key: cord-0774321-k438woag
authors: Pintaudi, Basilio; Garavaglia, Giulia; Disoteo, Olga Eugenia; Meneghini, Elena; Epis, Oscar Massimiliano; Colombo, Fabrizio; Bertuzzi, Federico
title: First televisits provided by the public health system for patients affected by diabetes mellitus in COVID-19 pandemic
date: 2021-02-09
journal: Diabetes Res Clin Pract
DOI: 10.1016/j.diabres.2021.108697
sha: 1bb545c440e5632a061c5a6727b087b1adae67da
doc_id: 774321
cord_uid: k438woag

nan

The Covid-19 pandemic has required a transformation in the delivery systems of care for people with diabetes [1] . The necessary reorganization of the services in the initial period of the pandemic provided only for telephone consultations and for unregulated teleconsultations [2] .

In the Lombardy Region the activation of remote medical care services, in particular televised, was regulated in August 2020 [3] . According to these regulations, televisits are defined as medical acts in which doctors interact with patients remotely, possibly supported by caregivers, which can lead to the prescription of drugs or treatments.

Since October 2020, a pilot project for televisits in the diabetes field is being conducted at the diabetes unit of the ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. In order to carry out the televisits, a special platform of the Lombardy region was used, easily accessible on the internet from PCs, tablets and smartphones through a link (App engineered by ARIA, Regione Lombardia, provided by Reply, s.p.a.). The platform is certified as Class 2A medical devices [4] and it allows the exchanging of documents, images and videos between doctors and patients, assuring traceability of the activities and safety of data management.

A specific agenda for appointments was created. Televists have been proposed to eligible patients by specialists. Consequently, both patients and doctors have been able to access the platform through an account with private credentials. In two months, 129 visits were planned and 113 performed in 111 patients. 80 patients were affected by type 1 diabetes mellitus and 31 by type 2 diabetes (55 male, 56 females, mean 48 years old). 5 patients were over 80 years old. During the televisits, patients shared their glycemic profiles and examination results with specialists through the platform. At the end of the televisit, specialists booked the following appointments, released the prescriptions for the other visits and for the examinations through the platforms. At the end of the visits, patients were requested to fill in a satisfactory questionnaire on the service. A number of 82% of patients resulted satisfied and 69% interested to continue the service, 79% considered the televisit accurate.

Our pilot project has shown that televisits can be included successfully among the standard of care solutions of diabetes within a public health system. The extensive application can no longer be postponed [5] , especially in this pandemic situation.

COVID-19 in people living with diabetes: An international consensus

People living with type 1 diabetes point of view in COVID-19 times (COVIDT1 study): Disease impact, health system pitfalls and lessons for the future

Seduta di Giunta numero 120 del 05 agosto 2020 -XI Legislatura

The Digital/Virtual Diabetes Clinic: The Future Is Now-Recommendations from an International Panel on Diabetes Digital Technologies Introduction