1. Background and Aims The poster highlights emerging issues in the initial evaluation of a tele-monitoring system for COPD patients in four practices in Central Scotland using a tele-monitoring system as a vehicle for: early identification of exacerbation communicating and coordinating patient information and care plans across distributed care teams extending access to care services and self care materials at home Research Methods The pilot involved quantitative and qualitative measures involving a wide range of stakeholders in the nexus of patient care. We draw on action research, grounded theory and realistic evaluation, feeding back data for validation, refinement and to support evolving design and implementation of the process as a socio-technical whole. Acknowledgements The research would not have been possible without the generous help of patients, carers, the extended NHS care team, the project implementation team, installation team and also Intel, for the provision of an unrestricted educational grant for the initial pilot. Findings Patients Perceptions Patients were very positive about tele- monitoring in COPD, providing two reasons in particular for this. In the first instance they reported allayed anxiety about delays in accessing treatment - both because of their own unwillingness to bother GPs when unsure, and because of the difficulty in many cases of getting a timely appointment. There’s some times you phone them up for an appointment you can’t get one.. So I feel as if I’ve got that (tele-monitoring system) I’ve got a chance of a doctor anyway. They also reported a reduction in anxiety and a greater sense of security that they were being monitored. Many felt that an externally managed system, based on threshold scores would avoid delay where they hesitated to bother a GP. Perceptions of Care Team Nurses and nurse managers typically saw the effectiveness of such a system as dependent on the wider matrix of communication and coordination of services. In the reconfiguration of services around patients at home, information had to be communicated ‘to the right person, in the right place, at the right time’. In this context, the role of training for home care staff became crucial, as also did interoperability with other systems in use. Other allied health care professionals such as physiotherapists also saw wider opportunities for using the system to extend services to home-based patients in new ways. Contact: J.Hanley@napier.ac.uk, Brian.Mckinstry@ed.ac.uk, Claudia.Pagliari@ed.ac.uk gillian.kidd@nhs.net, Alex.Tarling@gmail.co.uk Jenny.Ure@ed.ac.ukJ.Hanley@napier.ac.uk Brian.Mckinstry@ed.ac.ukClaudia.Pagliari@ed.ac.uk gillian.kidd@nhs.netAlex.Tarling@gmail.co.uk Jenny.Ure@ed.ac.uk Telemetry-Supported Self-Care: an overview of the West Lothian COPD Pilot I don’t like calling a unless I’m really, really bad. And as I said, if you need to see a doctor, and they’re going to inform a doctor then that’s better than me calling them. GPs Perceptions GPs and their practice nurses were aware of an initial integration in workload, as new routines and roles evolved, but balanced this against the very positive feedback from patients. They found benchmark scores alone of limited value and highlighted the need for further context and person specific information. The use of video- conferencing in the second phase is expected to provide a useful way of both adding more input, and negotiating appropriate interventions with patients.