Inhalers that tell you before they run dry. Oxygen equipment light enough to carry out of the front door. A way of distinguishing whether sudden breathlessness is anxiety or the first sign of a dangerous flare-up. These are not the wish lists of engineers chasing the next technical breakthrough, but the priorities of the people who actually live with lung disease and treat it every day. They form the core of a new study from the University of Oxford, published in the journal Thorax, which has produced one of the most systematic attempts yet to ask patients, carers and clinicians what respiratory technology they actually need rather than what the market happens to be selling.
The research, known as the HERON study, was led by the Nuffield Department of Primary Care Health Sciences at the University of Oxford together with the NIHR HealthTech Research Centre in Community Healthcare. Over five months, from June to November 2025, the team surveyed 314 people across all four nations of the United Kingdom, asking them to describe the biggest problems in respiratory care and the places where technology might help. The responses amounted to nearly 1,300 distinct challenges and ideas, which the researchers then sorted and refined into 73 separate areas where a device, app, test or data system could plausibly make a difference to care.
What happened next is what gives the study its force. Rather than simply publishing a wish list, the team checked each of the 73 areas against what already exists, ranging from early laboratory prototypes to products currently on sale. The results were stark. In 52 of the 73 areas, they found nothing adequate on the market or in development. A further 21 areas were only partly covered by existing technology. And not a single area met the demanding bar the study set itself: a suitable solution already in routine use at scale across the UK. The authors note that the picture may have shifted in the time since they completed their review, but the overall message is difficult to escape. The technology that patients and clinicians want most is, for the most part, not the technology being built.
This mismatch matters because the scale of respiratory disease in the UK is enormous. Around one in five people lives with a lung condition, making respiratory illness the third leading cause of death in the country and responsible for more than 700,000 hospital admissions each year. The burden falls disproportionately on poorer communities, where air quality, housing conditions and access to care combine to worsen outcomes, yet research funding has not kept pace with the scale of the problem. Meanwhile, the market for respiratory technology has grown quickly, but the products emerging from it have tended to follow what is technically possible rather than what users have asked for. Cutting-edge features, the study’s authors observe, do not always match what the people using those products actually want or need.
To break that pattern, the Oxford team adapted a method with a strong track record in a different field. The James Lind Alliance has long brought patients and clinicians together to agree which research questions matter most, a process known as priority setting. HERON turned that same participatory logic onto technology itself, defining the term broadly to include anything from a home lung-function test to a smartphone app to the data infrastructure behind a virtual ward. As far as the authors are aware, no one had previously described a systematic method of this kind for setting HealthTech priorities in chronic respiratory disease, making the study a methodological first as well as a practical roadmap.
The researchers were also deliberate about who they reached. Online surveys, however convenient, systematically miss many of the people most affected by lung disease, including those without reliable internet access, those with low literacy and those whose lives are consumed by managing illness. So alongside the survey, the team went into the community, attending pulmonary rehabilitation classes, a singing group for people living with breathlessness and a respiratory service for people who are homeless. These sessions took place in Greater Manchester, Norwich, Bristol, Nottingham and Weston-super-Mare, and were kept deliberately informal to lower the barriers to participation. The researchers did not collect demographic details at these sessions, so they cannot measure precisely how far they succeeded in broadening the sample, an honest limitation they acknowledge openly.
In March 2026, the longlist was put to the test. Twenty-three patients, carers and clinicians spent a day together working through the 73 areas and narrowing them down to a final top 20. The priorities span the whole journey of living with lung disease, from screening people who are at risk before symptoms become serious, through day-to-day management, to helping people maintain their gains after a course of pulmonary rehabilitation ends, a point at which support often abruptly stops. Some of the most striking items are strikingly modest in conception: an inhaler that shows when it is running out, oxygen equipment that can leave the house, a tool that helps separate anxiety from the onset of an exacerbation. Each addresses a failure point that patients describe constantly and that current devices simply ignore.
One demand cut across all twenty priorities, and the authors present it as the study’s central design principle. Whatever gets built has to work for someone with poor eyesight, unsteady hands or no confidence with a smartphone, and it has to be affordable to run, both for the National Health Service and for the patient. Accessibility, usability and equity, they argue, cannot be retrofitted late in development or bolted on as an afterthought; they need to be built in from the very start. Dr Helen Ashdown, an academic general practitioner at the University of Oxford who led the study, said that there is enormous potential for technology to improve respiratory care, but that simply developing more technology is not enough. HERON, she explained, identifies not only where the eventual users of technology think innovation could make the greatest difference, but also what they need from those technologies if they are going to work in real life.
The roadmap is already being put to work. The National Institute for Health and Care Research has opened its latest Invention for Innovation, or i4i FAST, funding opportunity for chronic respiratory health technology, and it explicitly encourages applicants to address the HERON priorities in their applications. That means the list is not merely an academic exercise but a live filter through which public research money will flow. The Respiratory Transformation Partnership, a national collaboration between the NHS, government and industry established to improve asthma and COPD care, is also supporting the findings, which will inform its considerations and help connect promising technologies with the needs of patients and respiratory services. Dr Jonathan Fuld, National Clinical Director for Respiratory Disease at NHS England and Chair of the partnership, said that patients should be at the heart of how new respiratory technologies are developed, and that by aligning innovation support with these priorities there is an opportunity to help promising technologies progress from development and evaluation through to adoption in the NHS.
The study was funded by LifeArc, a medical research charity, and its ambitions extend beyond the chest clinic. The method itself, the authors point out, is not tied to lungs. The same structured process of gathering challenges from patients, carers and clinicians, mapping them against the existing technology landscape and distilling a ranked set of priorities could be applied wherever HealthTech priorities need setting, from diabetes to dementia. If it catches on, the HERON study may be remembered less for its list of twenty technologies than for the question it forces the industry to answer before writing a single line of code or moulding a single prototype: who asked for this, and what did they actually say they needed? For the one in five people in the UK living with lung disease, and the clinicians trying to keep them out of hospital, the answer has never been spelled out so clearly.
Subject of Research: Patient and clinician priorities for respiratory health technology development in the UK
Article Title: Respiratory patients and clinicians name the 20 technologies they want most – and could transform NHS lung care
Article References: Respiratory patients and clinicians name the 20 technologies they want most – and could transform NHS lung care. (n.d.). Original publication
Image Credits: AI Generated
DOI: Not provided
Keywords: respiratory disease, health technology, HERON study, University of Oxford, Thorax, patient priorities, NHS, inhalers, COPD, asthma, medical devices, NIHR
Barbara Leach. (October 4, 2026). Patients and clinicians reveal 20 priority technologies that could reshape lung care. Scienmag.
