BackgroundCOPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services.ObjectiveThe aim of this study was to compare COPD patients’ care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals’ (HCPs) perceptions about the current pathways.MethodsHCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview.ResultsLack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers.ConclusionService and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients’ engagement could optimize current care pathways resulting in a better integrated system.

We propose WELCOME, an innovative integrated care platform using wearable sensors and smart cloud computing for Chronic Obstructive Pulmonary Disease (COPD) patients with co-morbidities. WELCOME aims to bring about a change in the reactive nature of the management of chronic diseases and its comorbidities, in particular through the development of a patient centred and proactive approach to COPD management. The aim of WELCOME is to support healthcare services to give early detection of complications (potentially reducing hospitalisations) and the prevention and mitigation of comorbidities (Heart Failure, Diabetes, Anxiety and Depression). The system incorporates patient hub, where it interacts with the patient via a light vest including a large number of non-invasive chest sensors for monitoring various relevant parameters. In addition, interactive applications to monitor and manage diabetes, anxiety and lifestyle issues will be provided to the patient. Informal carers will also be supported in dealing with their patients. On the other hand, welcome smart cloud platform is the heart of the proposed system where all the medical records and the monitoring data are managed and processed via the decision support system. Healthcare professionals will be able to securely access the WELCOME applications to monitor and manage the patient's conditions and respond to alerts on personalized level.

AEGLE project 1 targets to build an innovative ICT solution addressing the whole data value chain for health based on: cloud computing enabling dynamic resource allocation, HPC infrastructures for computational acceleration and advanced visualization techniques. In this paper, we provide an analysis of the addressed Big Data health scenarios and we describe the key enabling technologies, as well as data privacy and regulatory issues to be integrated into AEGLE's ecosystem, enabling advanced health-care analytic services, while also promoting related research activities.

In this paper, we consider the design methodology of a mobile patient hub for the remote self-management of COPD patients. The patient hub design forms a part of the WELCOME system. WELCOME is a current EU project that aims to design and develop a new mobile health system to provide integrated care for COPD patients with comorbidities. The approach adopted for this research is based on the Web of Things architecture with RESTful principles as the enabler of communications. The proposed patient hub architecture design is based on three layers: an application layer, a middleware layer and the sensors layer. This paper presents the detail of the initial design of the middleware and an analysis of the architecture in the context of the system's requirements.

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