The users of Telehealth's services. The case of the San Giovanni Addolorata Hospital in Rome

Abstract

The recent pandemic period required a rapid and efficient response in order to fulfill the healthcare needs of patients outside the hospital environment, to avoid contagion from Covid 19. In this context, the San Giovanni Addolorata Hospital of Rome (AOSGA) responded to the needs of patients by introducing an asynchronous Telemedicine service, the first services were born thanks to the vision and availability of the operators for the solution of healthcare problems. The first part of the report reports the national indications for the provision of Telemedicine services and the outline of the AOSGA process carried out in the period analyzed, currently in the implementation phase. The central theme addressed in this report was the opinion of patients using the service. Once the service had been provided, the patient was invited to complete a completely anonymous satisfaction questionnaire made up of 19 closed-ended questions and a suggestions section. The satisfaction questionnaire was introduced in July 2021 while the data was extracted in October 2023. In the intervening period, 575 satisfaction questionnaires were collected, equal to 13.40% of the patients involved in the service. First, the patients to whom the questionnaire was administered were characterized based on gender and age group. The population is made up of 53% women and 47% men, over half of whom are over 60. Among the questions in the questionnaire, the selection of specific response options made it possible to intersect with multiple patient needs in order to extract their characterization and the distribution. This analysis of particular subpopulations allowed us to define more focuses within the respondents. The percentage of patients who needed help from friends, relatives or caregivers to carry out the Televisit increased with age and was largely composed of pensioners. The service was widely appreciated by patients for having avoided mobility especially for the 30-80 age group, the over 80s were divided among those who also appreciated the service for having avoided a relative having to be accompanied on site. Although 65% of patients appreciated the service, even when asked "What didn't you like about the service", there were 31% who did not appreciate it, due to the impossibility of live contact with the doctor and the depersonalisation of the service. These last two aspects, at the level of perception by the patient, represent the main problem of Telemedicine. The “Suggestions” section confirms and supports patients' concerns on the matter; the need to convey and reassure patients on how Telemedicine is a tool to support in-person visits and not the only way to interface with the doctor is clear. This population is proportionally represented by all age groups. Overall, approximately 1 in 5 patients did not appreciate the service due to the lack of live contact but appreciated it for avoiding having to go on site. The offer proposed by AOSGA proved to be particularly well received by patients, as in the subpopulation of those who did not appreciate the depersonalization of the service, as many as 94% would use it again, of which 33% only if they were unable to carry out the visit in person. The Telemedicine service offered by AOSGA healthcare workers during the pandemic period was found to meet the needs of patients and was pleasantly welcomed and appreciated, not only by patients accustomed to technology or holders of SPIDs or who have access to their ESF, but by a particularly heterogeneous population. The provision of the Telemedicine service has proven to be an auxiliary component to the effective in-person visit, for different motivations and needs of the patients. The San Giovanni Addolorata Hospital in Rome is currently implementing the service, making it compliant with the State-Regions agreement of 17 December 2020 in which the national indications for the provision of Telemedicine services are defined.