Telemedicine and chronic disease managementThe use of telematics technologies in medicine, to make remote diagnosis and therapies, is then increasingly necessary in Italy, especially if we consider that the problem of chronic diseases is becoming more and more central and priority.
In fact, according to the WHO, among the most common chronic diseases in the world, with a high incidence of mortality, there are cardiovascular diseases (responsible for 17.5 million deaths per year), cancer (7.6 million), respiratory diseases (4.1 million) and diabetes (1.1 million). 
For example, untreated hypertension, one of the main risk factors (atherosclerosis in the coronary arteries, carotid arteries, renal arteries and lower limbs) could be remotely controlled with relative simplicity.
According to WHO experts, in 2000 about 1 billion people suffered from hypertension in the world (equal to over 25% of the world population over the age of 20).According to estimates, in 2025 the number of people with hypertension should reach 1.5 billion people (almost 30% of the population). 
If we look at hypertension, for example, we can deduce that it is the cause of about 14% of all deaths in the world and is also one of the most common causes of disability.  It has in fact been shown that the proportion of patients with hypertension increases with the age of the population.
Telemedicine can therefore represent the frontier for following all other patients, making them autonomous as quickly as possible and facilitating their self-management (self-sufficiency in their own home, in the “neighborhood” in which they are used to living).
An integrated hospital-territory-home network would be activated, in which the various professional figures who are already in the field should interact (general practitioners, pediatricians of free choice, expert nurses and podiatrists, doctors and surgeons specialists in the various sectors of competence of the pathologies concerned) and one could think of the descent into the field of new useful forces
(such as pharmacists who are experts in this sector), to whom other tasks such as the management of appointments with the professionals mentioned above, the preparation of ad hoc galenic products, the sensitization and the health education of patients and care-givers.
What to do to develop telemedicine in ItalySurely the first thing to do is try to “make everyone speak the same language”. Therefore training-information intended for all the professionals involved in the project.
In particular, some priorities would be absolutely necessary, for example:improve the training of medical / nursing staff capable of following patients in the various departments and in medical / nursing clinics;
disseminate the guidelines for the correct treatment of difficult wounds through all the means available to the scientific community, such as newsletters, scientific journals, meetings, face-to-face and online events.
inform family doctors about references, specialized on the subject, in the hospital and in the territory in order to have safe places of reference for information, diagnostic-therapeutic framework, setting up correct medications, the education of care-givers to autonomous in time short patients, and periodic control scheduled remotely (via computer) and live (outpatient checks).and better case management.
Also, if we think about technology, many portable medical devices have become familiar by now.Digital thermometers, blood pressure monitors, blood glucose monitoring systems, blood oxygen meters and heart rate monitoring systems are non-invasive devices now known and used in the home.
This is a constantly evolving trend, parallel to the fact that devices are created with increasingly sensitive monitoring features and advanced algorithms to allow diagnostic and treatment functions and to be used even outside the doctor’s office.
The Internet of Things, allowing devices to be connected to each other, capable of intercommunicating and adapting their behavior to the data and information they receive, can give life to real intelligent and integrated systems, thanks to information processing that monitor and optimize.
The devices behave like sensors, which in turn are remotely controlled through the network.Furthermore, with the spread of e-Health solutions and connected Internet sensors, new issues are also emerging regarding patient privacy and safety, as well as the quality, functionality and certification of applications.
In the current socio-economic context, the creation of a health model aimed at efficiency and continuity in health care will therefore be fundamental, which will lead to improving the quality of life of patients (not only the elderly), optimizing existing resources and reducing costs.
In this perspective, decentralization of treatment is of particular importance, going, where possible, from the hospital to the home care system, while improving the quality and effectiveness of professional medical care for patients.White Paper – Smart Health: a guide to the new digital frontiers of healthcareDigital health, telemedicine and artificial intelligence
Medicine based on the observation of events has been for a long time, starting with Hippocrates, the epistemological guiding criterion of the healthcare profession. This criterion then evolved with the progress of medicine up to the formulation of Evidence-Based Medicine (EMB).
This can be defined as “the process of research, evaluation and systematic use of contemporary research results as a basis for clinical decisions” or even as “the use of mathematical estimates of risk, benefit and harm derived from high quality research on population samples, to support the clinical decision-making process in the diagnostic investigation phases or in the management of individual patients “.