Telemedicine: A cornerstone of healthcare assistance during the recent pandemic outbreak of COVID-19 but also a great opportunity for the future. A pilot experience in the largest Teaching Hospital in Southern Italy.

Abstract Background: At the end of 2019, Wuhan, China, experienced an outbreak of a novel coronavirus. The epidemiologic burden of COVID-19 is constantly evolving, with numbers of infected persons, hospital admissions and deaths growing near exponentially. The recent pandemic outbreak of COVID-19 worldwide caught the health care systems in every country around the world by storm and without a proper defense mechanism to cope and control such a pandemic. In fact, this outbreak is causing an overwhelming burden of illnesses that stresses health system capacity and adverse effects on healthcare workers including the risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. In this paper the Authors reports their own experience with Telemedicine. Methods: During the “lockdown”, the AOU“Federico II” was forced to create peculiar pathways to ensure the safety of the patients and medical staff, and to keep an appropriate medical assistance, therefore it was introduced the telemedicine, wherever possible, by modifying the Information Technology (IT) related to the waiting times, rescheduling all booked visits and identifying several outpatient’s clinics suitable for telemedicine activities. Besides, safe pathways were properly studied to screening all patients who had a medical consult in person.Results: Since the introduction of telemedicine service, 953 consultations were provided in this way, about 13 % of all medical consults delivered by AOU “Federico II” in this period; 97,38% of them were follow-up visits, that otherwise would have been missed during the current pandemic, so an economic loss has been avoided. In addition, it has been calculated that, using Telemedicine visits vs a face-to-face consultation, about 65-70% of direct costs were spared by our Healthcare Company.Conclusions: Telemedicine has been the keystone that has allowed a rapid, appropriate response of whole overloaded healthcare systems to current Pandemic, and, as reported by Ohannessian et al., all stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks, and the COVID-19 pandemic is a call to adopt the necessary regulatory changes supporting wide adoption of telemedicine.