196 - Telemedicina per la gestione dei pazienti in terapia anticoagulante orale (TAO)
Rivista: RIMeL - IJLaM, Vol. 1, N. 3, 2005 (MAF Servizi srl ed.)
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.
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