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Telemedicine in chronic obstructive pulmonary disease

Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
Breathe 2016 12: 350-356; DOI: 10.1183/20734735.014616
Nicolino Ambrosino
1Fondazione Volterra Ricerche, Auxilium Vitae, Volterra, Italy
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  • For correspondence: nico.ambrosino@gmail.com
Guido Vagheggini
1Fondazione Volterra Ricerche, Auxilium Vitae, Volterra, Italy
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Stefano Mazzoleni
2The Biorobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
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Michele Vitacca
3Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Lumezzane, Italy
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  • Figure 1
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    Figure 1

    An example of eHealth platform. SpO2: oxygen saturation measured by pulse oximetry; GP: general practitioner.

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    Figure 2

    A nurse case manager during a video conference with a COPD patient.

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    Figure 3

    An example of flow/volume curve during a telespirometry.

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    Figure 4

    A physiotherapist case manager during a video training session with a COPD patient.

Tables

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  • Table 1

    Definitions and applications

    TelemedicineDistribution of health services in conditions where distance is a critical factor, by healthcare providers that use ICT to exchange information useful for diagnosis at distance
    TelecommunicationsUse of cable connections, radio, optical means or other electromagnetic channels to transmit or receive signals, such as voice, data or video communications
    TelematicsUse of telecommunications to permit computers to transfer programs and data
    TeleconsultationSecond opinion on demand between patient/family and staff or among health operators; opinions, advice provided at distance between two or more parties separated geographically
    TelemonitoringDigital/broadband/satellite/wireless or Bluetooth transmission of physiological and other noninvasive data (i.e. biological storage data transfer)
    Decision support systemsAccording to a sentinel value, an alert starts for health personnel, who call patient
    Remote diagnosisIdentifying a disease by the assessment of the data transmitted to the receiving party through instrumentation monitoring a patient away from the clinic
    Tele-evaluationOn-demand data transfer to use as biological outcome measures
    TelecareNetwork of health and social services in a specific area; in case of emergency, patient calls medical personnel, emergency call service or members of family
    TelerehabilitationAllows reception of homecare and guidance on the process of rehabilitation through connections for point-to-point video conferencing between a central control unit and a patient at home
    TelecoachingDirect reinforcement or recorded messages/communications to improve adherence
    Teleconference, audioElectronic two-way voice communication between two or more people located in different places
    • Reproduced from [3].

  • Table 2

    Legal risks of telemedicine [3]

    • Teleconsultation may fail to reach standard of care

    • Equipment or system may fail

    • Electronic data can be manipulated

    • Electronic record may be subject to abuse

    • The network may suffer from poor data protection (poor confidentiality, authenticity, data report, procedure certification, security and privacy)

    • The network may show difficulty to ascertain responsibilities and potential obligations of health professionals

  • Table 3

    Barriers to tele-monitoring [3]

    • Lack of knowledge of eHealth among patients, citizens and healthcare professionals

    • Lack of interoperability among different solutions

    • Limited evidence of cost/effectiveness

    • Legal problems and fears

    • Lack of transparency on data utilisation

    • Insufficient reimbursement schemes

    • High start-up costs

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Vol 12 Issue 4 Table of Contents
Breathe: 12 (4)
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Telemedicine in chronic obstructive pulmonary disease
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
Breathe Dec 2016, 12 (4) 350-356; DOI: 10.1183/20734735.014616

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Telemedicine in chronic obstructive pulmonary disease
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
Breathe Dec 2016, 12 (4) 350-356; DOI: 10.1183/20734735.014616
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