Improving primary care in Europe beyond COVID-19: from telemedicine to organizational reforms
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IM-POINT OF VIEW
Improving primary care in Europe beyond COVID‑19: from telemedicine to organizational reforms Livio Garattini1 · Marco Badinella Martini1 · Pier Mannuccio Mannucci2 Received: 23 October 2020 / Accepted: 30 October 2020 © Società Italiana di Medicina Interna (SIMI) 2020
Abstract The COVID-19 pandemic has put under pressure all the health national systems in Europe and telemedicine (TM) has been an almost unavoidable answer for primary care (PC) services to constrain the contagion. PC includes all the healthcare services that are the first level of contact for individuals. General practitioners (GPs) are the pivotal providers of PC throughout Europe. Although GP costs are mainly covered by public services or social insurances in Europe, they are still self-employed physicians everywhere, differently from their colleagues in hospitals who are traditionally employees. TM is a very general term open to various interpretations and definitions. TM can now be practiced by means of modern audio-visual devices and is an alternative to the traditional face-to-face consultation in general practice. Although the adoption of TM seems to be compelling in our era, its practical dissemination in PC has been quite slow so far, and many different concerns have been raised on it. On the whole, TM widespread adoption in PC seems to be more a matter of labor organization and health care funding than of technology and ethics. Larger-scale organizations comprising a wide range of health professionals have become a pressing priority for a modern PC, because working together is crucial to provide high-quality care to patients, and co-location should boost teamwork and facilitate the management of information technology. A national network of large organizations in PC could be rationally managed through local budgets and should increase efficiency by adopting tools such as TM. Keywords Primary care · Telemedicine · European Union
Introduction The COVID-19 pandemic has put under pressure all the national health systems in Europe. Telemedicine (TM) has been an almost unavoidable answer for primary care (PC) services to constrain the contagion by means of physical distances between patients and physicians, particularly during the first period of this catastrophic event. The pandemic has dramatically undermined the traditional face-to-face patientphysician relationship, especially in general practice, and brought TM to the forefront of PC on a broad scale as never before [1].
* Livio Garattini [email protected] 1
Institute for Pharmacological Research Mario Negri IRCCS, Ranica, BG, Italy
IRCCS “Ca’ Granda Maggiore Policlinico” Hospital Foundation, Milan, Italy
2
With this background, first we briefly summarize the main features of PC in Europe. Then we give an insight of the vast literature on TM and discuss the major concerns that limited until now its widespread adoption. Finally, we depict a radically different post COVID-19 scenario for PC in Europe, in which TM should be exploited at its best.
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