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The Role of Telemedicine and EHR in Supporting Care Pathways in the Management of Chronic Illness: The Experiences of the Lombardy Region

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New Perspectives in Medical Records

Part of the book series: TELe-Health ((TEHE))

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Abstract

Nowadays, healthcare systems need to face the growing incidence of chronic diseases and new services have to be planned and managed for elderly people.

This work shows how the regional services in the Region of Lombardy (ten million people) have been set to face this challenge. It takes roots from the recent Regional Act that redesigned the organisation of the regional healthcare system and highlighted the importance to “take care” of the chronic patients. As such, the Act promotes the diffusion of clinical pathways and e-health tools, such as telemedicine, that can be used in an efficient way for monitoring the chronic diseases.

The paper will look specifically at:

  • The existing healthcare information system, as a new development of the regional health information system (Sistema Informativo Socio Sanitario, or SISS)

  • The services offered by the New Healthcare Networks (Nuove Reti Sanitarie, or NRS) for the remote monitoring of patients affected by CHF and COPD

  • The experience of chronic related groups (CReG), a GP-led integrated service for chronic patients

  • The local hospital units (POT), small local hospitals that have been redesigned to provide medium- to low-intensity health and welfare services

It shows how crucial it is to learn from past experiences to identify good solutions for a sustainable and high-quality healthcare system.

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Notes

  1. 1.

    Passmore, O’Shea, and Horney, “Leadership Agility: A Business Imperative for a VUCA World, People and Strategy, Volume 33, Issue 4-2010″Kail, Leading in a VUCA Environment, HBR Blog Network, November 3, 2010 through January 6, 2011.

  2. 2.

    http://ec.europa.eu/health/maor_chronic_diseses/docs/ev_20140403_mi_en.pdf.

  3. 3.

    Regional Act no. 23, August 11, 2015.

  4. 4.

    Law no. 221 of December 17, 2012, no. 221. Conversion into law, with amendments, of Decree Law no. 179 of October 18, 2012, containing additional urgent measures for the country’s economic growth.

  5. 5.

    Definition taken from the 2010–2012 National Waiting List Management Plan (Piano Nazionale per il Governo delle Liste d’Attesa, or PNGLA).

  6. 6.

    Giordano, A. et al. – Home-Based Telesurveillance Program in Chronic Heart Failure: Effects on Clinical Status and Implications for 1-Year Prognosis, Telemedicine and E-Health, 2013; 19 (8): 605–612.

    Vitacca, M et al.- Home-based telemanagement in advanced copd: who uses it most? Real-life study in Lombardy - COPD: Journal of Chronic Obstructive Pulmonary Disease, in press.

  7. 7.

    Region of Lombardy, DGR X/1465 of June 3, 2014.

  8. 8.

    Region of Lombardy DGR X/1465 of June 3, 2014.

  9. 9.

    DGR X/1185 of 2013: A bold step towards taking care of the chronically ill, therefore, begins with the establishment of a separate territorial pole capable of offering its own services and attracting patients as an alternative to the hospital and which, along with the hospital, will form a virtuous circuit of continuity in the territory.

  10. 10.

    DGR X/1521/2014.

  11. 11.

    Regione Lombardia, Libro Bianco – luglio 2014.

  12. 12.

    DGR X/4191 of October 16, 2015.

  13. 13.

    The local hospital units approved in 2014 are Sant’Angelo Lodigiano (LO), Somma Lombardo (VA), two polyclinics and Villa Marelli in central Milan, Soresina (CR), Calcinate (BG), Leno and Orzinuovi (BS), Morbegno (SO) and Vaprio d’Adda and Bollate (MI).

  14. 14.

    “Telemedicine – National guidelines”- State/Regional Agreement of February 20, 2014.

Suggested Reading

  1. Giordano A et al (2013) Home-Based Telesurveillance Program in Chronic Heart Failure: Effects on Clinical Status and Implications for 1-Year Prognosis. Telemed E-Health 19(8):605–612

    Article  Google Scholar 

  2. Passmore B, O’Shea T, and Horney N (2010) Leadership agility: a business imperative for a VUCA world. People Strategy 33(4). Kail, Leading in a VUCA Environment, HBR Blog Network, November 3, 2010 through January 6, 2011

    Google Scholar 

  3. Vitacca M et al (2016) Home-based telemanagement in advanced COPD: who uses it most? Real-life study in Lombardy. COPD J Chron Obstruct Pulmon Dis 13(4):491–498. http://dx.doi.org/10.3109/15412555.2015.1113243

    Article  Google Scholar 

  4. Regione Lombardia – Regional Act no. 23, August 11, 2015

    Google Scholar 

  5. Regione Lombardia, Libro Bianco sullo sviluppo del Sistema sociosanitario in Lombardia. Un impegno comune per la Salute, Milano 30 giugno 2014

    Google Scholar 

  6. “Telemedicine – National guidelines”– State/Regional Agreement of 20 February 2014

    Google Scholar 

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Author information

Authors and Affiliations

  1. ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Loredana Luzzi

  2. Cefriel, Milan, Italy

    Gabriella Borghi

  3. Region of Lombardy Welfare General Directorate, Milan, Italy

    Chiara Penello

  4. Politecnico di Milano, School of Management, Milan, Italy

    Cristina Masella

Authors
  1. Loredana Luzzi
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  2. Gabriella Borghi
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  3. Chiara Penello
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  4. Cristina Masella
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Corresponding author

Correspondence to Loredana Luzzi .

Editor information

Editors and Affiliations

  1. Ospedali Riuniti Marche Nord, Pesaro, Italy

    Giovanni Rinaldi

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Luzzi, L., Borghi, G., Penello, C., Masella, C. (2017). The Role of Telemedicine and EHR in Supporting Care Pathways in the Management of Chronic Illness: The Experiences of the Lombardy Region. In: Rinaldi, G. (eds) New Perspectives in Medical Records. TELe-Health. Springer, Cham. https://doi.org/10.1007/978-3-319-28661-7_18

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  • DOI: https://doi.org/10.1007/978-3-319-28661-7_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28659-4

  • Online ISBN: 978-3-319-28661-7

  • eBook Packages: MedicineMedicine (R0)

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