Uptake of telehealth implementation for COPD patients in a high-poverty, inner-city environment: A survey

This study aimed to investigate computer and internet access and education attained in patients with chronic obstructive pulmonary disease (COPD) as potential barriers to implementation of telemedicine. We prospectively assessed 98 patients admitted with an acute exacerbation of COPD (mean age: 70.5 ± 9.3 years; force expired volume in the first second: 0.75 ± 0.39 L; 59% male) recording educational level attained and home computer and internet access. Hospital readmission surveillance occurred up to 2.7 (2.6–2.8) years following the index hospital admission. Only 16% of patients had a computer and only 14% had internet access; this group were younger and more educated than those without a computer. There was no difference in hospital readmissions over 2 years between those with and without access to a computer or internet. Only 12% of the whole cohort were educated to a school leaving age of 16 years and this group were more likely to be still working. School leaving age was directly associated with fewer hospital readmissions (r = 0.251, p = 0.031). In conclusion, these data highlight the current challenges to the widespread implementation of telehealth in COPD patients as there is limited availability of computer and internet access with such patients demonstrating a lower level of education achievement.