The SUMMA Project: a feasibility study on telemedicine in selected Italian areas.

Telemedicine is achieving relevant clinical importance in rural areas in the management of patients. The Second opinion Unificata per Medici di Medicina generAle (SUMMA) Project was designed to evaluate the feasibility of a joint telemedicine service application across general practitioners and clinical specialists in Italy. The secondary objective of the study included the comparison of telemedicine with the routine general practitioners' approach and a cost-effectiveness evaluation. One hundred and thirty-five general practitioners from Lombardy, Molise, and Valle d'Aosta were enrolled. An ad hoc questionnaire was used to evaluate the feasibility, approval, efficacy, and satisfaction of telemedicine among the general practitioners. Ninety-three general practitioners used the telemedicine consultation (responders) for a total of 1,396 calls (1,264 for cardiology, 65 for dermatology, 32 for diabetology, 22 for rheumatology, and 13 for pneumology). In cardiology, telemedicine was used to address all problems without further action in 733 cases (61%). Ninety-eight percent of responders indicate satisfaction with telemedicine. The cost of telemedicine in our study was estimated to be 25.36 Euros/contact. In conclusion, the SUMMA Project demonstrated for the first time clinically the effectiveness of second-opinion consultation by general practitioners and therefore fulfilling the actual needs in areas usually managed by the National Health System.

[The homecare management of chronic heart failure followed up by hospital cardiologists: a pilot study]. / Gestione integrata ospedale-territorio nello scompenso cardiaco cronico: progetto pilota di fattibilità.

BACKGROUND: The management of patients with chronic heart failure turns to new diagnostic and therapeutic approaches, focusing on an integrated network among general practitioners and cardiologists. METHODS: In order to improve heart failure patient care, we developed a pilot study to assess the feasibility of a homecare program including visits performed by hospital cardiologists on request of general practitioners. RESULTS: This pilot study confirmed the feasibility of the collaborative project among general practitioners and cardiologists and the suitability of home visits performed on request. In 80/96 visits (85%) the cardiologist confirmed that home visit could be shared. Preliminary epidemiological data showed an elderly population (mean age 82 years) with prevalence of females (60%); hypertension in 46%, diabetes in 27%, and infrequent access to outpatient visits. CONCLUSIONS: This integrated management showed good results in terms of an improvement of cooperation among general practitioners and cardiologists, and allowed to verify a very high level of diagnostic accuracy of general practitioners.