JMIR Publications

ABSTRACT

Background:

Telemedicine enables the provision of health services at a distance using information and communication technologies and includes different types of services: telemonitoring, remote control, virtual visit or televisit, tele referral, teleassistance, medical teleconsultation, health professionals’ teleconsultation and tele rehabilitation. There are not many studies in the literature investigating the use of telemedicine in cardiology in Italy.

Objective:

Aim of this study is to illustrate the results of the survey on telemedicine in cardiology conducted by the Department of Cardiovascular, Endocrine-metabolic diseases and Aging of the Italian National Institute of Health. One of the ultimate objective of this mapping is to provide help in the future design and use of telemedicine services in cardiology in Italy.

Methods:

The "Telehealth quality of care tool" (TQoCT), from the World Health Organization (WHO) was used as a model. A survey was disseminated through a link to operative units (OUs) of hospital and university cardiology identified through the 8th Census of Cardiological Structures in Italy, by ANMCO, from June 2024 to October 2024. The facilities were contacted by email and/or telephone. The survey was built through Microsoft Forms and composed of a questionnaire of 52 questions, divided into 6 sections. The analysis was carried out for the whole national territory and by geographical area.

Results:

443 hospitals were contacted; response rate is 56.7%. Overall, 78.9% of facilities report telemedicine initiatives, providing telemonitoring (64.6%), tele referral (52.5%), medical teleconsultation (47%), tele-visit (41.4%), health professionals’ teleconsultation (32.3%) and tele rehabilitation (0.5%). The most frequently followed cardiovascular conditions are heart failure, ischemic heart disease and cardiac arrhythmias, especially atrial fibrillation. Fifty-one per cent of facilities use deliberations, procedures, protocols and/or informed consent for their activities and 46% of the reported services are paid. Lack of dedicated staff, complexity on organizational terms and lack of technological equipment in the structure are principals’ health professionals’ obstacles; lack of familiarity with technology is the principal one for patients.

Conclusions:

There are still organizational and clinical limitations to resolve, in order to make telemedicine in cardiology an integral part of medical practice. The true challenge of Telecardiology probably is the integration of available technology with precise, concrete and simplified organizational models. As a tool, technology is fundamental, if only it is accessible and adequate. However, it must be integrated with new paths built according to the needs of the territory, patients and health personnel. Clinical Trial: The survey was submitted to the National Ethics Committee for Trials of Public Research Institutions and other public bodies with a national character (CEN), that approved the study on May, 17 2024, with protocol no. 0021567.