Telemedicine is an integrated, biomedical and psychosocial, secondary prevention intervention, where a specialized team guides the patient and his family in the course of the disease by reducing the stress of caregivers and allowing patients to stay longer at home, reducing, consequently, costs related to go to the specialist clinic. Teleneurology is a part of Telemedicine which uses modern communication technologies to allow neurology to be practiced when the doctor and patient are not present in the same place, and possibly not at the same time. This study focuses on identifying regional spots as potential territorial stations for the telemedicine service through the GIS (Geographical Information System), a computerized systems that allows placement of data of different types and sources into one system to manage and form spatial relationships that allow the display and analysis of relationships of geographic, environmental, and population factors (Scholten & de Lepper, 1991). We analyzed the optimal location of territorial telemedicine spots in correspondence of general practitioner clinics. It could be intended as a way to involve general practitioners in the management of those patients. The aim of this study is to improve the quality of life of patients and their caregivers providing a continuity of care through this system that reduces the inconvenience of travel and related costs. We estimated, then, the reduction of costs for patients and care-givers joining the telemedicine service in terms of hours out of work.
Background The cloud is a promising resource for data sharing and computing. It can optimize several legacy processes involving different units of a company or more companies. Recently, cloud technology applications are spreading out in the healthcare setting as well, allowing to cut down costs for physical infrastructures and staff movements. In a public environment the main challenge is to guarantee the patients’ data protection. We describe a cloud-based system, named ReportFlow, developed with the aim to improve the process of reporting and delivering electroencephalograms. Methods We illustrate the functioning of this application through a use-case scenario occurring in an Italian hospital, and describe the corresponding key encryption and key management used for data security guarantee. We used the X2 test or the unpaired Student t test to perform pre-post comparisons of some indexes, in order to evaluate significant changes after the application of ReportFlow. Results The results obtained through the use of ReportFlow show a reduction of the time for exam reporting (t = 19.94; p < 0.001) and for its delivering (t = 14.95; p < 0.001), as well as an increase of the number of neurophysiologic examinations performed (about 20%), guaranteeing data integrity and security. Moreover, 68% of exam reports were delivered completely digitally. Conclusions The application resulted to be an optimal solution to optimize the legacy process adopted in this scenario. The comparative pre-post analysis showed promising preliminary results of performance. Future directions will be the creation and release of certificates automatically.
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