Psycho-physiological tele-monitoring of human operators in commercial diving: The Life Support System in the SUONO project.

Sea-diving operations for monitoring or intervention are carried out by highly-specialized divers called Certified Commercial Divers (CCD). CCDs operate under highly demanding working conditions in extreme and hazardous environments. Every day consists of an 8 hours' shift. To avoid decompression problems the remaining 16 hours are spent in a hyperbaric environment located aboard the surface vessel or on the platform. These operating conditions require the design of a technologically-advanced device for tele-monitoring, to maximize CCDs' safety. Here we describe a proposal for monitoring and supporting CCDs during operations. We design a dedicated Life Support System (LSS), that captures real-time, vital (heart rate, respiratory rate, accelerometry, etc) and stress-related (heart-rate variability) signals from operators to transmit them to dedicated servers via telematic protocols. LSS is equipped with protocols for tele-medicine/tele-consultation. Our system is being developed within the research project SUONO (Safe Underwater OperatioNs in Oceans).

[Telemedicine and wireless devices in heart failure]. / Telemedicina e sistemi wireless nello scompenso cardiaco.

Telemedicine has the potential to constitute the central element of the future primary care and become an effective means of prevention and early warning of acute exacerbation of chronic diseases. Up to now, the application of telemedicine has found a variety of difficulties, regarding the types and methods of acquisition and transmission of biological signals, the acceptance and cooperation of the patient, etc. The latest technological developments involve the combined use of wireless technologies and smartphones, for the collection and the transmission of data, and specific softwares for their automatic analysis. This paper examines some of the critical aspects in the application of new technologies for heart failure remote management.

Telematic integration of health data: a practicable contribution.

The patients' clinical and healthcare data should virtually be available everywhere, both to provide a more efficient and effective medical approach to their pathologies, as well as to make public healthcare decision makers able to verify the efficacy and efficiency of the adopted healthcare processes. Unfortunately, customised solutions adopted by many local Health Information Systems in Italy make it difficult to share the stored data outside their own environment. In the last years, worldwide initiatives have aimed to overcome such sharing limitation. An important issue during the passage towards standardised, integrated information systems is the possible loss of previously collected data. The herein presented project realises a suitable architecture able to guarantee reliable, automatic, user-transparent storing and retrieval of information from both modern and legacy systems. The technical and management solutions provided by the project avoid data loss and overlapping, and allow data integration and organisation suitable for data-mining and data-warehousing analysis.

A web based health technology assessment in tele-echocardiography: the experience within an Italian project.

Due to major advances in the information technology, telemedicine applications are ready for a widespread use. Nonetheless, to allow their diffusion in National Health Care Systems (NHCSs) specific methodologies of health technology assessment (HTA) should be used to assess the standardization, the overall quality, the interoperability, the addressing to legal, economic and cost benefit aspects. One of the limits to the diffusion of the digital tele-echocardiography (T-E) applications in the NHCS lacking of a specific methodology for the HTA. In the present study, a solution offering a structured HTA of T-E products was designed. The methodology assured also the definition of standardized quality levels for the application. The first level represents the minimum level of acceptance; the other levels are accessory levels useful for a more accurate assessment of the product. The methodology showed to be useful to rationalize the process of standardization and has received a high degree of acceptance by the subjects involved in the study.