Telemedicine is typically defined as a combination of technologies and devices capable of remotely obtaining information about a patient's health status to assist in determining whether an intervention is necessary or urgent. As such, it may serve as both a screening and diagnostic tool, a role that has gained prominence in recent literature, owing largely to the increased deployment and development of digital technologies (e.g., smartphones and digital connections). Appropriate tools assist clinicians in reaching and monitoring patients who have difficulty attending specialist visits, particularly those with chronic diseases who require continuous monitoring. Additionally, in the absence of a face-to-face appointment, therapy could be evaluated periodically by sending the data recorded on the digital tool to a specialist. For instance, cardiovascular diseases and diabetes and their chronic complications are two of the major clinical areas covered by telemedicine. Telemedicine can help alleviate this burden, as current guidelines suggest.
Telemedicine was initially developed to provide medical assistance in rural areas or areas with limited access to care, with the primary goal of improving chronic disease management, most notably in emergencies. Over the years, the onset of global epidemics has necessitated the use of increasingly novel digital technology strategies, which has also resulted in the increased use of telemedicine during the various stages of infection, as was the case with the SARS epidemic in 2003, the MERS-CoV epidemic in 2013, and recently SARS-CoV-2 pandemic in 2019.
Due to the novelty of telemedicine and the breadth of its potential applications, it has also been difficult to establish a clear distinction between the settings in which it should be used during emergencies. For instance, e-health can be applied to all asymptomatic subjects in an epidemic area. Additionally, positive asymptomatic subjects can be followed up via phone and web consulting periodically. Over the last few years, digital geolocation tools have improved these services.
Additionally, telemedicine can be used to care for patients in the domiciliary or nosocomial isolation. In the latter case, telemedicine ensures adequate safety for clinicians and caregivers by restricting direct contact with infected patients to strictly non-deferrable emergencies. Finally, telemedicine can currently assist outpatients in managing their periodic visits, halted due to mandatory lockdown imposed by local governments.
Cardiovascular diseases, in particular, require constant monitoring, posing an increased risk of infection for both patients and clinicians. Remote monitoring has expanded beyond emergencies in this context, as evidenced by the rapid advancement of e-health technologies during epidemics and pandemics. Non-emergency procedures should be postponed or, if necessary, coordinated on the same day of the visit to minimize multiple exposures, with postprocedural follow-up performed remotely. In this regard, the SARS-CoV-2 coronavirus pandemic has provided a remarkable impetus for managing other chronic diseases.