Interview with Dr. Su Madge from The Royal Brompton Hospital

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The other week we had the chance to sit down with Su Madge PhD, the Director of the Adult CF service at the Royal Brompton Hospital. Su has been working with children and adults with CF since 1979 and works as a CF consultant nurse.

Su has been involved with developing national and international guidelines and standards of care in CF and has taught around the world. Su has been helping NuvoAir create a virtual clinic for CF patients at the Royal Brompton Hospital. Out of the 600 CF patients, there are currently close to 200 patients using NuvoAir remotely.

NuvoAir, the Royal Brompton Hospital and adults with CF have worked in close collaboration to specifically design the program and ensure its success. Take a look at the interview we had with Su about our partnership:

You have been working here at the Royal Brompton with NuvoAir for some time and you have talked about how you have developed the technology together. What do the adults with CF think about having a smartphone enabled spirometer and an app?

All the people I have spoken to so far have been very enthusiastic about it. They are excited to look at their trends. They like the control that they have and showing us the data, not us owning it and re-showing it back, they are in control. They like discussing the results with us as we go through the trends. It’s a very positive experience and they are very engaged.

There is a perception that people don’t want to share their data with the healthcare team. What is your experience in that?

There has never been a problem with that. Patients willingly share their data with us, that’s the whole point.

What has been the best part about working with a digital health startup like NuvoAir?

I think the enthusiasm and the seeming willingness for us to work together and take this forward. It isn't them telling us what to do or us telling them what to do, it’s been very much a partnership to develop it together. The project overall has also brought forward enthusiasm from the adults with CF and that all three, the tech company, the clinicians and the patients are working together, is what has made this the most exciting.

What is your advice for someone who wants to start a virtual clinic based on spirometer data?

From a clinical perspective, the team needs to decide whether to run the virtual clinic as a service improvement or to initiate it as part of a research project. We decided for the former as it increased the speed of implementation and required us to think more holistically around operational issues.

There used to be some issues with talking over distance, but the technology is getting better and better. The technology especially with the Spirometer is fantastic and people really love using it and want us to use it more.

Identify the clinicians who have the time to be involved, the money to buy the technology and the space to do it in. Test your equipment and confidential space so you don't get interrupted during a consultation with a patient.

What part do you think technology will play in the future of CF?

We used to treat everyone the same, basically one size fits all and over time we have realized that all CF isn't the same and that we should personalize our care more to people's disease and their needs, family members and life. Digital innovations will really help us to do that.

The digital part has been pitched to help people with long term conditions take more responsibility for their health. People with CF generally take ownership over their condition and are part of the decision making. Anything in the digital space must be done in partnership with the patient and for them to accept and be excited about the development. I see it working very well, but we have to do this together, not designing something and telling them how it should be used.