IMPLEMENTATION OF TELEMEDICINE IN ASST BERGAMO EST: RESULTS ACHIEVED

Abstract The Healthcare Trust Bergamo Est (ASST–bergamo Est) started a telemedicine project in 2020, setting up a Telemedicine Team and a managment model called “TEELEMEBII strategy” (see dedicated abstract). Three years after their establishment, the four minimum Telemedicine services required by the legislation, are active: Televisit, Teleconsultation, Home monitoring, Teleassistance (Figure 1). Televisit has been active in the company in six Units: Rehabilitative Cardiology, Diabetology, Home Artificial Nutrition, Gynaecology, Addiction Service and Pain Therapy. Teleconsultation was developed in two healthcare contexts: Teleconsultation among General Practitioners and Specialists: the GPs can ask for a teleconsultation with the hospital physicians of ten specialties. Multidisciplinary teleconsultation for the discussion of complex clinical cases. The diagnostic–therapeutic process of patients with head–neck cancer is discussed in teleconsultation with the synchronous participation of Otolaryngologist, Oncologist and Radiation Oncologist and, if necessary, Radiologist, Anatomopathologist, Speech therapist, Nutritionist. Other multidisciplinary teams are activating this service. Telemonitoring allows transmission of clinical parameters through wearable sensors. The service, primarily provided by nursing staff, is active in Rehabilitative Cardiology for patient with chronic heart failure and in Electrophysiology Clinic for patients with implantable devices (PM, ICD, wearable defibrillator). A feasibility project is being activated in Gazzaniga Community House where nursing staff can remotely monitor vital parameters of fragile patients. Teleassistance provided by a nurse is based on the remote interaction between the professional and the patient. Nursing teleassistance is active, associated with telemonitoring, for patients with chronic heart failure, diabetes mellitus and fragile patients. Data express the positive impact of the implementation of the management model (Figure 2): Medical specialties involved in company telemedicine processes went from 7 in 2022 to 18 in the first half of 2023, with an increase of 157%; The number of operators with access to the company‘s telemedicine platform increased from 33 in 2022 to 107 in the first half of 2023, an increase of 224%; Televisits provided since the beginning of 2022 are approximately 800; in the first half of 2023 there were 293, 38.2% more than in the same period of the previous year.