Telemedicine: Current Status and Future Perspectives

Abstract

41 Using a widely available technology (a computer with a webcam and dedicated platforms that can ensure patients’ data safety), a virtual consultation can be established between patient and clinicians in total safety. Besides the evident convenience for patients (who can overcome the travel and parking issues and are not required to find an accompanying person), telemedicine offers some peculiar advantages, such as: y getting a more informal assessment of mental status thanks to the opportunity to observe patients in their home environment; y gather other social information, e.g.: y living environment; y interactions with family and caregivers; y patients’ lives at home [11]. The most significant question is whether telemedicine is comparable (“as good as”) to in person consultation in terms of outcomes and quality. In some non-inferiority studies, tele-psychiatric outcomes were deemed as not inferior to in person care in terms of diagnosis and treatment, decreasing length of hospital stays, improving medication adherence, and reducing symptoms in conditions such as posttraumatic stress disorder on an evidenced based level [2]. Unfortunately, this comparison has not been made in other specialties. Despite its attractivity, this tool has some obvious limitations: Telemedicine and telehealth are often considered synonyms, but while telemedicine refers particularly to clinical patient care, telehealth includes all the educational, administrative, and other non-clinical healthcare activities. Although the roots of telemedicine date quite far back, the modern era of telemedicine started in 1968: in that date, the Massachusetts General Hospital (MGH) became the first hospital-based multispecialty telemedicine practice offering remote clinical examinations to travelers and airport workers at Logan International Airport [1]. Historically, telemedicine has been applied in several medical specialties such as psychiatry, cardiology, pediatrics, gynecology, geriatrics, with general patient satisfaction [2-9]. With the evolving technology, more specific applications of telemedicine have been developed, e.g., tele-dermatoscopes (pecific general patient cameras mounted on webcams or smartphones and controlled by app) have been used to monitor skin lesions [10]. During the COVID-19 pandemic, telemedicine has been increasingly used to bypass the severe restrictions for outpatients’ visits and access to hospitals. As often happens, an urgent need (in this case the necessity to guarantee follow up for patients suffering from chronic conditions who cannot postpone their visits) became the driving force to rapidly develop and implement telemedicine and telehealth systems. Editorial