In the United States, chronic obstructive pulmonary disease (COPD) affects over 16 million people, costs $32 billion per year, and is the fourth leading cause of death.Exacerbations of COPD are among the most devastating complications of COPD, because they greatly increase the risk of death and account for 60% of COPD costs.Efforts have focused on standardizing recommendations for therapies that improve symptoms and limit exacerbations, identifying patients who might benefit from these treatments, and increasing compliance with recommended therapies.Surprisingly, only about 50% of COPD patients receive recommended therapies for COPD and COPD exacerbations, up to two-thirds of COPD exacerbations are not reported to health care providers,and only half of primary care physicians use COPD guidelines. Therefore, novel methods to improve health care delivery could bring substantial benefits, and may be particularly important given the disruption in health care due to the recent coronavirus 2019 (COVID-19) pandemic.