Telemedicine in Emergency

Emergency events are always very critical to manage as in most cases there is a human life risk. Such events could become even more serious when occurring in remote areas not equipped with adequate healthcare facilities, able to manage life risk. This is the case in many rural geographical areas. In such scenarios telemedicine can play a very important and determinant role. This is mainly the basis of the experience described in the following chapter about telemedicine application in a small hospital located in the town of Branca, near Gubbio Italy. The first aid department, responsible for emergency support in a territory where distances between houses and hospital is quite important and the lack of healthcare structures and speedways connections makes it even more difficult, has decided to use telemedicine solutions to face the emergency events. The experience has shown how the use of Videocommunication based telemedicine systems has improved the service and what procedural impact the adoption of such technology has required. A brief description of the experience and highlights of the service still under experimentation will be shown in the following.

Telemedicine and Alzheimer Disease

The focus of this chapter is to asses a new model of care in dementia, particularly Alzheimer’s Disease (AD). According with sociotechnical approaches, the authors describe a proof of concept, Information and Communication Technologies (ICT) intervention, as a technical and organizational model of robust, reliable, and efficient clinical practice to meet the medical, psychological, and social needs of AD people and their family. The authors also propose the “Identification-Recognition-Evaluation-Application Model” as process methodology in a telemedicine project. In this perspective, the technology has to be analyzed as technology-in-use, a process coming out from an ecology of specific actions and actors. Finally, the authors describe their experience of a longitudinal study in which ICT networking technologies are used to implement coping strategies, in order to improve the quality of life of AD families.

Remote Electronic Monitoring in Chronic Pulmonary Diseases

In this chapter the main aspects of telemonitoring are described and discussed in the field of chronic respiratory diseases. The authors describe the various challenges they faced, in the order in which they did. First, they face the problem of effectiveness of the method, then, the problems related to the economic viability, and finally, the problems related to the operating method. The authors conclude that remote monitoring is a promising method in terms of effectiveness of follow-up that must be performed under well controlled conditions. They still require further validation studies to improve the effectiveness and reduce the effects of new issues that arise.

The Role of Telemedicine in Paediatric Cardiology

Paediatric cardiology is a subspecialty ideally suited to telemedicine. A small number of experts cover large geographical areas and the diagnosis of congenital heart defects is largely dependent on the interpretation of medical imaging. Telemedicine has been applied to a number of areas within paediatric cardiology. However, its widespread uptake has been slow and fragmentary. In this chapter the authors examine the current evidence pertaining to telemedicine applied to paediatric cardiology, including their own experience, the importance of research and, in particular, economic evaluation in furthering telemedicine endeavours. Perhaps most importantly, they discuss the issues relating transitioning a pilot project into a sustainable clinical service.

Global Telemedicine and eHealth

This chapter is about the intersections taking place globally in the delivery of healthcare. In today’s world, quality health is about access: access to transportation to the hospital, access to the right people, doctors, nurses, and specialists, and the doctor’s access to the latest lab tests and equipment. But in our future, all of this goes away. You do not need transportation, as medical ecosystems are becoming ubiquitous. Access to the best medical care available means access to the hospital system living in the cloud. The best labs are built into our phones whereby today’s array of sensors can be focused on prevention and delivery systems designed for keeping people healthy. Behind this is the driving vision that medicine will be transformed from reactive and generic to predictive and personalized, reaching patients from the cloud through their telephones in their own homes, making up for a coming shortage in doctors and nurses. Where this brings us is that there is an abundance of confusion as to what Telehealth and eHealth is or what it will be. This chapter addresses an eHealth definition for review, thoughts on eHealth systems, resistance to change issues to be considered, the CVS Minute Clinic’s introduction of innovation and disruptive eHealth care models and systems, a Systems Engineering Management proof of concept project with the Kansas Department of Corrections, and globally oriented conclusions and recommendations. (Diamandis & Kotler, 2012).

