons of infection control in the pandemic [6], and in many contexts have been
convinced of the utility (though not necessarily the time/cost efficiency) of telephone/
videoconsultations [26]. Both patients and professionals have highlighted the potential loss of
empathy and “human-ness” in remote consultations, and that remote consulting “worked better”
when interaction built on existing relationships [27–29].
CONNECT Clinical Research Collaboration
More recently, an ERS Clinical Research Collaboration (CRC) has been established to promote
research relevant to the implementation of digital respiratory healthcare [30]. Whatever the policy
or disease context, significant organisational changes are needed to establish and sustain digital
healthcare (e.g. practical resources, skills training, proper reimbursement, integration with existing
patient management systems, transferability of data across settings, privacy issues) [12, 31].
Terminology
One of the challenges in such a fast-moving field is the evolving terminology. Definitions vary
– see the European Commission study on health data, digital health and AI in healthcare for a
discussion on European and worldwide definitions [2]. The relationship between these
modalities is illustrated in chapter 11 of this Monograph in the context of digital transformation
of healthcare services in the European Union (EU) [32]. For clarity, we have summarised the
key definitions in table 1, and have taken an editorial decision to standardise terminology
throughout the Monograph.
Using this Monograph
The Monograph is divided into three complementary sections, as follows.
Technological and regulatory challenges and opportunities
In the first section (chapters 1–6), we present an overview of the extensive range of technology
that can potentially support digital respiratory healthcare [39–44]. Some of the technology is
x https://doi.org/10.1183/2312508X.10016623
European Respiratory Society (ERS) as an opportunity for better healthcare, research and
policymaking [17]. With the launch of OpenAI resources such as ChatGPT [18], artificial
intelligence (AI) has become a major talking point for the public and policymakers. AI is
already supporting professionals to make healthcare decisions, but there is evidence that wider
use may be outstripping the trust of patients and professionals [19].
A priority for respiratory healthcare
Digital respiratory care is of interest to both professional and patient respiratory organisations.
The theme of the ERS Presidential Summit 2021 [20], a research seminar and three successive
Congresses [21–23], the creation of the m-Health/e-health ERS Group [24], and the
commissioning of reviews [11], all reflect the significance of digital health to ERS members.
Similarly, the European Lung Foundation (ELF) adopted digital health as the theme for their
Patient Organisation Networking Day 2021 [25] and have run workshops on digital health to
explore the potential benefits and concerns.
Patients report being keen to use apps to monitor and learn about their condition, access timely
advice and reduce travel time for consultations. They are interested in using remote monitoring
and consultations to develop new kinds of relationships with their healthcare team, and to
maintain disease control. They want to understand how their data could be used by others but
have concerns about data privacy and security. Healthcare professionals embraced remote
consulting for reasons of infection control in the pandemic [6], and in many contexts have been
convinced of the utility (though not necessarily the time/cost efficiency) of telephone/
videoconsultations [26]. Both patients and professionals have highlighted the potential loss of
empathy and “human-ness” in remote consultations, and that remote consulting “worked better”
when interaction built on existing relationships [27–29].
CONNECT Clinical Research Collaboration
More recently, an ERS Clinical Research Collaboration (CRC) has been established to promote
research relevant to the implementation of digital respiratory healthcare [30]. Whatever the policy
or disease context, significant organisational changes are needed to establish and sustain digital
healthcare (e.g. practical resources, skills training, proper reimbursement, integration with existing
patient management systems, transferability of data across settings, privacy issues) [12, 31].
Terminology
One of the challenges in such a fast-moving field is the evolving terminology. Definitions vary
– see the European Commission study on health data, digital health and AI in healthcare for a
discussion on European and worldwide definitions [2]. The relationship between these
modalities is illustrated in chapter 11 of this Monograph in the context of digital transformation
of healthcare services in the European Union (EU) [32]. For clarity, we have summarised the
key definitions in table 1, and have taken an editorial decision to standardise terminology
throughout the Monograph.
Using this Monograph
The Monograph is divided into three complementary sections, as follows.
Technological and regulatory challenges and opportunities
In the first section (chapters 1–6), we present an overview of the extensive range of technology
that can potentially support digital respiratory healthcare [39–44]. Some of the technology is
x https://doi.org/10.1183/2312508X.10016623