Feasibility of telemedicine in anaesthetic preoperative evaluation: the organisational management experience of a teaching hospital in Italy
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Università Vita-Salute San Raffaele Italy
San Raffaele Hospital Italy
Università Vita-Salute San Raffaele, San Raffaele Hospital Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A602
The Covid-19 pandemic highlighted the essential role of remote healthcare solutions, following the isolation rules forcing the loss of follow-ups, thus implying a worldwide growth of disease burden and costs for health systems. This need turned into an opportunity as telemedicine is now - post-pandemic – an essential tool to lighten the pressure on hospitals and healthcare facilities, to ease health-related processes for both patients and physicians, to reduce possible complications implied by people aggregations in these structures, without reducing the overall quality of healthcare. San Raffaele Hospital was the first Italian hospital to provide a free telemedicine platform in 2020. We aimed to report the advantage of digitalisation, extend telemedicine to the preoperative anesthesiological evaluation in minor surgeries, and assess patient and hospital-related outcomes to create a framework pattern. A literature review was performed to retrieve the state of knowledge, but Italy lacked real-life applications. This framework aimed to be faster and more patient-friendly, avoiding wasted resources and the overloading of surgical waiting lists. Our pilot was meant to raise awareness on the topic and, as future perspectives, extend the pool of pre-surgical evaluations accessible by telemedicine. From the end of 2021, we started reconstructing the hospital’s clinical and administrative preoperative pathways. We recruited an anaesthesiologists team and started screening surgeries where preoperative evaluation could be led through remote consultation, therefore creating a framework proposal. Piloting this new process, surgeons freely enrolled patients, explaining the role of telemedicine in the preoperative procedure. A hospital administrative team accomplished the patients’ chart creation on the platform and followed-up the steps completeness. Patients were requested to upload previous medical records and fill out an anesthesiological survey. Surgery-specific routinary screening exams were provided before the video-visit evaluation; further investigations were eventually requested. When anesthesiological fitness was reached, patients could be hospitalised for surgery.