DIGIVENT

It is estimated that COPD will be the third leading cause of death by 2030.[1] More than 250 million people worldwide already suffer from this irreversible narrowing of the airways.[2] In Europe, treatment and lost productivity costs amount to 48.4 billion euros per year.[3] Non-invasive ventilation (NIV) is a non-drug treatment option for some advanced COPD patients. It can improve quality of life and long-term survival. The new findings on the effectiveness of NIV in a selected group of patients, the expected increase in the number of patients prescribed NIV and the already noticeable shortage of specialists could become a health policy problem. Innovative digital solutions are needed to meet these challenges. "With DIGIVENT, we want to develop a solution that supports the guideline-based initiation and monitoring of non-invasive ventilation in COPD patients outside the hospital and thus enables sufficient and high-quality care in the future," explains Thomas Vollmer, Senior Scientist at Philips GmbH Innovative Technologies Aachen and project coordinator.

Studies confirm the benefits of NIV for COPD

Numerous scientific studies confirm the importance of NIV as a treatment option for COPD patients. For example, a British study from 2017 supported by Royal Philips showed that COPD patients with persistent hypercapnia after a life-threatening exacerbation benefit from home NIV. The risk of having to be hospitalized again or dying within the next twelve months was 17% lower in the group receiving long-term oxygen therapy plus NIV than in the group receiving oxygen alone; the risk of a new exacerbation was reduced by 25%.[4]

Guideline advocates cross-sectoral care and networking

NIV is still initiated and monitored as part of an inpatient stay in hospital lasting several days. However, the S2k guideline "Non-invasive and invasive ventilation as therapy for chronic respiratory insufficiency - 2017 revision" states that "cross-sectoral care for patients receiving outpatient ventilation is generally desirable."[5] This is where the DIGIVENT project comes in. "DIGIVENT aims to investigate whether the initiation and monitoring of NIV in COPD patients should in future be carried out by medical staff outside the hospital under telemedical medical supervision," says Prof. Dr. Michael Dreher, Director of the Department of Pneumology and Internal Intensive Care Medicine at RWTH Aachen University Hospital and initiator of the project.

[1] http://www.who.int/respiratory/copd/World_Health_Statistics_2008/en/

[2] Global Burden of Disease Study 2016, http://ghdx.healthdata.org/gbd-2016

[3] European Lung White Book. The cost of respiratory disease, www.erswhitebook.org/chapters/the-economic-burden-of-lung-disease/

[4] Murphy, Patrick B. et. al: Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation. A randomized clinical trial. JAMA, 2017. https://jamanetwork.com/journals/jama/fullarticle/2627985

[5] https://www.awmf.org/uploads/tx_szleitlinien/020-008l_S2k_NIV_Nichtinvasive_invasive_Beatumung_Insuffizienz_2017-10.pdf, Chapter 5.4

BMBF

Digitalized healthcare

Philips GmbH Innovative Technologies Aachen

Kairos GmbH

University Hospital Aachen

Daniel Keuchel, Britta Böckmann and Nicolai Spicher. Semantic verification during BPMN modeling of healthcare processes by integrating Shapes Constraint Language (SHACL) graphs. In Proceedings of the 64th Annual Conference of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), Dortmund, Germany, 08.-11.09.2019

Kamil Lorek