digital solutions, whether for surveillance of epidemic progression, contact tracing or remote
patient management from home, provide inspiration for controlling future epidemics [54].
In another epidemic, tuberculosis, for which nonadherence to treatment is associated with
increased risk of poor outcome, drug resistance and infection transmission, digital adherence
technologies have been utilised to both monitor and promote drug adherence [55].
It is likely that digital solutions could have a major impact in chronic respiratory disease
management. In asthma, they can support patient adherence through varied solutions, including
digital inhalers and spacers, self-management apps, web-based interventions, telehealth and
text-messaging services [56], as well as enable self-management by allowing patients to monitor
health status, receive timely feedback, avoid triggers and change lifestyle behaviours [57].
In COPD, telehealth is also employed for remote patient monitoring and self-management
support, and has additionally been piloted for managing comorbidities (anxiety and depression)
and end-of-life care [58]. Further, mobile apps can assist smoking cessation [59]. In sleep
medicine, digital health applications are already enabling remote respiratory device monitoring
and follow-up, but teleconsultations also have potential utility in screening and diagnosis,
communicating test results and treatment options, and tele-education [60]. In cystic fibrosis,
where the aim is to reduce care burden, teleconsultations integrating symptom and spirometry
data could become the primary management approach for patients with access to the modulators
of cystic fibrosis transmembrane conductance regulator [61]. For most chronic respiratory
diseases, telerehabilitation represents a hope that the benefits of pulmonary rehabilitation
(improved exercise tolerance, quality of life and symptom control) can reach more patients [62].
Finally, advances in AI suggest that screening, diagnosis and monitoring of respiratory diseases
based on radiological imaging could be automated, such as in interstitial lung disease [63].
As the possibilities for digital health multiply, the foremost question remains their acceptability
and efficacy. Within each chapter, the reader will find a literature review indicating key
outcomes for each respiratory condition and application domain, plus one or more practical
examples describing barriers and facilitators to implementation.
The future of digital respiratory healthcare
Digital transformation of healthcare is already underway with multiple and diverse initiatives.
The question is no longer “Will it happen?” but “How can digital health be implemented so that
connected care provides an optimal seamless service?” This was the question that inspired this
Monograph and which the ERS CRC CONNECT aims to address [30].
We thank Professor Peter M.A. Calverley and the editorial team for their guidance, and the
many colleagues who have contributed to the writing of the different chapters and have given
willingly of their expertise. We hope their insights will catalyse further interest and enquiry so
that implementation of digital healthcare addresses the challenges and mitigates the
disadvantages, ultimately realising the benefits for people with respiratory conditions.
References
1 Shaping Europe’s digital future. Luxembourg, Publications Office of the European Union, 2020.
2 Lupiáñez-Villanueva F, Gunderson L, Vitiello S, et al. Study on Health Data, Digital Health and Artificial
Intelligence in Healthcare. Brussels, European Commission, 2021.
3 Aceto G, Persico V, Pescapé A. The role of information and communication technologies in healthcare:
taxonomies, perspectives, and challenges. J Netw Comput Appl 2018 107: 125–154.
4 World Health Organization. Future of Digital Health Systems: Report on the WHO Symposium on the Future of
Digital Health Systems in the European Region. Copenhagen, WHO, 2019.
https://doi.org/10.1183/2312508X.10016623 xiii
patient management from home, provide inspiration for controlling future epidemics [54].
In another epidemic, tuberculosis, for which nonadherence to treatment is associated with
increased risk of poor outcome, drug resistance and infection transmission, digital adherence
technologies have been utilised to both monitor and promote drug adherence [55].
It is likely that digital solutions could have a major impact in chronic respiratory disease
management. In asthma, they can support patient adherence through varied solutions, including
digital inhalers and spacers, self-management apps, web-based interventions, telehealth and
text-messaging services [56], as well as enable self-management by allowing patients to monitor
health status, receive timely feedback, avoid triggers and change lifestyle behaviours [57].
In COPD, telehealth is also employed for remote patient monitoring and self-management
support, and has additionally been piloted for managing comorbidities (anxiety and depression)
and end-of-life care [58]. Further, mobile apps can assist smoking cessation [59]. In sleep
medicine, digital health applications are already enabling remote respiratory device monitoring
and follow-up, but teleconsultations also have potential utility in screening and diagnosis,
communicating test results and treatment options, and tele-education [60]. In cystic fibrosis,
where the aim is to reduce care burden, teleconsultations integrating symptom and spirometry
data could become the primary management approach for patients with access to the modulators
of cystic fibrosis transmembrane conductance regulator [61]. For most chronic respiratory
diseases, telerehabilitation represents a hope that the benefits of pulmonary rehabilitation
(improved exercise tolerance, quality of life and symptom control) can reach more patients [62].
Finally, advances in AI suggest that screening, diagnosis and monitoring of respiratory diseases
based on radiological imaging could be automated, such as in interstitial lung disease [63].
As the possibilities for digital health multiply, the foremost question remains their acceptability
and efficacy. Within each chapter, the reader will find a literature review indicating key
outcomes for each respiratory condition and application domain, plus one or more practical
examples describing barriers and facilitators to implementation.
The future of digital respiratory healthcare
Digital transformation of healthcare is already underway with multiple and diverse initiatives.
The question is no longer “Will it happen?” but “How can digital health be implemented so that
connected care provides an optimal seamless service?” This was the question that inspired this
Monograph and which the ERS CRC CONNECT aims to address [30].
We thank Professor Peter M.A. Calverley and the editorial team for their guidance, and the
many colleagues who have contributed to the writing of the different chapters and have given
willingly of their expertise. We hope their insights will catalyse further interest and enquiry so
that implementation of digital healthcare addresses the challenges and mitigates the
disadvantages, ultimately realising the benefits for people with respiratory conditions.
References
1 Shaping Europe’s digital future. Luxembourg, Publications Office of the European Union, 2020.
2 Lupiáñez-Villanueva F, Gunderson L, Vitiello S, et al. Study on Health Data, Digital Health and Artificial
Intelligence in Healthcare. Brussels, European Commission, 2021.
3 Aceto G, Persico V, Pescapé A. The role of information and communication technologies in healthcare:
taxonomies, perspectives, and challenges. J Netw Comput Appl 2018 107: 125–154.
4 World Health Organization. Future of Digital Health Systems: Report on the WHO Symposium on the Future of
Digital Health Systems in the European Region. Copenhagen, WHO, 2019.
https://doi.org/10.1183/2312508X.10016623 xiii