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Telemedicine solutions have been rapidly expanding in recent years and the COVID pandemic has provided an unforeseen testbed of their potential. In Piedmont, a few studies have clearly shown that the deployment of telemedicine results from the intertwining of many factors, including the consideration of access and sustainability issues. Building on these premises, this study analyses the 2019 health mobility to specialist care in Piedmont local health areas. It investigates to what extent telemedicine services might overcome the distance gap between the place of residence of patients and that of delivery of healthcare services, thus reducing the need to move. Medical specialties and the type of examinations which can be delivered digitally were first identified; then the number of patients eligible to telemedicine treatment was estimated. Finally, a few hypotheses regarding the possibility to substitute physical encounters with virtual ones, through tele-visits were formulated and their impact on the reduction of mobility flows and travelled distance examined. To give more practical ground to the discussion, reference is made to the situation of TO3 ASL, where a telemedicine plan has been recently laid out.

La télémédecine (TM) permet aux professionnels de la santé d'évaluer, diagnostiquer et traiter des patients à distance à l'aide des technologies de l'information et des communications (TIC), permettant l'accessibilité et l'équité des soins. Dans le but de planifier une voie d’accréditation pour les services de TM, la Direction régionale de la santé du Piémont a mené, en 2017, une enquête explorant plusieurs domaines, tels que définis par les directives nationales. Elle a révélé une riche expérience existante en Piémont. Cependant les niveaux de maturité des services sont très variés, ce qui suggère la nécessité d’une gouvernance centrale pour assurer des services appropriés et durables et ainsi les intégrer dans le système de santé régional. Deux études de cas sont présentées, où les obstacles et les facilitateurs de la TM sont discutés. La TM pendant la pandémie du Covid et la possibilité d'un cadre d'évaluation avec l'approche HTA (Health Technology Assessment) ont également été traité.

Emergency Room (ER) can be considered as a High Reliability Organization expected to guarantee reliability despite facing hectic and unpredictable events. To achieve this status, ER should invest on the management style of Organizational Mindfulness, focused on anticipation and containment of errors. The aim of this exploratory research was to investigate how Organizational Mindfulness occurs in Italian ERs and what is the role of Safety Culture and Work Engagement in predicting Organizational Mindfulness measured with an ad hoc questionnaire. Results show how the communal sphere of Safety Culture seems a better predictor of Organizational Mindfulness than the individual sphere of Work Engagement.