Patients promote remote care delivered in the year of the pandemic and ask for no return when the emergency is over. A opinion shared also by specialists, but with some doubts related to the intensity of treatment and the management phases of the various pathologies, in relation to the individual patient: for health professionals, in fact, one of the key points from which to start redesigning health care, with a view to capillarity and therapeutic continuity, is undoubtedly the implementation of the remote assistance, but as a supplement to face-to-face visits, and not as a substitute approach.
This is what emerges from the research “Teleservice at the time of Covid19: the point of view of citizens and professionals” realized by the Operational Unit for Quality and Clinical Governance of the Romagna AUSL – one of the largest healthcare companies in Italy, covering 5,100 square kilometers of territory with 1,300,000 users and over 15,000 employees – in collaboration with the Social Innovation Service of the Emilia-Romagna ASSR, who photographed the cross-section of the region’s health care offer between July and October 2020. Approx 3 out of 4 patients (the 74%) out of a total of 953 people belonging to the services of Diabetology, Pediatrics, Neurology and Oncology, they evaluated the remote assistance services provided by the SRG with an “excellent” or “good” rating, which, for the 57% of the interviewees, they turned out valid in the same way as visits in person. Furthermore, the 63% of patients were in favor of continuing to use these services in the future.
On the other hand, many of the specialists involved in the survey felt they were stressed that teleservice cannot be considered the same as face-to-face visits: therefore, the decision to offer a remote service will have to be evaluated case by case, on the basis of the specific type of patient, therapeutic path and necessary assistance or treatment. A need, that of concrete appreciation by the health professional, about the opportunity of the remote visit, which is perceived as essential, across the board and without significant distinctions, among all the specialists involved in the survey.
From a qualitative point of view, a data of interest emerges regarding the degree of patient involvement through the services offered remotely: for almost all the participants, through the use of remote assistance it was possible keep the relationship between specialist and patient strong. The periodic contact with their clients has allowed the specialists to remain ‘close’ to them and to reassure them, counteracting the sense of loneliness and bewilderment, especially in the elderly. In other words, at a time when proximity and closeness were in fact impossible, the Tele-assistance has certainly represented the tool through which to bridge the therapeutic continuity gap caused by the emergency, and it has proved crucial too in therapeutic patient education, another element considered valid even beyond the pandemic situation.
“The investigation we conducted confirmed that the time is ripe for a crucial change: the remote assistance can become a structural method of taking charge by the NHS “, comments Mattia Altini, Health Director of the Romagna company.
As he points out Nunzia Boccaforno, Director of Quality and Clinical Governance Unit, telecare “However, it must be modulated by health professionals, on the basis of the specific care and therapeutic needs that are based on the specific condition of each patient. We therefore need to understand which patient characteristics are appropriate for this care approach. These could be concretely evaluated only by each specialist and in relation to each patient”.
“From this point of view, the Covid-19 it was simply a process catalyst, but also of our ability to observe and evaluate the phenomenon, more than ever in the area of chronic conditions, which have paid the highest price and which, not by chance, we have identified as the chosen ground for our investigation. The survey results tell us that we need to investments certainly in digitization, but also in the training of the healthcare personnel involved in these activities, so that it is possible to reconcile a reform of the Health Service in terms of sustainability and proximity, but also of effectiveness, in terms of performance and return to health for citizens ” need Tiziano Carradori, AUSL General Manager of Romagna.