The "Lazio ADVICE" telemedicine platform: First results of general practitioners' usage, facilitators and barriers in the Local Health Authority Roma 1.

Background: Telemedical approaches represent a valuable tool for the management of coronavirus disease 2019 patients, allowing daily clinical assessment, monitoring of vital parameters, remote visits, and prescription of treatment or hospitalization in case of clinical worsening. This cross-sectional study aims to evaluate the use, barriers and facilitators of the "Lazio ADVICE" telemedical platform, a regional system for remote assistance for coronavirus disease 2019 patients at home, according to General Practitioners and Family Pediatricians of the Local Health Authority Roma 1, during the coronavirus disease 2019 pandemic. Methods: An interview-based survey was performed between December 2020 and January 2021. The survey investigated the demographic information of General Practitioner and Family Pediatricians, the knowledge of the platform, frequency of utilization, usefulness, strengths and weaknesses, and hypothesis of future implementation proposed. Results: We interviewed 214 physicians and 89 (41.6%) were classified as users and 125 (58.4%) as non-users. Older age and working in District 1, 14 and 15 (vs. District 13) significantly reduced the probability of using the platform physician. Among the 89 users, 19 (21.3%) used the platform every day or even several times a day, 40 (44.9%) several times a week but less than one access per day, 30 (33.7%) used the platform several times a month up to one entry per week. Most of them (92.3%) consider the platform useful. Barriers were poor integration with software and work routine (76.4%), and usability issues (53.9%). Among the 125 non-users, 14 (11.2%) didn't know the existence of the platform, 60 (48.0%) never tried it and 51 (40.8%) tried to use it. Reported reasons for the interruption of use were not very user-friendly (45.1%), perceived useless (37.3%), non-optimal functioning (23.5%), and lack of time (19.6%). Conclusion: The pandemic accelerated the implementation of telemedicine services around Lazio Region, starting a positive and continuous exchange of experiences, activities and best practices among physicians.

Rethinking the COVID-19 Pandemic: Back to Public Health.

The COVID-19 pandemic has highlighted vast differences across countries in their responses to the emergency and their capacities to implement public health measures that could slow the progression of the disease. As public health systems are the first line of defense during pandemics, it has become clear that sustained investment in strengthening public health infrastructure is a major need in all countries, irrespective of income levels. Drawing on the successful experiences of Switzerland, Georgia, and New Zealand in dealing with COVID-19, we suggest prioritizing core public health capacities with links to the International Health Regulations, improving international cooperation, coordination, and multisectoral action, addressing health inequities by targeting vulnerable groups, and enhancing health literacy, including through sophisticated and sustained communication campaigns to build resilience. These measures will ensure that health systems and communities will be better prepared for the disruptions that future disease outbreaks will inevitably bring.