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 working with NuvoAir to create a virtual clinic for CF patients at the Royal Brompton Hospital. Out of the 600 adult CF patients, there are currently over 300 patients using NuvoAir technology 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:

Su you have been working with NuvoAir for some time. What do people with CF think about using the technology?

All the people I have to spoken to so far have been very enthusiastic about it. They are excited to look at their lung function trends. They like the control that they have and being able to show us their data. It’s a very different ethos us from us as a healthcare team owning it and just showing it back to them - they are in control. They like discussing the results with us as we go through the trends. It has been a very positive experience and the adults here are very engaged.

There’s sometimes a perception that people don’t want to share their health data, what has been your experience?

So far we have not had a problem with that. Patients willingly share their data with us.

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

I think the enthusiasm and willingness for us to work together and take this forward. It isn't NuvoAir telling us what to do or us telling them what to do, it’s been very much a partnership. 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 would be your advice for someone who is considering setting up a virtual clinic?

Firstly the team needs to decide whether to run the evaluation of the virtual clinic as a service improvement or to initiate it as part of a research project. At the Brompton, we decided the former as it increased the speed of implementation and required us to think more holistically around operational issues that needed regular modifications. It allowed us to make numerous iterations based on feedback from staff and patients. Especially since the technology is getting better and better. The Air Next spirometer is fantastic and people really love using it and want us to use it more.

A good place to start is to identify the clinicians who have the time to be involved, the money to buy the technology and secure the space to do it in. I would recommend testing the equipment and process on the staff first and finding a quiet 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, needs of family members and their life. Digital health tools and sharing data between patients and clinicians will really help us to do that.

There’s huge potential for digital health tools to help people with long term conditions take more responsibility for their health. People with CF generally want to take ownership over their condition and be part of the decision making. Therefore, 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.