Pulmonology
COPD Management Optimization

Optimizing COPD Management & Preventing Readmissions with Realize-365

How Pulse Health identifies early respiratory fatigue, standardizes discharge education, and detects outpatient exacerbations before they become emergencies.

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Risk Reduction

30% lower hospitalization risk

Early Detection

Identifies deterioration 12-18h earlier

Clinical Background

Patient: James Whitaker, 67y (Diagnosis: Severe COPD with frequent exacerbations)

Setting: Hospital Admission → Outpatient Pulmonology → Home Health. History: 40 pack-year smoker, HTN, Type 2 DM. Reason for Admission: Acute COPD exacerbation with hypoxemia.

1

Inpatient Phase: Early Recognition of Respiratory Fatigue

Clinical Problem

By hospital Day 2, James appears clinically stable on 2 L/min O2. However, findings like "thicker sputum", rising RR, and mild accessory muscle use are buried across 7 different EMR tabs.

Pulse Health Action

Realize-365 pulls information from multiple EMR tabs to generate AI Summary:

CO2 Retention WarningPaCO2 ↑ 48 → 54 mmHg
Rising RR20 → 26/min over 12 hrs
Sputum QualityThickening, increased volume

Insight: Pattern concerning for early CO2 retention and impending ventilatory fatigue. Recommend ABG reassessment, pulmonary consultation, and consideration for early BiPAP.

Impact

  • Identifies deterioration 12–18 hours earlier than usual.
  • Prevents ICU transfers through earlier BiPAP initiation.
2

Discharge Planning & Patient Education

Clinical Problem

Discharge requires confirming inhaler regimen, O2 settings, and correct spacer usage. Info is scattered across pharmacy lists and notes.

Pulse Health Action

Query: "Compile discharge medication regimen, oxygen titration plan, inhaler technique documentation, missing education items."

Controller InhalerReinforce BID dosing
Rescue InhalerTeach 2-puff protocol
Teaching GapsNo documentation of spacer use

Insight: Patient needs reinforcement on inhaler sequence and spacer technique. Recommend scheduling video-based inhaler demo before discharge.

Impact

  • Cuts discharge preparation time by 15–20 minutes.
  • Reduces early readmission risk.
3

Outpatient/Home Health: Early Exacerbation Detection

Clinical Problem

Two weeks post-discharge, home health notes SpO2 drop, HR increase, and thicker sputum. Most EMRs bury these in free text.

Pulse Health Action

Query: "Show 7-day trend for SpO2, HR, sputum consistency. Assess risk for early COPD exacerbation."

Day 5 SpO2 / HR89% / 98 bpm (Early flare)
Day 6 SymptomsSOB on exertion (High-risk)
Day 7 TrendPersistent flare

Insight: Pattern shows progressive oxygenation decline + rising HR + worsening sputum quality consistent with early COPD exacerbation. Recommend prednisone and early outpatient flare protocol.

Impact

  • Detects exacerbation 2–3 days before symptoms peak.
  • Reduces hospitalization risk by up to 30%.
4

Long-Term Management & Risk Stratification

Clinical Problem

To determine eligibility for CCM (Chronic Care Management), clinicians must know annual exacerbation count and adherence. This info lives in disconnected fragments.

Pulse Health Action

Query: "Extract full 12-month COPD burden: exacerbations, ER visits, steroid courses, refill adherence."

Hospitalizations / ER Visits3 / 2 (Frequent exacerbator)
Steroid Courses4 bursts (Uncontrolled COPD)
Rehab Attendance40% (Suboptimal)

Insight: Patient meets GOLD Group D criteria. Recommend enrollment in CCM: telemonitoring, RT-guided inhaler optimization, pulmonary rehab reinforcement.

Impact

  • Identifies high-risk COPD phenotypes automatically.
  • Enables targeted interventions improving quality of life.

Why this case matters

Early Detection

Pulse Health identifies early signs of respiratory failure (rising RR, CO2 retention) that are often missed in routine checks.

Discharge Safety

Ensuring patients understand their inhaler regimen and O2 use prevents avoidable readmissions and ER visits.

Risk Stratification

Automated analysis of long-term trends helps enroll high-risk patients in chronic care management programs.