Chronic obstructive pulmonary disease (COPD) is a global health problem throughout the world. It’s not only the fourth cause of death with 600 million deaths every year, but it’s also the most rapidly increasing pathology in terms of mortality in industrialized countries and in 2020 it will become the second cause of death (WHO data). Moreover it’s impact is largely underestimated. Only one patient on four is diagnosed, often with delay, and this obviously reduces therapeutic chance. Consequently, COPD is often identified and cured only in late stages, while it constitutes an important health problem also in younger people (from 45-50 years). Recent studies estimated an average cost of 1.300 euro per patient every year, which can increase to 7.000 euro in more severe stages. A tailored management of COPD patients would obviously allow to reduce costs for hospitalizations and improve quality of life. This management could benefit of the Information and Comunication Technology support, which can offer the possibility of telemonitoring patients without the need of repeated hospital visits and improving the efficacy of healthcare services. Moreover, the high frequency of exacerbations and their often atypical clinical presentation in the aged patient make particularly desirable the availability of a telemonitoring system which could guarantee continuous control and early intervention in case of necessity. The use of telemonitoring systems in COPD patients has already demonstrated a moderate efficacy in reducing hospidalizations and other related outcomes (Pedone C et al. BMC Health Serv Res 2003), but evidence is not homogeneous (Pedone C e Lelli D Pneumonol Alergol Pol 2015). A further improvement of the impact of telemonitoring systems on health status of COPD patients could derive from Decision Support System (DSS), able to predict clinical events (i.e. exacerbations) and to assist healthcare providers in monitoring or predicting events on the basis of variation of clinical parameters, not directly collected with conventional strategies.