{
  "abstract": "Background Obstructive sleep apnoea (OSA) is highly prevalent yet substantially underdiagnosed in the United Kingdom, with prolonged National Health Service (NHS) waiting times contributing to delayed treatment and preventable morbidity. Manual administration, workforce limitations, and fragmented logistics frequently constrain conventional diagnostic pathways. Digitally enabled, home-based diagnostic models may improve efficiency and access; however, real-world implementation data across diverse NHS settings remain limited.Methods A prospective multi-site service evaluation (May 2025–January 2026) was conducted across Betsi Cadwaladr University Health Board (BCUHB), Northumbria Healthcare NHS Foundation Trust (NUH), and University Hospitals Coventry and Warwickshire NHS Trust (UHCW). Consecutive adults referred with suspected OSA were managed using a fully digital diagnostic pathway (AirConnect Dx), incorporating electronic referral, remote triage, homebased diagnostic device, automated device logistics, and cloud-based analysis.Outcomes were compared with retrospective data from standard care pathways. Primary outcomes were referral-to-diagnosis time, diagnostic completion, and retest rate. Secondary outcomes included estimated healthcare professional (HCP) time (modelled), patient experience (Net Promoter Score [NPS]), and stakeholder feedback.Results Baseline characteristics were comparable across sites (n=807): mean age 50.9–52.4 years, mean BMI 33.2–34.5 kg/m 2, and 36.5%–49.8% female. Diagnostic completion ranged from 79%–98%. Referral-to-diagnosis time decreased across sites from 105–347 days under standard care to 8–21 days with the digital pathway (90%–97% reduction). Detailed stage-level pathway reductions are summarised in table 1. Retest rates decreased from 10%–18% to 0%–7.2%. A minority of patients (10% of patients at BCUHB, 8% at NUH and 14% at UHCW) required additional diagnostic assessment for clinical correlation, consistent with standard clinical practice and reflecting appropriate clinical judgement in cases where further confirmation was warranted.Modelled HCP time decreased by 58%–70%, corresponding to a 2.4–3.2-fold increase in diagnostic capacity without additional staffing. Among 266 respondents, mean satisfaction was 8.6/10, with an NPS of +51.5 (65.2% promoters). Stakeholders reported improvements in operational efficiency, workforce utilisation, and backlog reduction.Conclusions A fully digital OSA diagnostic pathway significantly reduced diagnostic delays and improved efficiency across three NHS organisations, with high patient acceptability. This approach represents a scalable solution to address NHS diagnostic backlogs.Abstract O3 Table 1Comparison of diagnostic pathway timelines (in days): NHS current pathway vs. airconnect Dx pathway",
  "authors": [
    {
      "affiliations": [
        "University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom"
      ],
      "name": "A Ali"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, United Kingdom"
      ],
      "name": "M Anderson"
    },
    {
      "affiliations": [
        "Resmed UK, United Kingdom"
      ],
      "name": "L Bullus"
    },
    {
      "affiliations": [
        "Resmed UK, United Kingdom"
      ],
      "name": "A Ghildiyal"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, United Kingdom"
      ],
      "name": "A Hallas"
    },
    {
      "affiliations": [
        "Resmed UK, United Kingdom"
      ],
      "name": "J Innes"
    },
    {
      "affiliations": [
        "Resmed UK, United Kingdom"
      ],
      "name": "Joanna Murphy"
    },
    {
      "affiliations": [
        "Betsi Cadwaladr University Health Board, United Kingdom"
      ],
      "name": "C Owens"
    },
    {
      "affiliations": [
        "Betsi Cadwaladr University Health Board, United Kingdom"
      ],
      "name": "B Paynes"
    },
    {
      "affiliations": [
        "Betsi Cadwaladr University Health Board, United Kingdom"
      ],
      "name": "J Roberts"
    },
    {
      "affiliations": [
        "University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom"
      ],
      "name": "J Shakespeare"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, United Kingdom"
      ],
      "name": "M Weatherhead"
    },
    {
      "affiliations": [
        "University Hospitals Coventry and Warwickshire NHS Trust, United Kingdom"
      ],
      "name": "J Darley"
    }
  ],
  "title": "O3 Real-world implementation of a fully digital diagnostic pathway for obstructive sleep apnoea in the NHS: a multi-site service evaluation",
  "uid": "2fd275c7-d82a-5de0-9ff5-7836fe328991"
}