1.1 Definition and scope of study
Telemedicine is a sub-category of digital health, which includes innovations in the use of information and communication technologies (ICTs) in the health sector. There are multiple and different finalities of telemedicine, which indeed, serve as the basis to distinguish the activity into three main macro- categories:
- Specialized tele-medicine: remote medical services provided within a specific medical discipline, between doctor and patient or between doctors and other health care professionals.
- “Telesalute”: the systems and services that connect patients, especially chronic patients, with doctors to assist them.
- Teleassistance: social-assistance system for taking care of the elderly or fragile person at home.
The Italian market has been receiving awareness and capital inflow recently, since 2016 in fact public expenditure grew by 2-3% per year. In the attempt to leverage on technological advances to transform a traditional infrastructure. Although demand seems to be following more slowly, especially due to the digital divide - in between Italian territories, ages and social upbringings - and general scepticism for this innovative form of health service. Still 26% of Italians state they would not use telemedicine.
Major changes, like the COVID-19 pandemic, have definitely brought forward the condition for the sector to thrive in. In fact, the share of physicians willing or currently using telemedicine services in 2020 has tripled in all categories compared to pre-COVID. The Recovery Fund and Next Generation Italy fund will see billions of euros injected into this sector over the next decade
1.2 The global market
According to Fortune Business Insights, the global telemedicine market is set to grow from $**.* billion at the end of **** to $*** billion in **** with an average annual growth rate of **.*%, driven by a combination of increasing life expectancy, the incidence of chronic diseases and increased patient confidence in adopting and using digital ...
1.3 The Italian market
Telemedicine is a sub-segment of the E-Health (***) or the Ministry of Public Health [***].
Expenditure in digital health Italy, ****-****, in billions of euros Source: ****
Expenditure for digital health, by financing institution Italy, ****, in % Source: ****
Digital health includes the following categories: hospital information systems, information systems for healthcare professionals and archiving services. ...
1.4 The Impact of COVID-19
The COVID-** pandemic was, and is, primarily a huge failing of public health, which then unleased terrible economic consequences. This reality directly intersects with the telemedicine and digital health sectors specifically, and health more generally. The *** billion euro Recovery Plan sets aside almost ** billion euros of investment in public health, and ...
2.1 Different needs and expectations
Pharmacies are a large vector for telemedicine, and, in fact, a large share of Italian pharmacies offer the possibility to conduct various health services and tests through telemedicine.
Share of pharmacies offering tests and service through telemedicine Italy, ****, in % Source: ****
WhatsApp is also an vastly used digital tool for the purpose ...
2.2 Italian's opinion on telemedicine
In ****, telemedicine was not a widely used service. In fact, an Ipsos poll found out that only *% of Italians had already used it.
Answer to the question: 'What of the following best describes your thoughts on using telemedicine?' Italy, ****, in % Source: ****
Conversely however, Italians have overwhelmingly positive attitudes towards the ...
2.3 Unequal distribution of professionals
The ageing of the population also requires the development of solutions for the care of the elderly, particularly in the most isolated areas of Italy. Medical deserts, areas where the number of doctors per **,*** inhabitants is low, are numerous in Italy.
Density of doctors, by region Italy, ****, in doctors per **.*** inhabitants Source: ...
3.1 Individual actors
Italy lags behind other developed nations in terms of telemedicine. For example, the UK has their Babylon Health system which is integrated directly within the NHS for telemedicine and teleconsultations, while the offer France revolves around a framework of regional platforms supported centrally by the state. In Italy, the practice of ...
3.2 Technologies and pros & cons of telemedicine
We can divide the development of telemedicine into four specific areas.
*) Remote visits
In this case the doctor has the possibility to visit his/her patient using video communication systems or applications, from Skype, Zoom, Teams, and other custom solutions developed ad hoc according to the needs of the clinical ...
3.3 Distribution of telemedicine
The digitalisation of patient records facilitates telemedicine processes, in fact the latter is not possible without the former. Doctors and healthcare professionals must have electronic records of their patients to perform any form of intervention or diagnosis from a distance. In Italy these are called Fascicolo Elettronico Sanitario. The graph below ...
4.1 Different offers and support
Since telemedicine is rather decentralised in Italy the offer varies from doctor to doctor, hospital to hospital, clinic to clinic etc. The table below gives a general picture of the type of processes and areas of expertise offered in the field of telemedicine in Italy.
4.2 New governmental initiatives aimed at expanding the offer
Following the conference between the regions and the state, the Ministry of Health released new 'national guidelines for the delivery of telemedicine' at the end of October ****. It addresses new scopes and ambitions for telemedicine and how to invest *.* billion euros in this sector (***) over the next ** years.
The guidelines increase ...
4.3 Tariffs and reimbursement
The national guidelines for the delivery of telemedicine mentioned above also deal with the remuneration system of these processes.
The document establishes that the national/regional regulatory framework regulating access to the various LEAs (***), shall apply to all remote healthcare services. It is also correctly stated that teleconsultation and teleconsultation activities ...
4.4 Innovative offer
The development and integration of more sophisticated technologies within telemedicine has resulted in a variety of new innovative processes.
Telemedicine and Big Data: a winning combination
Telemedicine in itself represents an advantage and an opportunity for the entire healthcare system. The combination with big data and big data analytics unleashes its ...
4.5 Issues and limitations of telemedicine
Despite its vast potential and use, telemedicine has its limitations and faces challenges in its use.
There are two serious endemic problems in Italy that truly limit telemedicine and its processes and these are the lack of digital skills and low connectivity level. Only **% of Italians use the Internet on a ...
There are various regulations regarding telemedicine or related processes, and these are at the national but also regional level. Below is a non-exhaustive list showing some of the most relevant normatives.
Law n.*** from December *th **** defines what telemedicine is and it's parameters Art. * bis of Legislative Decree ***/**** and subsequent amendments ...
- AiSdET (Associazione Italiana di Sanità Digitale e Telemedicina)
- Digital SIT
- Health Italia
- Reply Healthy
- DaVinci Salute
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