Cortellaro Francesca, Taurino Lucia, Delorenzo Marzia, Pausilli Paolo, Ilardo Valeria, Duca Andrea, Stirparo Giuseppe, Costantino Giorgio, Galbiati Filippo, Contro Ernesto, Bertolini Guido, Fenech Lorenzo, Sechi Giuseppe Maria
Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), 20124 Milano, Italy.
Pronto Soccorso e Medicina D'Urgenza, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Epidemiologia (Basel). 2025 Jul 11;6(3):36. doi: 10.3390/epidemiologia6030036.
he surge in the use of Pre-hospital Emergency Medical Systems (EMS) and Emergency Departments (ED) has become a pressing issue worldwide after the COVID-19 pandemic. To address this challenge, we developed an experimental and innovative care pathway supported by telemedicine. The aim of this study is to describe the activity of the Integrated Medical Center (CMI): a new telemedicine-based care model for patients referring to the Emergency Medical System. A prospective observational study was conducted from January 2022 to December 2022. The CMI was established to manage patients referring to the Emergency Medical System. From January to December 2022, a total of 8680 calls were managed by CMI, with an average of 24 calls per day. 6243 patients (71.9%) were managed without ED access of whom 4884 patients (78.2%) were managed through telemedicine evaluation only, and 1359 (21.8%) with telemedicine evaluation and dispatch of the Home Rapid Response Team (HRRT). The population treated by the HRRT exhibited a higher age. The mean satisfaction score was 9.1/10. Telemedicine evaluation allowed for remote assessments, treatment prescriptions, and teleconsultation for HRRT and was associated with high patient satisfaction. This model could be useful in future pandemics for managing patients with non-urgent illnesses at home, preventing hospital admissions for potentially infectious patients, and thereby reducing in-hospital transmission.
在新冠疫情之后，院前急救医疗系统（EMS）和急诊科（ED）使用量的激增已成为全球范围内的一个紧迫问题。为应对这一挑战，我们开发了一种由远程医疗支持的实验性创新护理路径。本研究的目的是描述综合医疗中心（CMI）的活动：一种针对转诊至急救医疗系统患者的新型远程医疗护理模式。于2022年1月至2022年12月进行了一项前瞻性观察性研究。CMI的设立是为了管理转诊至急救医疗系统的患者。2022年1月至12月，CMI共处理了8680个呼叫，平均每天24个呼叫。6243名患者（71.9%）在未进入急诊科的情况下得到管理，其中4884名患者（78.2%）仅通过远程医疗评估得到管理，1359名患者（21.8%）通过远程医疗评估并派遣家庭快速反应团队（HRRT）得到管理。由HRRT治疗的人群年龄较高。平均满意度评分为9.1/10。远程医疗评估允许对HRRT进行远程评估、治疗处方和远程会诊，并与患者的高满意度相关。这种模式在未来的大流行中可能有助于在家中管理非紧急疾病患者，防止潜在感染患者入院，从而减少医院内传播。
