Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic found Italy unprepared to cope with the large concentrated numbers of patients infected with coronavirus disease 2019 (COVID-19) who often required hospital admission and in many cases intensive care. This pandemic very quickly overwhelmed the Italian Healthcare System. This paper describes the Active Home Surveillance System (Operations Center for Discharged Patients; COD19) and the Home Hospital Care System (COD20) and presents the clinical data collected and the level of user satisfaction with the service. The Operations Center for Discharged Patients (COD19) is an active surveillance service for home-care patients which involves: (1) monitoring critical clinical conditions; (2) recognizing social and health issues; (3) and providing necessary clinical services in the form of a telemedicine service. COD20 is a patient-specialist video consultation service that allows to perform an assessment of clinical conditions and any need to visit; defining the priority of access to specialist outpatient visits in the presence or manageable with the new video consultation model. This service was immediately necessary during the COD19 monitoring. COD19 and COD20 are based on the Amazon Web Services Serverless certified platform. The COD19 and COD20 platform can be intrinsically utilized for future epidemic outbreaks; also those with non-respiratory transmission; and is sufficiently flexible to adapt to natural catastrophes.
Highlights
The first Italian case of coronavirus disease 2019 (COVID-19) was reported in the Lombardy region on 20 February 2020
COD19 and COD20 are based on the Amazon Web Services (AWS) Serverless certified platform
The actions undertaken as a result of the phone calls include 424 contacts with the infectious disease specialist for assessment and discussion of parameters and symptoms related to COVID-19 and 72 patients referred for psychological support based on the results of the depression and anxiety screening tests
Summary
The first Italian case of coronavirus disease 2019 (COVID-19) was reported in the Lombardy region on 20 February 2020. The province of Milan (the capital city of Lombardy) witnessed a growth in the ratio between cases among its resident population and total cases in Lombardy, the former accounting for approximately 25% of the region’s total cases in the month of May 2020 This event severely undermined disease management models at the regional level where patients were treated:. The second level, focused on structuring relations between the players, including the local health agency and the epidemiology service, is able to promptly provide information on the clinical course of home-care patients and the need for new services With these premises, a service was set up based on a computer platform that was specially created during the pandemic by the collaboration of the University of Milan, the Health Protection Agency (Agenzia per la Tutela della Salute, Health Protection Agency—ATS) Metropolitan City of Milan and the Local Health and Welfare Agency (Azienda Socio-Sanitaria Territoriale—Local Health Authority, ASST) Fatebenefratelli-Sacco hospitals, and industrial research partners. Care system (COD20) and presents the clinical data collected and the level of user satisfaction with the service
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