Narne E, MAST 5th May 2010, Berlin

How will decision makers ofHow will decision makers ofAzienda Ospedaliera of Padova/ Azienda Ospedaliera of Padova/

Padova University Hospital Padova University Hospital use MAST in practise? use MAST in practise?

Narne E, MAST 5th May 2010, Berlin

Azienda Ospedaliera of PadovaAzienda Ospedaliera of Padova University Hospital of Padova University Hospital of Padova

Azienda Ospedaliera di Padova is a national referral hospital, in charge

of teaching, care and research, linked with the School of Medicine of

Padua University.

ITS MISSION IS :ITS MISSION IS :

•to contribute to the promotion, recovery and maintenance of health;

•to deliver specialistic outpatient and inpatient care in the framework of

health national and regional planning;

•to work for a system approach

to patient-centred care

Narne E, MAST 5th May 2010, Berlin

Outcomes useful for decisions on Outcomes useful for decisions on investment in telemedicine applicationinvestment in telemedicine application

Outcomes “weighting” could depend on the kind of telemedicine application!

– Azienda Ospedaliera of Padova as “third level specialized centre” for other regional hospitals (as for neurosurgical teleconsultation) (clinical effectiveness, safety as reduction of delays in care )

– Azienda Ospedaliera of Padova as deliver of Services (lab exams, specialistic visit) integrated with primary and secondary points of care (as for periferic monitoring of anticoagulation therapy) (patient accessibility)

– Azienda Ospedaliera of Padova as deliver of Education Services (improvement of staff performances, efficiency of provider and staff satisfaction)

Narne E, MAST 5th May 2010, Berlin

Primary/secondary Hospital

Azienda Ospedaliera di Padova

Emergency

Consultation required

Consultation performed

Neurosurgical teleconsultationNeurosurgical teleconsultation

More than 3500 teleconsultation since 2004(12 Hospitals Net)

With kind permission of Ing. De Nardi

Narne E, MAST 5th May 2010, Berlin

Surgery on line: Surgery on line: “live” and “on demand”“live” and “on demand”

With kind permission of Giancarlo Pengo

In Azienda Ospedaliera of Padova:

299 surgical videos published

1525 hours of surgical intervention recorded

493 hours of Video conferences (live)

Narne E, MAST 5th May 2010, Berlin

7 Domains of MAST and specific 7 Domains of MAST and specific outcomes of telemedicine applicationsoutcomes of telemedicine applications

1. Health problem and characteristics of the application 2. Safety:

• Lower severity and frequency of harms compared to conventional methods;

• Reduction of delays in care.

3. Clinical effectiveness:• Improvement of quality of care;• Increased appropriateness of hospitalization;• Reduction of rehospitalization;• Increased efficiency of provider.

4. Patient perspectives:• Reduction of barrier to access,• Increased patient satisfaction.

Narne E, MAST 5th May 2010, Berlin

7 Domains of MAST and specific 7 Domains of MAST and specific outcomes of telemedicine applications outcomes of telemedicine applications

5. Economic aspects:• Reduction of overall health care costs (considering Hospital, staff,

administrative, equipment costs of telemedicine application and its consequences),

• Reimbursment from Health System. • Measurement with health indicators as QALYs;

6. Organizational aspects:• Identification of different steps in workflow process and organizational

relations, • Effective address of access problems.

7. Socio-cultural, ethical and legal aspects:• Compliance with legal regulation and with regional and local ethics

committee reccomendations.

Narne E, MAST 5th May 2010, Berlin

MAST and Azienda Ospedaliera di Padova

In conclusion:

MAST can produce useful informations for assessing a telemedicine application for AOP

• Strenghts:– Multidisciplinary approach,– Broad evaluation,– Standardization with other countries,

• Weekness:– Limitation in evaluating new application

Narne E, MAST 5th May 2010, Berlin

Thank you to:

Dott. G. Rupolo, Health Director of Azienda Ospedaliera di Padova

Ing. P. De Nardi, Director of Information and Clinical Technology Unit, AOP

Dott. M. Castoro, Director of Health Technology Assessment Unit, AOP

Mr G. Pengo, Surgical Video Producter, collaborating with AOP.

And thank you for the attention