Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

Author:

Pietrantonio Filomena12ORCID,Vinci Antonio34ORCID,Maurici Massimo5ORCID,Ciarambino Tiziana6ORCID,Galli Barbara7,Signorini Alessandro2,La Fazia Vincenzo Mirco89ORCID,Rosselli Francescantonio10,Fortunato Luca11,Iodice Rosa11,Materazzo Marco1213ORCID,Ciuca Alessandro14,Cicerchia Lamberto Carlo Maria1516,Ruggeri Matteo217,Manfellotto Dario1819,Rosiello Francesco121420ORCID,Moriconi Andrea21

Affiliation:

1. Internal Medicine Unit, Castelli Hospital, Asl Roma 6, 00072 Rome, Italy

2. Departmental Faculty of Medicine, St. Camillus University of Medicine and Health Sciences, 00131 Rome, Italy

3. Local Health Authority Roma 1, 00193 Rome, Italy

4. Doctoral School in Nursing Science and Public Health, University of Rome “Tor Vergata”, 00133 Rome, Italy

5. Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy

6. Department of Internal Medicine, Luigi Vanvitelli University, 81100 Caserta, Italy

7. Casa Circondariale Rebibbia, Nuovo Complesso Prison, 00185 Rome, Italy

8. Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, TX 78705, USA

9. Department of Systems Medicine, Division of Cardiology, Tor Vergata University, 00133 Rome, Italy

10. Cardiology and Coronary Intensive Therapy Unit, San Francesco di Paola Hospital, 87027 Paola, Italy

11. Studio Legale Fortunato, 00100 Roma, Italy

12. Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, 00100 Rome, Italy

13. PhD Program in Applied Medical-Surgical Sciences, Breast Oncoplastic Surgery, University of Rome Tor Vergata, 00100 Rome, Italy

14. Department of Infectious Disease and Public Health, Sapienza University of Rome, 00185 Roma, Italy

15. General practitioner School, ASL Latina, 01100 Latina, Italy

16. Local Health Authority Roma 5, 00036 Palestrina, Italy

17. National Centre for Health Technology Assessment, National Health Institute, 00153 Rome, Italy

18. UOC Medicina Interna, Fatebenefratelli Isola Tiberina-Gemelli Hospital, 00186 Rome, Italy

19. “Centro Studi” FADOI, 20123 Milan, Italy

20. Department of Hystological, Anatomical Sciences and Legal Medicine, Sapienza-University of Rome, 00196 Rome, Italy

21. Department of Business and Management, LUISS University, 00197 Rome, Italy

Abstract

Background: In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios. Methods: To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient’s perspective). In this perspective paper, the main findings of these studies, from the operators’ point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner. Results: Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization. Conclusions: The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases.

Funder

Fondazione FADOI

Publisher

MDPI AG

Subject

Electrical and Electronic Engineering,Biochemistry,Instrumentation,Atomic and Molecular Physics, and Optics,Analytical Chemistry

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