Digital innovation at scale: the story of MyCOPD and the NHS tariff

Written by Tara Donnelly, Chief Executive at Health Innovation Network

MyCOPD is the first patient-facing digital product to be awarded funding under the innovation and technology tariff. I’ve a great interest in how we support people with long term conditions to support themselves to best effect, and think it is fantastic that we have now got a digital solution at such scale within this country.

The COPD challenge

As you may know Chronic Obstructive Pulmonary Disease (COPD) is the umbrella term for a range of relatively common progressive lung diseases including emphysema, chronic bronchitis, and refractory asthma. Progressive means it sadly inevitably gets worse over time. Features are “exacerbations” –  when breathing becomes exceptionally difficult and specialist assistance can be needed.

In fact, respiratory disease including the COPD group is the second most common reason for emergency hospital admission in this country, and it is highly seasonal. And we are – as you’ll be well aware – coming out of a particularly brutal winter with the worst performance in terms of access since records began in 2004.

It is also much more common in people who are vulnerable and are deprived / in lower social economic groups, with 90% sufferers having smoked and the vast majority having other comorbidities.

Although COPD is a chronic lifelong and worsening condition, it is highly amenable and responsive to self management. If people with COPD do all of the following they maximise their likelihood of living well for longer with the disease:

• Stop smoking if still smoking
• Undertake a Pulmonary Rehabilitation programme which is an exercise and education programme that is evidenced to make a significant difference
• Keep doing the exercises after the programme
• Achieve optimal inhaler technique
• Track symptom scores regularly
• Monitor the weather and environmental issues
• Be able to cope well when breathless without panicking – learning and practicing mindfulness techniques can help.

It’s a long list. Challenging even for those with every advantage.

A digital approach

An entrepreneurial British Respiratory physician has developed a digital platform that covers all aspects. It uses the behavioural insights knowledge combined with great technology to make this a manageable task. The innovator, Simon Bourne, got early support from his local AHSN Wessex, also the Health Foundation, and won an SBRI grant (an R&D grant administered by the AHSN Network for promising ideas) and the product is now in use nationwide.

Examples of its amazing impact include:

• Around 90% of people with inhalers do not have optimal technique meaning that these important drugs are unable to do their job. The tool has been demonstrated to achieve 98% optimal technique through patients watching and copying videos of how to use the particular inhaler that they have.
• Over 20,000 patients have now completed the online Pulmonary Rehabilitation course. This is a huge number and we could anticipate that this year it will exceed those we manage to get on a Face to Face programme which is typically 15,000 – 20,000 across the NHS.

The Royal College of Physicians recently published an Audit of Pulmonary Rehab courses and demonstrated that most people have to wait over 90 days to get on a programme (60%). A very high proportion don’t attend at all, although it is a highly evidence based intervention. So complementing face-to-face classes with this online availability can only be a good thing.

In total 100,000 licences have been purchased. Part of the reason for this rapid growth is that it’s a great product but this is also a rare story of different parts of the NHS aligning with each other brilliantly and to great effect. After that early support Simon Bourne was successful at getting on the NHS Innovation Accelerator, and then made the NHS England tariff. It was one of the first products to join the NHS Apps Library, and if, as a patient, you look up COPD on NHS Choices it tells you all about it there.

The end result of all this? Tangible benefits for patients. Like Paul, a COPD patient who tells his story in this terrific short film.