ANMCO/SIT Consensus Document: telemedicine for cardiovascular emergency networks

Caldarola, Pasquale; Gulizia, Michele Massimo; Gabrielli, Domenico; Sicuro, Marco; Giammaria, Massimo; Grieco, Niccolò; Grosseto, Daniele; Mantovan, Roberto; Mazzanti, M; Menotti, A; Brunetti, Natale Daniele; Severi, Silva; Russo, Giancarmine; Gensini, Gian Franco

doi:10.1093/eurheartj/sux028

Cited by 27 publications

(20 citation statements)

References 49 publications

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“…The current evidence has largely been centred on the validation of technologies, feasibility, usability or the impact on process outcomes, but there are paucity of data on the impact on patient-centred outcomes to justify implementation of telemedicine. 6 Given the challenges to implementing telemedicine systems, benefits should be clearly demonstrated in terms of these patient-centred outcomes. Individual studies are underpowered to detect differences in mortality.…”

Section: Introductionmentioning

confidence: 99%

Impact of telemedicine interventions on mortality in patients with acute myocardial infarction: a systematic review and meta-analysis

Marcolino

Maia

Oliveira

et al. 2019

Heart

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BackgroundDespite the promise of telemedicine to improve care for ischaemic heart disease, there are significant obstacles to implementation. Demonstrating improvement in patient-centred outcomes is important to support development of these innovative strategies.ObjectiveTo assess the impact of telemedicine interventions on mortality after acute myocardial infarction (AMI).MethodsArticles were searched in MEDLINE, Cochrane Central Register of Controlled Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), Indice Bibliográfico Español en Ciencias de la Salud (IBECs), Web of Science, Scopus and Google Scholar, from January 2004 to January 2018. Study selection and data extraction were performed by two independent reviewers. In-hospital mortality (primary outcome), and door-to-balloon (DTB) time, 30-day mortality and long-term mortality (secondary outcomes) were assessed. Random effects models were applied to estimate pooled results.ResultsThirty non-randomised controlled and seven quasi-experimental studies were included (16 960 patients). They were classified as moderate or serious risk of bias by ROBINS-I (Risk Of Bias In Non-randomized Studies–of Interventions tool). In 31 studies, the intervention was prehospital ECG transmission. Telemedicine was associated with reduced in-hospital mortality compared with usual care (relative risk (RR) 0.63(95% confidence interval[CI] 0.55 to 0.72); I2 <0.001%). DTB time was consistently reduced (mean difference −28 (95% CI −35 to –20) min), but showed large heterogeneity (I2=94%). Thirty-day mortality (RR 0.62;95% CI 0.43 to 0.85) and long-term mortality (RR 0.61(95% CI 0.40 to 0.92)) were also reduced, with moderate heterogeneity (I2=52%).ConclusionsThere is moderate-quality evidence that telemedicine strategies, in particular ECG transmission, combined with the usual care for AMI are associated with reduced in-hospital mortality and very-low quality evidence that they reduce DTB time, 30-day mortality and long-term mortality.

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Section: Introductionmentioning

confidence: 99%

Impact of telemedicine interventions on mortality in patients with acute myocardial infarction: a systematic review and meta-analysis

Marcolino

Maia

Oliveira

et al. 2019

Heart

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“…There have been various attempts in Italy and in other countries to build remote control systems for medical devices, to allow teleworking, medical teleconsultations, and remote reporting. The methodologies for telemedicine applied to different medical branches include the “Telemedicine for cardiovascular disease continuum” [ 7 ], the “L'ANMCO/SIT - Consensus Document: Telemedicine for cardiovascular emergency networks” [ 8 ], the European project “HEALTH OPTIMUM (Health OPTIMization throUgh Telemedicine)” of the Veneto Italian region for neurosurgical teleconsultations, and the Telelaboratory, the Neurological Teleconsultation for the management of ischemic stroke and the management of oral anticoagulant therapy [ 9 ], and also the digitization projects for electronic health records of patients (ESF) of the Tuscany [ 10 ] and Emilia Romagna Italian Regions [ 11 ].…”

Section: Brief Historical and Technical Notesmentioning

confidence: 99%

The Italian technical/administrative recommendations for telemedicine in clinical neurophysiology

Stipa¹,

Gabbrielli

Rabbito

et al. 2020

Neurol Sci

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Recent advances in technology, information technology, Internet networks, and, more recently, fiber optics in industrialized countries allow the exchange of a huge amount of data, in real time, across the globe. The acquisition of increasingly sophisticated technologies has made it possible to develop telemedicine, by which the specialist’s evaluation can be carried out on the patient even remotely. In Italy, this very useful tool, although possible from a technological and information technology point of view, has not been developed because of the lack of clear and univocal rules and of major administrative obstacles related to the Italian Public Health System. To promote telemedicine implementation in Italy, the Italian Society of Clinical Neurophysiology and the Italian Society of Telemedicine together with the National Centre for Telemedicine and New Assistive Technologies of the Italian Higher Institute of Health prepared these inter-society recommendations. Because of potential forensic value of these recommendations, they were prepared considering the current regulations and the General Data Protection Regulation and will provide the basis for a Consensus Conference planned to discuss and prepare National Telemedicine Guidelines.

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“…Ha sido demostrado que la realización de un ECG-PH es el factor más importante que facilita que el paciente reciba una reperfusión oportuna 10 . Esto permite eliminar la demora en la sala de emergencia enviando al paciente directamente al laboratorio de cateterismo para realizar una ACP [12][13][14] . Las guías de la AHA/ACC, como también las europeas, recomiendan la realización de un ECG por el personal de emergencia en el sitio del PCM en pacientes con síntomas consistentes con IAMCEST.…”

Section: Importancia Del Ecg -Phunclassified

Infarto Agudo del Miocardio: conducta en el período prehospitalario

Escobar

Akel

2019

Rev Chil Cardiol

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ANMCO/SIT Consensus Document: telemedicine for cardiovascular emergency networks

Cited by 27 publications

References 49 publications

Impact of telemedicine interventions on mortality in patients with acute myocardial infarction: a systematic review and meta-analysis

Impact of telemedicine interventions on mortality in patients with acute myocardial infarction: a systematic review and meta-analysis

The Italian technical/administrative recommendations for telemedicine in clinical neurophysiology

Infarto Agudo del Miocardio: conducta en el período prehospitalario

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