Ten Years of Experience With a Telemedicine Platform Dedicated to Health Care Personnel: Implementation Report.

BACKGROUND: Telemedicine, a term that encompasses several applications and tasks, generally involves the remote management and treatment of patients by physicians. It is known as transversal telemedicine when practiced among health care professionals (HCPs). OBJECTIVE: We describe the experience of implementing our telemedicine Eumeda platform for HCPs over the last 10 years. METHODS: A web-based informatics platform was developed that had continuously updated hypertext created using advanced technology and the following features: security, data insertion, dedicated software for image analysis, and the ability to export data for statistical surveys. Customizable files called "modules" were designed and built for different fields of medicine, mainly in the ophthalmology subspecialty. Each module was used by HCPs with different authorization profiles. IMPLEMENTATION (RESULTS): Twelve representative modules for different projects are presented in this manuscript. These modules evolved over time, with varying degrees of interconnectivity, including the participation of a number of centers in 19 cities across Italy. The number of HCP operators involved in each single module ranged from 6 to 114 (average 21.8, SD 28.5). Data related to 2574 participants were inserted across all the modules. The average percentage of completed text/image fields in the 12 modules was 65.7%. All modules were evaluated in terms of access, acceptability, and medical efficacy. In their final evaluation, the participants judged the modules to be useful and efficient for clinical use. CONCLUSIONS: Our results demonstrate the usefulness of the telemedicine platform for HCPs in terms of improved knowledge in medicine, patient care, scientific research, teaching, and the choice of therapies. It would be useful to start similar projects across various health care fields, considering that in the near future medicine as we know it will completely change.

Managing chronic pathologies with a stepped mHealth-based approach in clinical psychology and medicine.

Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the "chronic care management" challenge in both traditional and mHealth settings.

Telepathology in emerging countries pilot project between Italy and Egypt.

Pathological examination includes gross & microscopic examinations at different magnification. Through the steps of examination, we obtain many images that can be used for telepathology. Telepathology is the practice of pathology at a distance, viewing images on a monitor rather than directly through a light microscope. It can be used for primary diagnosis, second opinion, quality assurance and distance learning. Telepathology is classified into Static, Dynamic, Hybrid and Whole Slide Imaging (WSI). We have a successful experience in Egypt in applying the static & dynamic techniques in a pilot project between the Italian Hospital in Cairo (NPO) and the Civico Hospital in Palermo. This project began in 2003 and continued till now. From the second year 2004, Ospedale S. Giovanni e Paolo Hospital in Venice, Charing Cross Hospital in London and the University of Pittsburgh Medical Center Health System (UPMC) in the USA participated actively in our project. During the past five years we consulted on many problematic pathological cases with these different specialized pathological centers in Italy, UK & USA. In addition to the highly specialized scientific value of consulting on the cases and exchanging knowledge, we saved a lot of time and money and succeeded in providing our patients with a better medical service.We are now in the process of establishing a Digital Telepathology Center (DTC) in the pathology department, Cairo University, using the latest technique of telepathology which is Whole Slide Imaging (WSI). We believe that it will help us to improve and extend diagnosis for our difficult pathological cases and will facilitate increased E-learning opportunities for staff and students both in Egypt and in the longer term in the wider Eastern Mediterranean.

Teleconsultations as a step towards hospital interoperability.

The paper presents an interregional telemedicine project between hospitals from two countries that encourage good economic cooperation. It uses modern technology and diverse human resources that contribute to a better accomplishment of the goals of the project and insures continuity of the services after the ending of the project. It instantiates the vision of e-Europe regarding access to healthcare services and the increasing mobility of patients.

[The health technology assessment]. / La valutazione delle tecnologie sanitarie.

The aim of this paper was to describe exhaustively, but concisely, the matter of the health technology assessment. It is a method of evaluating health technologies based on principles and tools of Evidence Based Medicine. We started from etymology to speak about its definition and implementation methodology. Moreover we guide the reader throughout the constellation of international societies of health technology assessment and the meaning of their international cooperation. Finally, we deal with the health technology assessment as a tool being an integral part of the clinical governance process.

The goals and the perspectives of the common research and development work: the Italian-Hungarian bilateral programme.

According to health politicians at present, the modernisation of the health care system is a continuous task of the health policy of governments. The core of this modernisation: to have information about the needs of the population and the patients, to ensure immaterial and material conditions of health care, to organise and direct the process of health care in the interests of the favourable results of the outcome of care activities. The fundamental conditions of the modernisation to update the health information systems are harmonised on an international level. The main goal of the bilateral program is: to develop and introduce health informatics telemedicine systems for transmission and integration of information systems and health data between structures in Hungary and Italy. The program contemplates doing problem-oriented electronic patients record structures with a flexible, interactive and high operation-speed knowledge basis network for health institutes of both countries.