2015 ERS EVENTS

DATE: SATURDAY SEPTEMBER 26TH

VENUE: Wyndham Apollo Hotel, AmsterdamROOM: BoardroomTIME: 11:00AM-13.00PM

CO-CHAIRS: Alexandra Dima: Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands

Richard Costello: Associate Professor Medicine, RCSI, Consultant Beaumont Hospital, Dublin, Ireland

TECHNOLOGIES WORKINGGROUP MEETING

Agenda

Meeting Objectives

• Agree terms of reference for the group

• Agree practical implementation steps for small, seed projects

• Discuss and agree 1-2 longer-term projects for the group to support

Terms of reference for the group11.00-11.15AM

What will we be doing…

Terms of reference: scope• Technology-based solutions (TBS): designed to Including (but

not limited to): o Deviceso Appso Web-platforms.

• Technology purpose: o Monitoring (e.g. adherence and medication usage)o Behavioural change

• Geography: International / global• Disease area: Chronic respiratory conditions, specifically, but not

limited to obstructive lung diseases, i.e. asthma and chronic obstructive lung disease (COPD).

Terms of reference: objectives• Explore generic questions associated with respiratory TBS, e.g.:

o Demand / user need; Usability; Effectiveness; Impact; Storage; Standardised, optimised development

• Work collaboratively with other REG working groups to support research activities with specific technology-based components

• Curate and publish information on the current knowledge & evidence available on TBS for chronic respiratory conditions

• Identify unmet research needs in relation to TBS for chronic respiratory conditions

• Work with aligned multi-disciplinary groups to share and develop knowledge for optimising the utility and ethical use of TBS for chronic respiratory conditions and related data

• Providing guidance, in collaboration with wider REG working groups, on opportunities to optimise the research utility of data sets enabled by technology-based solutions (e.g. warehousing, storage, coding, anonymisation).

Unique perspective of the group• REG collaborators have experience in addressing

practical challenges within clinical practice.

• Through REG there is an opportunity to fit the technology-based solution to the needs of the user (rather than fitting an engineering-derived solution to fit a clinical need).

• Position the group as a resource and source of guidance for people who are thinking about developing a technology – what is the “recipe” (similar to that for drug development) that you should follow to develop a TBS?

Terms of reference

Operationalizing Initial Study Ideas11.15AM-11.45PM

Let’s get started…

Overview of initial ideas

• Development of technology-based solutions (TBS): evaluating and describing current development practice

• Changing behaviour: how should health information be fedback to change patient behaviour (literature review)

• Patient preference: optimising TBS interfaces for older people with chronic respiratory diseases

• Stakeholder perceptions: attitudes towards smart inhalers

Development of technology-based solutions

Current Practice• Concept: Explore the optimum way to feedback TBS-

generated health information to change patient behaviour

• Nature of activity: Market Research

• Grant Opportunities:o Wellcome Seed Funding explored as an opportunity –

conclusion = unlikely.o Alternative source required

• Status: Multiple informal discussions with technology developers already conducted by John Blakey

Using TBS to change patient behaviour

Patient “Education”• Concept: Drawing on existing literature: how should health

information be feedback to (positively) change patient behaviour?

• Nature of activity: Systematic review

• Grant Opportunities:o Research / Knowledge Transfer Fellowship within/between current

collaborator group

• Status: Preliminary concept drafted; fellowship opportunities to be explored

User Need & Preference• Concept: Optimising TBS interfaces for older people with chronic

respiratory diseases:o Device (tablet, computer, e-reader); Text size & contrast;

Information / data format (graphs, numbers, video); Navigationo Outcomes: speed of use; accuracy of use; user acceptability;

knowledge retention

• Nature of activity: Prospective patient-centred comparative effectiveness research

• Grant Opportunities: Doctoral and PhD post

• Status: Preliminary concept drafted; target dates for posts to be explored among the group

Preliminary (REG-participant) data from Sam Howard’s PhD11.45AM-12.00PM

Perceptions of Smart Inhalers

Stakeholder perceptions• Concept: An online tool to record what attitudes are

toward smart inhalers amongst users, researchers, and practitioners (brief, can be anonymous)

• Nature of activity: Internet-based questionnaire

• Grant Opportunities: On-going PhD; o REG shared questionnaire via the REG network (via

twitter, newsletter, website). o 18 REG participants

Summary findings

Multi-stakeholder attitudes to smart inhalers suggests the following perception of greatest risks / benefits:

• Benefits: provision of accurate adherence records; securing useful research data; sense of a patient being “watched” can positively improve patient behaviour/adherence; improved symptom control

• Risks: potential for “gaming” the device (e.g. button press not reflecting actual activity); financial considerations – initial coasts and replacement costs; who will clean and interpret the data (not a traditional clinical role); potential to drive conflict between patient-reported behaviour and clinician’s understanding of behaviour (as informed by the technology)

Joining the debate…

ATS 2016 session proposal• Concept: In the rapidly-evolving world of digitized medicine and grown

emphasis for the patient (and patient preferences) to guide and individualize medical management, the session will consider the new e- and m-Health solutions available within Respiratory Medicine, and would aim to support managed release of such devices, by informing and educating ATS delegates about the medical, moral and ethical challenges, as well as opportunities, that emerging technologies bring.

• Presentation titles:o Get Smart: getting the most out of smart technologies o Giving patients back the powero Ubiquitous technologies – digital footprint – a step in which direction o The Digital Panopticon – is feeling watched enough?

• Status: submitted; awaiting decision from the ATS

Call for wider research ideas12.00-13.00PM

What next…?

Ideas put forward so far…

• Standard care with spirometry vs standard care with oscillometry for real-life outcomes in asthma or COPD o Ron Dundurand

• PatientsLIkeMe: starting technology development from the patient perspectiveo Dan Poscover

• Horizon 2020: a standardised pathway for TBS development o Group Discussion

• Application for a technologies ERS Clinical Research Collaboration or taskforce o John Blakey (remote)

• Other...?