“Last year, before using myCOPD I had 12 exacerbations, this year I have had two. I now know when and how to take my medication, when to use my rescue pack and I perform my rehab exercises most days. I know far more about my COPD than before. I rely on my doctor far less than before.”
myCOPD is an online self-management system that can reduce acute hospital admissions, NHS spending and improve the quality of patients’ lives.
An independent economic analysis suggests that myCOPD can save an average CCG £217,200 per year by cutting admissions, and moving to a new model of pulmonary rehabilitation that allows thousands, rather than hundreds of people to be helped.
Coping with chronic obstructive pulmonary disease (COPD) is a major and growing challenge for the NHS in England with 835,000 diagnosed and 2.2 million undiagnosed cases leading to around 122,000 hospital admissions and 23,000 deaths a year. The direct care bill is £800 million.
myCOPD is effective because it educates and empowers patients to take more control of their own care. This brings significant improvements in inhaler use and raises the currently low levels of compliance with treatment.
The system also allows COPD care to be monitored and tailored at patient and population level.
The platform has been created by Simon Bourne, Portsmouth-based innovation and respiratory consultant, NHS Innovation Accelerator (NIA) Fellow and founder of My mHealth, who has been developing the project in partnership with Wessex AHSN.
Chronic obstructive pulmonary disease (COPD) is a long-term respiratory condition (most commonly known as chronic bronchitis an/or emphysema) that is among the top five causes of death, leading to 23,000 deaths a year. It is also the second most common cause of hospital admissions with direct NHS healthcare costs of £800 million.
Hospital admissions are rising by 13% a year with 15% of those admitted dying within three months.
Around 835,000 people in England are currently diagnosed with COPD with 2.2 million undiagnosed.
In 2012-13 there were 121,836 hospital admissions (95% emergencies) which accounted for more than 778,000 bed days at a mean cost of £1,590 per patient.
As COPD has no cure it is essential to have effective symptom management. Even though this can be highly effective there are major problems as compliance with medication is poor, at between 10-40%. Most patients have an inhaler, but 90% do not use them correctly, affecting the dosage they receive.
Where patients feel functionally disabled by COPD, one of the standard responses is a PR programme. However, these are labour-intensive with high dropout rates, poor access and are expensive.
myCOPD is a cost-effective and easy online system empowering patients to manage their conditions and share information with their care team. A dashboard allows clinicians to monitor and manage patients remotely at individual and population levels, meaning they can tailor treatment and support.
It has been developed by innovation and respiratory consultant Simon Bourne, in response to the growing incidence and cost of COPD. The platform brings together key elements of COPD care in one readily accessible place. These are:
- Symptom scoring – the core of myCOPD is a personalised self-management plan. Patients answer a series of questions and the scores can be shared with clinicians.
- Medication diary – records use of inhalers and oral therapies. It’s a reminder for the patient, an adherence record and allows an independent assessment of symptoms.
- Inhaler techniques – shows a simple, clear video for inhaler use.
- Pulmonary rehabilitation – a six-week video-based education and exercise course.
There are also more than 20 general educational videos and information about COPD and its management.
Being an NIA Fellow has allowed Simon to work with mentors and leaders from NHS England.
Extensive research has been carried out including:
- Patient trials in Portsmouth
- A study comparing recovery rates of patients admitted to hospital with acute exacerbations who were then managed using either myCOPD or using the conventional approach
A study comparing the effectiveness of online and conventional pulmonary rehabilitation
- MyCOPD is being used in over 43 CCG areas
- myCOPD reduces acute admissions,
- An independent economic analysis shows that, taking into account the cost the myCOPD unit, running costs, and training, the average CCG with 5,000 patients with COPD, and 700 COPD admissions per year, would save £217,200 per year
- myCOPD corrects 98% of inhaler errors without any other clinical intervention, resulting in better quality of life.
- Patients using myCOPD showed a mean decrease in CAT score of 4.5 (SD+/-2.8) (P<0.001) over three months.
- The PR feature delivers greater improvements in outcomes such as walking distance, symptoms score and depression than traditional face-to-face classes.
- myCOPD costs £20 per patient for their lifetime, while standard PR alone typically costs £200-£600 per patient. The average CCG savings on PR can be £143,820 a year if deployed to 60-80% of the patient population.
Plans for the future
Simon hopes to see at least 90 CCGs take up myCOPD in the coming year.
myCOPD meets the specification of the new 2017/18 NHS Innovation and Technology Tariff, and has been available for CCGs to procure from 1 April 2017.
Which national clinical or policy priorities does this example address?
myCOPD helps deliver the commitments of the Five Year Forward View. It also helps meet Nice Clinical guideline 101 which states that PR should be offered to all patients who consider themselves functionally disabled by COPD. It addresses NHSE priorities for:
- Care and quality
- Funding and efficiency
- Health and wellbeing
- Driving economic growth.
Start and end date
Contact us for help and advice
Simon Bourne, Respiratory Consultant, Founder of My mHealth
Rebekah Tailor, Communications and Engagement Manager, NHS Innovation Accelerator