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Professor Simone Donati illustrated practical telemedicine applications during the 23rd Infopoverty World Conference

Private companies are playing a pivotal role in healthcare research, particularly in the realm of chronic diseases, investing heavily in the development of innovative treatments, advanced diagnostic tools, and comprehensive disease management strategies. By leveraging cutting-edge technology and data analytics, private enterprises are at the forefront of discovering new ways to prevent, manage, and potentially cure chronic conditions such as diabetes, cardiovascular diseases, and respiratory disorders.

Ongoing projects in regions like Madagascar highlight the critical importance of such initiatives, where private companies are actively engaged in telehomecare projects focused on remote patient monitoring and medical education platforms, with the aim to bridge the healthcare access gap by utilizing technology to deliver medical care to patients in remote or underserved areas.

Within this context, sustainable funding is essential for these initiatives to improve healthcare quality globally, as underlined by SIMONE DONATI, Associate Professor, Department of Medicine and Surgery at Insubria University, Italy.


“I thank Prof. Azzolini for his presentation and introduction to this session. Now we speak about the application of this technology, to illustrate the role of innovation technology in medicine. Traditional medicine was based on the relation with the patient, but now it is also the relation with other colleagues in the healthcare system. We began in 1996 with the trainees of vitreoretinal surgeons in a critical post-war Bosnia, to support them in vitreoretinal surgery, via a satellite link, that was the first possibility and experience of connection in this critical environment. However, after this experience, we developed different types of experiences and applications of informative technology, on web-based platforms, data-based management, and digital monitoring of medical care. 
In all these applications, we can apply neural networks, machine learning, and nowadays AI. Our experience is detailed in 4 different points, the information technology support, the medical databases in clinical studies, and e-health for increased quality in medical care, which is one of the points we must discuss about here in the UNHQ. Firstly, information technology support was applied in our project, developed from 2014 to 2015, to support outpatient settings with a web-based Tablet application for the follow-up of Age-related Maculopathy. We involved 12 Italian centers, and by a dedicated application, they could insert clinical data of patients, they can immediately have the possibility to refer to the hub center for the therapy, as well as score based on therapeutic indication, so they could understand if the patient was stable or critical for a therapy.
Another experience was dedicated to the medical databases in clinical studies, to collect data for rare ocular diseases by several national ocular disease center, that collect data on genetic alteration and related clinical features in young patients. A few cases from different centers make a big database to comprehend the natural history of the ophthalmological disease for future clinical trials. Not only rare diseases but also experimental studies. We connected data from clinicians, geneticists, and biologists about the histology a specific retinal pathology, to study it on a web-based database, to connect data, to unify databases with filters, to share images and data, and to progress with our research.
Another important experience with medical databases was during the COVID-19 pandemic, where we connected data from ophthalmology and infectious disease units, microbiologists, and genetic laboratories, to study, to evaluate with the support of AI, the basis and causes of the spread of the pandemic. We discovered and reported in this publication that the virus was present in the conjunctiva, understanding another reason for the diffusion of this pathology all over the world. This project was developed between 2020 and 2021, during the most severe impact of the Sars-Cov2- pandemic.
Lastly, not only public but also private companies may have a role in this type of research and applications. We involved the Airport Society that managed the Milan airports, in a project of screening for workers, to understand the epidemiological data, on a web-based application, to connect and collect data about health risks and the factors for this type of worker. So I underline the role of private companies in supporting this type of project.
Moreover, the importance in developing countries, but also Europe and the USA, of the study of chronic disease and anti-age medicine. We will listen to Doctor Boscher in the next presentation, about data collection in on chronic diseases, to understand what the risk factors are, and the therapies interactions. Here, AI could have a role in the management of the therapies and reduce the clinical burden in evaluating and monitoring this type of patient, as chronic diseases represent the real future challenge for health systems in our world.
So, Innovative technology is not only for chronic diseases and clinical databases but also for increasing the quality of our medical care. We describe here our project that has been working since 2023 in Madagascar, supported by a non-profit association, for surgical support and teaching for medical care in villages in Madagascar. Not only surgical but also clinical data transmission, where the physicians collect photos of the pathology of the patients and send them by a web-based platform, for a second opinion and support to a center in Italy. All to increase medical support and health quality in this critical situation.
Telehomecare is not only for images and second opinions but also to control and monitor the patient at home, by wearable devices. We proposed a Horizon project, to evaluate and monitor patients at home, sending data to a platform for a reduction in hospital burden and immediate possibility of intervention, in case of an automatic alert system, for example of a reduction in blood saturation in patients with pulmonary diseases. This project is working now in different areas.
Lastly, I spoke about teaching and learning, and this project presented a web-based platform for medical education. Italian residents and fellows connected to their teachers in different centers to send images, and a brief description of clinical cases. At a distance, the teacher could solve this problem, discuss this evaluation, and send them a consultation for teaching, and revision of the clinical case. It was an interesting and useful experience.
What I said in my presentation, is a description of pilot studies, that are working, while others stopped, for the need of funds, to have a sustained by the public administration. We aim to see that this type of project may have the possibility to continue, to increase the quality of healthcare, not only for physicians, but for all the operators, and finally for the population and patients They must be not only simple experiences like the ones I presented today but also scientific publications for a structural development of the health care. Thank you.”


The FINAL DECLARATION of the 23rd Infopoverty World Conference is now available! The Plan of Action including a list of projects and proposals that emerged from the discussion will be available soon. STAY TUNED!


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