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Tele-Medicine for Cardiovascular Emergencies: Ready for the Prime Time?

Natale Daniele Brunetti, Daniele Amoruso, Luisa De Gennaro, Giulia Dellegrottaglie, Giuseppe Di Giuseppe, Gianfranco Antonelli and Matteo Di Biase

According to the Wikipedia definition, “Tele-Medicine [(TM)] is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. It is also used to save lives in critical care and emergency situations”. TM may therefore be extremely useful in reducing time of treatment, especially when time is paramount, such as in cardiovascular emergencies. Pre-hospital Electrocardiograms (ECGs) may be useful in improving timeliness of treatments in acute cardiovascular disease, and TM may play a primary role in allowing any patient with a suspected cardiovascular emergency to be examined with pre-hospital ECG by a cardiologist, wherever the patient is, either in rural or urban areas. In the field of TM applied to cardiovascular emergencies managed by an Emergency Medical Service (EMS) in a large region-wide area, the focus is on Apulia, a region in South-Eastern Italy (19,358 km², population 4,091,259). The region is currently served by a TM hub from where cardiologists report back, 24/7, on pre-hospital ECGs transmitted by telephone (mobile or other). Evidence is provided showing the clinical utility of pre-hospital TM ECG in improving the quality of medical assistance in cardiovascular emergencies. The Apulia TM network provides an interesting demonstration of TM potential in health-care management, combining high-quality medical assistance with optimal spending of public resources.