In Europe, chronic diseases account for about 75% of health budgets and are the cause of 85% of premature deaths. While the Italian population is aging, in fact, there are also growing concerns about the sustainability of a national health care system that is at times obsolete, which is struggling to keep up with emerging innovative technologies and is in difficulty from various points of view.
In this article, we illustrate the potential of ehealth in the chronically ill patient management and of all those innovative technologies that mark the path that leads to the effective and efficient health care of the future.
CHRONIC DISEASES: HOW TO MANAGE A CHRONICALLY ILL PATIENT WITH EHEALTH
Thanks to the advances in medicine and to its link with technology, life expectancy has lengthened and this has led to the need to find solutions to manage chronic illness.
Today chronic diseases are widespread worldwide: heart disease, stroke, cancer, diabetes, chronic illness of the respiratory system, musculoskeletal and gastrointestinal tract disorders, vision and hearing defects and other chronic genetic diseases such as mental ones.
It can be defined as “chronic” that patient who has been living with one or more pathologies that require continuous treatment for a long time, pathologies that are not meant to heal but still allow a good quality of life if kept under control through visits and examinations.
The management of chronically ill patients offers different starting points for reflections concerning the health field, as well as the social and economic one. Having a large number of chronically ill patients for many years is a burden on the health system due to the high costs involved. In fact, the treatments involve the support of various services and professional figures who must assist the patient in his/her daily life, with visits and examinations. In chronic pathologies, even the psychological aspect has an important role: stress, anxiety and depression can have a negative impact on the pathology itself and on the adherence to treatment. Without forgetting the importance of actively involving the patient and his/her family and social life context, as well as the creation of new protocols and therapies that allow the treatment of chronic illness to be managed in a more functional way. Think of obesity and diabetes, chronic diseases that need the periodic monitoring of the patient’s vital parameters.
TELEMEDICINE, EHEALTH AND BENEFITS FOR PATIENTS
In a context that sees the necessity to find innovative solutions to meet citizens’ needs, we find telemedicine, the whole set of applications of technology in the health sector and the contribution offered for chronic conditions, together with ehealth. The Italian Ministry of Health itself has highlighted how the investment in innovative ehealth solutions aims at improving the health service, through the optimisation of doctor/patient relationship thanks to the adoption of user-friendly technological tools, therefore easy to use for patients of all ages.
The benefits offered by these solutions are related to the impact that ICT can have in some specific health areas, such as those related to cardiovascular and cerebrovascular illness, respiratory diseases, diabetes and psychiatric diseases, both for the child and for the adult during rehabilitation:
In addition, it is important to mention the practical benefits offered by telemedicine, such as the possibility of obtaining a remote consultation with your doctor, or the monitoring of vital parameters through specific medical software, without necessarily having to go to the health facility of reference.
Telemedicine, if introduced into the chronic patient’s health care facility, would significantly reduce (by 45%) the mortality rate due to chronic diseases, precisely because the continuous monitoring of the patient reduces the rate of aggravation of the disease. Telemedicine protects against the risks of complications, especially in the case of cardiovascular diseases, the metabolic syndrome and diabetes. Furthermore, through the telehealth services, doctors can assist patients in various phases, from the diagnosis to the monitoring and management of chronic conditions. In doing so, the chronic patient is led to be more responsible also through the transmission of data, which can be automated or carried out manually by the patient itself.
The term “telecare services” refers instead to all those services and devices that use ICT to communicate urgent and dangerous situations to the health worker or to the family of patients suffering from chronic diseases or elderly people living alone. Being always in touch with assistance and support services, allows families to face aging and chronic conditions with more tranquillity.
The fact that telemedicine responds promptly to the urgencies of the population and the chronically ill patients, also has positive effects on the health system itself:
Introducing telemonitoring for cardiology patients would lead to a 26% reduction in hospitalisation days, a 10% saving in health costs and an increase in the survival rate of 15% (Digital Agenda).
CHRONIC PATIENTS MANAGEMENT IN LOMBARDY
An example of a regional health system that in recent years has adopted a new model for managing chronic and/or frail patients is Lombardy. From January 2018, a medical manager organises all health and social-health services to meet the needs of the patient suffering from chronic disorder, planning specific treatment interventions and prescribing the most appropriate pharmacological treatments. The advantage for the patient is being relieved of the responsibility of booking visits and exams, a thing that he/she may forget to do.
With this model, the Lombardy Region guarantees the citizen suffering from chronic pathologies open access to treatments and continuous health and social care assistance. The services required for the management of chronic patients are associated with a “reference set” of services, illustrated in the Individual Assistance Programme.
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