The DYNAMIC way to improve patient care
Professor Chris Carlin, Respiratory Consultant, Clinical Lead West of Scotland Innovation Hub, supported by Chief Scientist Office, on how the DYNAMIC project is changing how clinicians and patients manage COPD.
Think about healthcare, and you’ll probably think of hospitals.
But by embracing everyday digital technology, we can provide patient-centred care where the patient lives, rather than bringing them into hospital.
The DYNAMIC project, run by the NHS Greater Glasgow and Clyde-hosted West of Scotland Innovation Hub, which provides remote patient-centred management to people with severe COPD (chronic obstructive pulmonary disease), is just one such example of the benefits of care in a community or home setting.
Once a patient is confirmed as having COPD, they can be referred to the DYNAMIC service. All they need after that is access to an electronic device with internet capability, such as a smartphone, tablet or computer, either personally or through a family member.
Once registered with the service, an online web portal and portable measurement devices are used to manage their condition, with patients provided with a range of self-management tools they access through a smartphone.
Using these digital tools, patients can engage with clinicians or community respiratory response teams who can provide support or intervene, arranging further follow up if required.
The project, part funded by the Chief Scientist Office, began just before the COVID-19 pandemic and has shown how effective remote monitoring of conditions can be, with more than 750 patients now using the COPD digital service as part of their routine care.
COPD affects approximately 140,000 Scots and is the country’s second most common reason for hospital admissions. Patients with COPD may have multiple stays in hospital because of it.
And this is where applying digital technology to home-based care comes into its own.
The DYNAMIC programme saw a 49 per cent reduction in hospital admissions among COPD patients remotely monitored at home.
This makes a huge difference, not just to the DYNAMIC patients –being treated at home, where they are likely to feel more comfortable – but also by freeing up of space for patients with other conditions who require hospital admission.
For those DYNAMIC patients who did require hospital care, the time between admissions increased, from six months up to a year in some cases. When hospital admissions were required, they were typically 4 to 5 days shorter than those that occurred before starting the programme.
By using data collected from digital monitoring, clinicians can provide more efficient care.
Having used these digital tools with COPD monitoring – and proven that they make a positive difference to patients live – we may be in a position to widen what they are used for.
Peer-reviewed publication of NHSGGC data, followed by adoption and evaluation by NHS Highland and Hull University NHS Trust, demonstrates that the service improves patient survival and quality of life, with significant reduction in hospital admissions, readmissions and occupied bed days in the year following onboarding.
DYNAMIC has shown that this model could potentially be used to manage other long-term conditions such as heart failure, or be adapted to undertake intermittent monitoring and lower intensity connected care for conditions such as diabetes, chronic kidney disease, asthma and sleep apnoea.
The management of long-term conditions presents a worldwide problem which will not be dealt with properly unless we are willing to consider alternatives to traditional care pathways.