Policies on Telemedicine-Enhanced Hospital Services

Modern telemedicine offers to hospitals a whole range of opportunities to improve the appropriateness of their care provision, to offer new services to primary care and to contribute to patient engagement. In this chapter, the authors briefly discuss their approach to facilitate the collaborative production of region-wide telemedicine roadmaps involving the hospitals, explicitly based on national and regional healthcare strategic priorities. In addition, as an operational contribution to support their approach, they introduce a conceptual frame for evaluating and prioritizing multiple ICT-enhanced innovation interventions, within an all-inclusive plan. The proposed frame captures relevant evaluation criteria belonging to four broad categories: the systemic benefits related to the quality of care; direct economic factors; the cultural viability; and the technological feasibility. As an example, the authors simulate an application of our conceptual frame to the comparative assessment of three kinds of telemedicine-enhanced interventions: (i) to improve the care processes driven by the hospital, (ii) to support health professionals, and (iii) to promote citizen’s engagement.

Sensorized Garments Developed for Remote Postural and Motor Rehabilitation

Every day, all around the world, millions of people request postural and/or motor rehabilitation. The rehabilitation process, also known as Tertiary Prevention, intends to be a sort of therapy to restore functionality and self-sufficiency of the patient, and regards not only millions of patients daily, but involves also a huge number of professionals in medical staffs, i.e. specialists, nurses, physiotherapists and therapists, social workers, psychologists, physiatrists. The care is given in hospitals, clinics, geriatric facilities, and with territorial home care. For the large number of patients as well as the medical staff and facilities necessary to support the appropriate postural and motor training, the monetary costs of rehabilitation is so large, it is difficult to estimate. So, every effort towards a simplification of the rehabilitation route is desirable and welcome, and this chapter covers this aspect.

Life Style Evaluation by Accelerometer

The assessment of the Spontaneous Motor Activity (SMA) of the life style (LS) is fundamental to establish the daily Physical Activity (PA) dose as therapy. The recent employment the accelerometer (AiperMotion 440 PC –Aipermon GmBH – Germany), can immediately distinguish “active” from “sedentary” subjects providing a larger adhesion to the exercise program. The study aims to verify the role of the accelerometer. 28 obese-hypertensive were evaluated either by the questionnaire or by the accelerometer. A larger sedentary LS in the population investigated was found by the accelerometer respect of questionnaire. After three months of regular physical exercise, the body compositions parameters, investigated principally, resulted to be improved. The accelerometer determines a real and objective visualization of the LS expressed as PAL resulting on a direct early improvement of the parameters strongly related with the cardiovascular risk. The results support the educational role of the employ of the accelerometer.

Telemedicine R&D Influencing Incoming Strategies and Organization Models

In the modern medicine and surgery, innovations arise from interdisciplinary work. Therefore, to analyse how telemedicine R&D is influencing strategies and organizational models in healthcare systems we have to study how ICT and robotics innovations can interact with structured healthcare services on a large scale. The problem is interdisciplinary, and the answer has to be on different levels: economical, technological, and organizational. Overall, change needs of two paradigms from telemedicine to telematic medicine and surgery and from financial strategies for saving to lean thinking for innovations. The innovation of value can be obtained when healthcare organization combines innovative telematic medicine and surgery services with utility, prices, and costs. To work on these innovations without rearranging the whole organizational flow around the future e-health service means inducing the healthcare organization to generate wastes and face unnecessary expenses attached to future healthcare processes with such high and probably unsustainable costs.

Health Services through Digital Terrestrial Television

This chapter defines a scenario for providing Health Services through the Digital Terrestrial Television (DTT), both for patients (monitoring health parameters) and healthy citizens. A number of services will be provided over DTT, not only by means of informative or interactive applications broadcast and installed on the set-top box, but also as transactional services through the secure return channel. However, much effort has to be spent to guarantee the usability of that new TV-based interface, which is quite different from that of a PC-based Web application.