Health Mobility, Telemedicine, and Local Areas: Exploring the Relationships in the Piedmont Region

Introduction

Telemedicine solutions improve the delivery of and access to healthcare services (WHO, 2010). Their importance has increased significantly during the past decade (European Commission, 2018; Joint Action to support the eHealth Network, 2017) and the recent pandemic had given them a further burst.¹ It has spurred government response to accelerate the deployment of TM services, providing new evidence of the benefits of digital health to professionals and the public, such as making access easier to healthcare services (Bashur et al., 2020; Esper et al., 2020; Ferrara, 2021; HIMSS, 2021; National Academies of Sciences, Engineering, and Medicine, 2021).

The pandemic experience has also revealed that the level of implementation of TM services varies considerably across areas and that in Europe connectivity and integration gaps exist in several Member States (HISSM, 2021a). This is the case of Italy, where a survey of TM initiatives, carried out before the pandemic (Ministero della Salute, 2018) clearly showed a patchy pattern in terms of the type of services and implementation level across the regions (see Box 1).

Latest reflections about the TM experiences shed new light on the fact that:

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  TM initiatives are developed in situated complex socio-technical contexts which include many different stakeholders, legal, organisational and financial conditions as well as a set of behavioural and ethical concepts (Occelli & Scelfo, 2020);

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  implementation of these initiatives proceeds along a path of continuous improvement based on a scale of maturity stages. By questioning the models’ feasibility to assess telemedicine initiatives proactively developers can have a practical support to guide them in the process (Otto, Whitehouse & Schlieter, 2019; Van Dyk, 2014);

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  to put in practice TM projects needs a supportive policy environment which facilitates, enables and promotes the spread of best practices through knowledge transfer and dissemination (Cravo & Hashiguchi, 2020). To reap the benefits of telemedicine and limit its risks, actually, care systems should engage in continuous learning and improvement, taking advantage of new and innovative care models, and exploiting all sources of data (OECD, 2019b; European Commission, 2020).

The last remarks, in particular, suggest that enquiring TM benefits and risks should embrace a perspective which acknowledges issues of access to healthcare without neglecting the latest societal concerns about sustainability.