Abstract
The limited resources and the practice of social distancing during the COVID pandemic create a paradigm shift in the utilization of telemedicine in healthcare. However, the implementation of best practices is hampered in part by a lack of literature devoted to telehealth in bronchiectasis. In this commentary, we examine multiple approaches to structuring of telemedicine care for patients with bronchiectasis, highlight current evidence-based interventions that can be incorporated into the management of bronchiectasis, and describe our experience with telemedicine at the University of Connecticut Center for Bronchiectasis Care during the COVID-19 pandemic. The structural model must be adapted to different local dynamics and available technologies with careful attention to patient characteristics and access to technology to avoid the potential paradoxical effects of increasing patients’ burden and healthcare disparities in underserved populations.
Highlights
Monitoring as an Adjunct to MedicalBronchiectasis is a chronic respiratory disease characterized by permanent abnormal dilatation of the bronchi, driven by chronic airway inflammation
77 stable cystic fibrosis (CF) patients, investigators found that home spirometric measures (FEV1, FVC, and peak expiratory flow rate (PEFR)) have strong correlations with the corresponding baseline lung function and concluded that home spirometry is a reliable device in monitoring CF patients [26]
FEV1 depacity (FIVC)inand can demonstrate flowDespite volumenoloop and time–volume valicline, the early intervention group had a shorter time to their first exacerbation and more dation of the device is being investigated in an NIH-funded randomized control trial
Summary
Bronchiectasis is a chronic respiratory disease characterized by permanent abnormal dilatation of the bronchi, driven by chronic airway inflammation. Cost effectiveness depends on the local healthcare reimbursement system, it is likely that by reducing the number of in person patient consultations, possibly, there would be a reduced cost for patients’ care as a result of exacerbations and hospitalizations [21]. These data have implications for time and cost saving for both patients and the healthcare system with the utilization of telemedicine in bronchiectasis. In addition to reviewing the relevant literature, we cite observations from our telemedicine experience at the University of Connecticut Center for Bronchiectasis Care during the COVID-19 pandemic
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