Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous lung condition causing persistent, progressive airflow obstruction. It is the most common disease-specific cause of adult emergency hospital admissions in Ireland1.
Virtual wards (VW) are a promising solution to optimize care for COPD patients 2. The VW aligns with the Slaintecare vision of delivering one universal health service, providing right care, in the right place, at the right time3 for COPD patients.
Approach: This study explores the feasibility and effectiveness of a COPD-VW pathway, expanding the existing Outreach service to include remote patient monitoring for acute exacerbation via MyPatientSpace (MPS). MPS is a platform designed to facilitate communication and engagement between patients and healthcare providers. It allows patients to record their vital signs, engage in self management education, manage their symptoms and access specialised respiratory care throughout the episode of care. The VW MDT provides comprehensive patient care.
A focus group allowed us directly engage with COPD patients for a deeper understanding of their experiences, challenges, and expectations regarding digital health solutions. As one participant remarked, “The technology I’d manage but being able to be in my garden in the sunshine would be amazing”. This collaborative approach ensured that this new service was not only clinically effective but also user-friendly and relevant. Another participant in the group commented, “all about your condition is spoken out loud for everyone to hear” following a recent Accident and Emergency presentation, “to share our stories, helps you see these problems for us” which in turn allows practical solutions.
Results: The feedback on usability has moulded the design for more intuitive interfaces, enhancing patient adherence and engagement. In a recent mHealth App Usability Questionnaire offered within MPS, a respondent scored 7/10 for “The information in the app was well organized, so I could easily find the information I needed.”
The COPD-VW has provided 73 care episodes since launching- April 2024. The average length of stay (LOS) is 6.06 days, 57.4% improvement on LOS compared to the national average 5 . The HIPE data report (2024) estimates costings €8179 per COPD hospital stay. This pilot to date has saved 500.8 days: an estimated €550,000 .
Implications: Findings from this study will provide valuable insights into the potential benefits of a COPD VW and inform future efforts to scale and embed this innovative care model.
Providing patients with feedback opportunities within a care package empowers them to actively participate in their treatment, ensuring that care is tailored holistically to their needs and preferences.