Hypothesis: The development of patient-focused tools and care processes will enable a transition from predominantly office-based CF care to a more convenient, co-produced model. The increased utilization of remote care will be associated with improved adherence to disease monitoring and complication screening guidelines and will increase patient satisfaction. Specific Aims: 1. Customize a patient-facing smartphone application (Nudge) designed to "coach" each patient toward a co-produced goal of convenient and effective health monitoring within the context of enhanced remote care. 2. Develop care processes that facilitate monitoring of respiratory status at home, using home spirometry and remote sputum collection, that include education, electronic reminders, and specimen collection/shipping supplies 3. Implement care processes that allow convenient access to necessary screening procedures, using the Nudge application to provide well-timed electronic reminders and track performance of screening tests.

Assessing the ability of a sensor for inhalers to measure inhaled volume and improve inhaler technique

We are performing a clinical study to determine the optimal frequency for medications for infected pleural fluid, referred to as intrapleural enzyme therapy (IET). Participants will either receive once daily IET or twice daily IET. We hypothesize that once daily IET will be non-inferior to twice daily IET.