Eugenio Mercuri1,2,3, Giuseppe Zampino4,5,6,7, Alisha Morsella4,8, Marika Pane4,9,5, Roberta Onesimo5,6,7, Carmen Angioletti4,8, Piero Valentini4,5,6, Claudia Rendeli4,5,10, Antonio Ruggiero4,5,11, Lorenzo Nanni4,5,12, Antonio Chiaretti4,5,6, Giovanni Vento4,5,13, David Korn5,6, Emilio Meneschincheri14, Paolo Sergi14, Giovanni Scambia4,5,15, Walter Ricciardi4,5,16, Andrea Cambieri17, Antonio Giulio De Belvis4,8. 1. Pediatric Neurology Unit, Fondazione Policlinico A Gemelli -IRCCS, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy. eugeniomaria.mercuri@policlinicogemelli.it. 2. Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. eugeniomaria.mercuri@policlinicogemelli.it. 3. Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. eugeniomaria.mercuri@policlinicogemelli.it. 4. Pediatric Neurology Unit, Fondazione Policlinico A Gemelli -IRCCS, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy. 5. Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 6. Pediatric Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 7. Rare Diseases Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 8. Critical Pathways and Outcomes Evaluation Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 9. Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 10. Spina Bifida Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 11. Pediatric Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 12. Pediatric Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 13. Division of Neonatology, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 14. ICT management Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 15. Ginecology Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 16. Section of Hygiene, Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy. 17. Healthcare Management - Fondazione Policlinico Universitario Agostino Gemelli -IRCCS, Rome, Italy.
Abstract
BACKGROUND: Suspending ordinary care activities during the COVID-19 pandemic made it necessary to find alternative routes to comply with care recommendations not only for acute health needs but also for patients requiring follow-up and multidisciplinary visits. We present the 'Contactless' model, a comprehensive operational tool including a plurality of services delivered remotely, structured according to a complexity gradient, aimed to cover diagnostic procedures and monitor disease progression in chronic pediatric patients. METHODS: A multidisciplinary and multiprofessional project team was recruited, in collaboration with patients' associations, to map a panel of available Evidence-Based solutions and address individual needs in full respect of the concept of personalized medicine. The solutions include a number of services from videoconsultations to more structure videotraining sessions. RESULTS: A modular framework made up of four three Macro-levels of complexity - Contactless Basic, Intermediate and Advanced - was displayed as an incremental set of services and operational planning establishing each phase, from factors influencing eligibility to the delivery of the most accurate and complex levels of care. CONCLUSION: The multimodal, multidisciplinary 'Contactless' model allowed the inclusion of all Units of our Pediatric Department and families with children with disability or complex chronic conditions. The strengths of this project rely on its replicability outside of pediatrics and in the limited resources needed to practically impact patients, caregivers and professionals involved in the process of care. Its implementation in the future may contribute to reduce the duration of hospital admissions, money and parental absence from work.
BACKGROUND: Suspending ordinary care activities during the COVID-19 pandemic made it necessary to find alternative routes to comply with care recommendations not only for acute health needs but also for patients requiring follow-up and multidisciplinary visits. We present the 'Contactless' model, a comprehensive operational tool including a plurality of services delivered remotely, structured according to a complexity gradient, aimed to cover diagnostic procedures and monitor disease progression in chronic pediatric patients. METHODS: A multidisciplinary and multiprofessional project team was recruited, in collaboration with patients' associations, to map a panel of available Evidence-Based solutions and address individual needs in full respect of the concept of personalized medicine. The solutions include a number of services from videoconsultations to more structure videotraining sessions. RESULTS: A modular framework made up of four three Macro-levels of complexity - Contactless Basic, Intermediate and Advanced - was displayed as an incremental set of services and operational planning establishing each phase, from factors influencing eligibility to the delivery of the most accurate and complex levels of care. CONCLUSION: The multimodal, multidisciplinary 'Contactless' model allowed the inclusion of all Units of our Pediatric Department and families with children with disability or complex chronic conditions. The strengths of this project rely on its replicability outside of pediatrics and in the limited resources needed to practically impact patients, caregivers and professionals involved in the process of care. Its implementation in the future may contribute to reduce the duration of hospital admissions, money and parental absence from work.
Authors: Katie Palmer; Alessandra Marengoni; Maria João Forjaz; Elena Jureviciene; Tiina Laatikainen; Federica Mammarella; Christiane Muth; Rokas Navickas; Alexandra Prados-Torres; Mieke Rijken; Ulrike Rothe; Laurène Souchet; Jose Valderas; Theodore Vontetsianos; Jelka Zaletel; Graziano Onder Journal: Health Policy Date: 2017-09-14 Impact factor: 2.980
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Authors: Salvatore C Rametta; Sara E Fridinger; Alexander K Gonzalez; Julie Xian; Peter D Galer; Michael Kaufman; Marisa S Prelack; Uzma Sharif; Mark P Fitzgerald; Susan E Melamed; Marissa P Malcolm; Sudha Kilaru Kessler; Donna J Stephenson; Brenda L Banwell; Nicholas S Abend; Ingo Helbig Journal: Neurology Date: 2020-06-09 Impact factor: 9.910
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