(by Andrea Bisciglia, cardiologist and director of Aidr digital health observatory) The response in the emergency and in the darkest moments that our country has gone through in recent months has come from digitalization. Primarily in healthcare, a sector that in the light of Covid -19 has perhaps shown all its fragility more than others. The use of technologies applied to the web has allowed the national health system not to collapse under the weight of the pandemic and to withstand the shock wave of one of the most important health emergencies in contemporary history, underlines Andrea Bisciglia, cardiologist and head of the AIDR Digital Health Observatory. Just look at one of the weakest links in the sector, local medicine. There, where shortcomings are atavistic, digitalization, often launched in a hurry, has been the most effective means of guaranteeing assistance. This is the case of the telemedicine service, which in the months of forced closure of the clinics allowed to continue to monitor the state of health of patients, through the electronic transmission of data. The remote consultation, started on an experimental basis for some time, has undergone a very strong acceleration, thanks to the use of latest generation Hi-tech supports.

High-tech tools and new means of communication, to keep in touch even from a distance. In these months of emergency, the vast majority of patients have familiarized themselves with new digital means of communication in order to be able to speak with the family doctor. WhatsApp messages have been the most used means, certainly still lucky, to be able to receive the prescription of drugs and medicines. Just a few months before the pandemic, according to a study conducted by the Politecnico di Milano, 7 out of 10 patients had declared that they preferred direct contact with the doctor, and that they were unable to use digital systems. Before Covid only 12% of those who were more familiar with digital systems used WhatsApp for communications with their doctor, today the figures are different. Of course, WhatsApp is not the panacea for all ills, but it has made it possible to send medical prescriptions in absolute safety and at no cost. A possibility foreseen even before is clear, but how many endless queues have we seen in our clinics to be able to collect the prescription? It is truly paradoxical if we consider that we already have suitable technologies to be able to send medical prescriptions not only to the patient, but also to the pharmacist.

Reliability, extreme transmission speed, capillarity are the main characteristics of digitalization in the healthcare sector. Then there is a no less important secondary effect, highlighted by the pandemic: the optimization of the service. In the wake of a process of corporatization that has involved the Italian system for over twenty years, telemedicine services and new technologies have proven to be able to respond adequately in terms of effectiveness and efficiency. Remote management with teleradiology, telemedicine, APPs or technologies used on ambulances for remote reporting of the electrocardiogram, a life-saving element in the event of a heart attack in progress; in fact, they allow the optimal management of health personnel, responding among other things to the chronic shortage of personnel. It is estimated that with telemedicine services up to 5% of healthcare costs could be saved, a percentage that rises to double figures if we look specifically at the system of care for patients suffering from chronic diseases. Yet, despite the foregoing, digital healthcare has always been a field of experimentation until March 2020, left to the goodwill of professionals, with peaks of excellence and excellent results, never included in an overall design. The government's decision to invest over a billion and a half for the next three years is therefore welcome to finally start the digitization process in the sector, starting with the electronic health record. It is necessary to focus on staff training and at the same time adopt guidelines that are valid throughout the national territory, in order to be able to give a single response to the patient's needs from North to South of the country.

Telemedicine to the rescue of the health system. Lesson not to be forgotten in time of Covid

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