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. 2021 Jul;42(7):2637-2644.
doi: 10.1007/s10072-021-05252-9. Epub 2021 Apr 30.

Neuro-telehealth for fragile patients in a tertiary referral neurological institute during the COVID-19 pandemic in Milan, Lombardy

Davide Pareyson  1   2 , Chiara Pantaleoni  3 , Roberto Eleopra  3 , Giuseppe De Filippis  3 , Isabella Moroni  3 , Elena Freri  3 , Federica Zibordi  3 , Sara Bulgheroni  3 , Emanuela Pagliano  3 , Daniela Sarti  3 , Antonio Silvani  3 , Licia Grazzi  3 , Pietro Tiraboschi  3 , Giuseppe Didato  3 , Elena Anghileri  3 , Anna Bersano  3 , Laura Valentini  3 , Sylvie Piacentini  3 , Cristina Muscio  3 , Matilde Leonardi  3 , Caterina Mariotti  3 , Marica Eoli  3 , Sara Nuzzo  3 , Fabrizio Tagliavini  3 , Paolo Confalonieri  3 , Francesca De Giorgi  3 ; Besta-Telehealth Task Force
Collaborators, Affiliations

Neuro-telehealth for fragile patients in a tertiary referral neurological institute during the COVID-19 pandemic in Milan, Lombardy

Davide Pareyson et al. Neurol Sci. 2021 Jul.

Abstract

Background: Lombardy was severely hit by the COVID-19 pandemic since February 2020 and the Health System underwent rapid reorganization. Outpatient clinics were stopped for non-urgent patients: it became a priority to manage hundreds of fragile neurological patients who suddenly had less reference points. In Italy, before the pandemic, Televisits were neither recognized nor priced.

Methods: At the Fondazione IRCCS Istituto Neurologico C. Besta, we reorganized outpatient clinics to deliver Neuro-telemedicine services, including Televisits and Teleneurorehabilitation, since March 2020. A dedicated Working Group prepared the procedure, tested the system, and designed satisfaction questionnaires for adults and children.

Results: After a pilot phase, we prepared a procedure for Telemedicine outpatient clinics which was approved by hospital directions. It included prescription, booking, consenting, privacy and data protection, secure connection with patients (Teams Microsoft 365), electronic report preparation and delivery, reporting, and accountability of the services. During the March-September 2020 period, we delivered 3167 Telemedicine services, including 1618 Televisits, to 1694 patients (972 adults, 722 children) with a wide range of chronic neurological disorders. We successfully administered different clinical assessment and scales. Satisfaction among patients and caregivers was very high.

Conclusions: During the dramatic emergency, we were able to take care of more than 1600 patients by organizing Neuro-telehealth in a few weeks, lessening the impact of the pandemic on fragile patients with chronic neurological disorders; this strategy is now stably embedded in our care pathways. In Italy, Telehealth is at present recognized and priced and is becoming a stable pillar of the health system.

Keywords: COVID-19; Neuro-telehealth; Neurology; Telemedicine; Teleneurorehabilitation; Televisit.

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Conflict of interest statement

The authors declare no competing interests.

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