The term TH became the most common terminology to describe this integration of information and communication technologies (ICTs) and healthcare services. It is currently the preferred term because it captures the broad applications of this technology in providing healthcare services [9]. The term digital health is a relatively new concept, defined as “the use of digital technologies for health” [10]. Both TH and digital health are broad concepts that might include planning, monitoring, assessment, diagnosis, education, and treatment [10]. In the literature, TH or digital health have been used successfully within different health care disciplines, including cardio-respiratory disease management, and in the provision of home care or self-management for patients with chronic diseases such as COPD [11,12]. In addition, technology can be used in COPD care to improve the timeframe of therapeutic contact, or as an alternative tool when access to care is not available [13] Figure 1.

Systematic reviews and meta-analysis showed that TH solutions that support self-management could contribute to improve user’s skills in controlling COPD, especially those with transport or economic limitations, or geographical barriers [12,14]. Considering the high cost of health care services, the TH approach could lower costs while maintaining quality of treatment in primary care clinics, decrease the pressure on the specialty care clinics, deliver tailored care, and facilitate the coordination of care among healthcare professionals [15]. Also, TH could be an opportunity to facilitate education reinforcement for professionals, patients and/or caregivers [16]. Additionally, digital health allows for frequent reminders to be provided to users to practice behavior which strengthens an existing behavior, like self-monitoring and self-efficacy, or facilitates early interventions for COPD conditions by detecting their exacerbation at an early stage, and could therefore prevent unnecessary emergency visits and hospital readmissions [17,18], as shown in Figure 2.

Development and innovation in digital health are steadily increasing [19]. Looking to digitalization alone as effective tool is not going to provide us with a better result in clinical practice. As clinicians, we could look at this technology as a key part of the package provided to the users. The package usually contains multiple components, which include complex mediums and interventions (i.e., telerehabilitation). However, it is difficult to evaluate the functionality of TH solutions that support disease management without considering three important components: (1) the context that was provided, (2) the mechanisms that package components went through, and (3) the outcomes that the solutions are targeting. The answers to these questions still need further clarification [20,21]. One way to resolve this conflict is understanding the functionality of digital health solutions in COPD management [22,23]. This functionality could be understood from a theoretical perspective by identifying the associations between the context, mechanisms, and outcomes of current TH solutions that support disease management, in other words, the conceptual frameworks that enhance the connection between these elements and make technology a valuable tool in the delivery of care (Figure 3).

The context of TH in COPD management includes three important factors: (1) the clinical setting, (2) digital health development, and (3) targeted populations. A summary of the literature is provided in Table 1.