196 - Telemedicina per la gestione dei pazienti in terapia anticoagulante orale (TAO)

S. Testa, A. Alatri, O. Paoletti, G. Morstabilini, M.N. Medagliani, N. Denti, E. Martellenghi Telemedicine For Managing Patients On Oral Anticoagulant Therapy Backgrounds. In the last decade the indications of oral anticoagulant therapy have increased significantly. Several studies have shown that anticoagulation management by an Anticoagulation Clinic (AC) results in better clinical control compared with routine medical care. As a consequence we observed a substantial increase in the number of patients followed up at our AC. The patients, coming from the whole province were 150 in 1991 and 2313 in 2004. We identified 3 problems in the organization: 1. Reduction of patient comfort at AC, due to overcrowding; 2. Difficulty in reaching the AC for a substantial number of patient; 3. Inadequate increase of health care staff. It was therefore necessary to reorganize the activity, maintaing the clinical quality level reached. Aims of our study were: 1. Decentralize the activity in the health territorial care units of the Cremona area, through a telemedicine system. 2. Maintain the same clinical quality levels. 3. Improve the quality of life of the patients living far from the AC site. 4. Reduce by 30% the number of patients seen daily at the AC. Methods. We installed a centralized net supported program (intra- and internet), TAOnet®, to collect and elaborate clinical data, connected with peripheral districts. PT-INR is performed on Coaguchek® portable monitors. Clinical data are obtained from the nourse and sent in real time to the AC. The AC sends within minutes the appropriate dose adjustment and the clinical suggestions to the district. All the process is under quality assessement as based upon ISO 9001-VISION 2000 standards. ...