Giuliano
Reboa
Talking
about telemedicine and health telematics it's opportune to make clear which
are the factors determining the success or endangering the development of
these two applications since the medicine and the technology world are hand
in glove with each other. A remarkable critic factor comes from the fact
that by now the sizeable part of initiatives and experimentation regarding
telemedicine has been carried forward in Italy most by private centres.
But in the sizeable part of the cases these attempts have not been successful
because of the magnitude of the required investments. Furthermore who has
attempted to enter this sector often was not able to have an enough number
of users. Such situation has provoked the introduction on market of products
very few related to the medical-scientific requirements. Such phenomenon
has prevented the settlement of guidelines directed to create satisfactory
quality standards and to set exact rules for whom supplies telemedicine
services. So it's very strong the risk that products do not correspond to
expectations and on consequence at all the potentialities of this sector
are not developed. So it is required that the employed equipment is linked
to Iso
9002 certificate
services centres, so to be able to give a reliable control about quality
regarding both the adopted technology and the intervention procedure. The
National Health System on the other hand has never arranged by the means
of its regional organisms an investments and incentives structured program
to foster initiatives favouring the employ of telemedicine. On the contrary
there are often oppositions to the rationalization policies of the health
structure over territory by some classes of health operators and managers,
sometimes due to the lack of aptitudes for technology. Another serious problem
for whom operates in these sectors is the lack of legislative rules governing
the medico-legal aspects concerning the responsibility of the involved operators.
To all that it must be added the scarce consent some physicians give to
the application fields and to the benefits of some telemedicine applications.
These reservations are often for fear of losing status by specialists or
to presumed problems about the compatibility of telemedicine with the traditional
idea of the medical profession. The telemedicine world and the health telematic
is affected furthermore by an excessive fragmentation of experiences besides
a lacking of or a bad structured promotion, advertising and trade actions
by the enterprises operating in this sector. Finally it must not be undervalued
the fact concerning that often, to launch on marked products and services
linked to telemedicine, potential clients have been wrongly searched among
patients without considering the need to propose them to physicians first.
First, it's essential to facilitate the rising of services centres linked
to telematic nets able to manage a huge amount of data that must be constantly
on disposal of physicians. To do that huge investments are obviously 
required,
both private and public allowing also giving incentives and allowances to
operators who by the means of the telemedicine, will contribute to lower
the admission in hospital structures. On the other side it is required to
urge a regional policy oriented to spread telemedicine among first-aid stations,
health emergency operators, prompt action structures and general medicine
physicians. It must be defined finally the standardisation of the managing
procedures both regarding the technique-organization aspects and those more
strictly medical. This target must be achieved favouring collaboration among
universities, manufacturing enterprises and physicians associations oriented
to the rationalization of the employed technologies that must be submitted
to quality certification controls. Nevertheless as already pointed out,
to achieve telemedicine growth, health operators must be considered as the
main interlocutors to spread the service: patients must play a role only
after capacitating physicians adequately. Telemedicine is surely destined
in future to gain more spaces since it will allow to reduce remarkably the
hospital enterprises costs and the Local Health Enterprises' ones. At the
same time it will better the physician-patient relationship. The first one
indeed will have in real time the clinic data of the latter that, as for
him, will avoid long stays in hospitals and in many cases will cure himself
at home. A decisive factor for the telemedicine development is the collaboration
between government and health organs, not only Italian but also belonging
to the European Union. The services net linked to health must not stay inside
the territory limits of a State but they must allow the EU member countries
citizens to have on disposal an integrated system.
Giuliano
Reboa
Presidente Associazione Italiana di Telemedicina e Telematica Sanitaria
Leadership Medica®
Mensile di scienza medica e attualita`
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