Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Rare Neurodegenerative and Neurometabolic Diseases Unit, Clinical Neurosciences Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
Neurol Sci. 2021 Jul;42(7):2637-2644. doi: 10.1007/s10072-021-05252-9. Epub 2021 Apr 30.
Lombardy was severely hit by the COVID-19 pandemic since February 2020 and the Health System underwent rapid reorganization. Outpatient clinics were stopped for non-urgent patients: it became a priority to manage hundreds of fragile neurological patients who suddenly had less reference points. In Italy, before the pandemic, Televisits were neither recognized nor priced.
At the Fondazione IRCCS Istituto Neurologico C. Besta, we reorganized outpatient clinics to deliver Neuro-telemedicine services, including Televisits and Teleneurorehabilitation, since March 2020. A dedicated Working Group prepared the procedure, tested the system, and designed satisfaction questionnaires for adults and children.
After a pilot phase, we prepared a procedure for Telemedicine outpatient clinics which was approved by hospital directions. It included prescription, booking, consenting, privacy and data protection, secure connection with patients (Teams Microsoft 365), electronic report preparation and delivery, reporting, and accountability of the services. During the March-September 2020 period, we delivered 3167 Telemedicine services, including 1618 Televisits, to 1694 patients (972 adults, 722 children) with a wide range of chronic neurological disorders. We successfully administered different clinical assessment and scales. Satisfaction among patients and caregivers was very high.
During the dramatic emergency, we were able to take care of more than 1600 patients by organizing Neuro-telehealth in a few weeks, lessening the impact of the pandemic on fragile patients with chronic neurological disorders; this strategy is now stably embedded in our care pathways. In Italy, Telehealth is at present recognized and priced and is becoming a stable pillar of the health system.
自 2020 年 2 月以来，伦巴第大区受到 COVID-19 大流行的严重打击，卫生系统迅速进行了重组。非紧急患者的门诊服务已停止：管理数百名突然减少参考点的脆弱神经科患者成为当务之急。在意大利，大流行前，远程就诊既没有得到认可，也没有定价。
自 2020 年 3 月以来，在 Fondazione IRCCS Istituto Neurologico C. Besta，我们重新组织了门诊服务，提供神经远程医疗服务，包括远程就诊和远程神经康复。一个专门的工作组准备了程序，测试了系统，并为成人和儿童设计了满意度问卷。
在试点阶段之后，我们为远程医疗门诊制定了一项程序，该程序已获得医院管理层的批准。它包括处方、预约、同意、隐私和数据保护、与患者的安全连接（Microsoft 365 Teams）、电子报告的准备和交付、报告以及服务的问责制。在 2020 年 3 月至 9 月期间，我们为 1694 名（972 名成人，722 名儿童）患有各种慢性神经疾病的患者提供了 3167 项远程医疗服务，包括 1618 项远程就诊。我们成功地进行了不同的临床评估和量表评估。患者和护理人员的满意度非常高。
在这场戏剧性的紧急情况下，我们在短短几周内通过组织神经远程医疗为 1600 多名患者提供了护理，减轻了大流行对患有慢性神经疾病的脆弱患者的影响；该策略现已稳定地纳入我们的护理途径。在意大利，远程医疗目前得到认可和定价，并成为医疗体系的稳定支柱。
