The strong increase in the number of patients at AC, mainly on long-term treatment, has determined the development of web management, through telemedicine systems [14
], in some areas.
Telemedicine systems for AVK have been developed during the last few years with the aim to decentralize in the health territorial care units the activity of ACs, improving the quality of life of patients living far from the AC site and maintaining the same clinical quality levels.
Until now, in daily clinical practice AVKs are still underused because they are often considered a therapy that can be hardly managed, laborious, and potentially dangerous for the patient, therefore an integration between hospital services and health care units can facilitate access to life-saving therapies.
Telemedicine systems for anticoagulated patients should be structured through net supported programs to collect and elaborate clinical data, connected among hospital divisions, health care peripheral districts, and patients. All information, including clinical data, laboratory controls, alerts, prescriptions, and recommendations have to be available in real time through a bidirectional connection [15
Telemedicine applied to anticoagulated patients offers several advantages, both for organization as well as for improving communications. Decentralize clinical activity through a telemedicine system gives the opportunity to redistribute patient population into different health care areas, whose medical services could be otherwise underused. It also can help accessibility to health care services for an increased number of patients, empowering management possibilities. At the same time the web gives the opportunity to export quality procedures and competences outside of specialized centres, increasing communications, not only between the physician and patient, but also between different clinical specialties.
Telemedicine organizations are opportunities to improve health care and patient's quality of life through a capillary distribution of medical assistance, supporting physicians in the application of good clinical practice in anticoagulation management.
As anticoagulant drugs are changing through the introduction of new antithrombotic drugs, telemedicine could help their management.
New-generation antithrombotic drugs will need different types of management compared with AVKs, with a less frequent clinical and laboratory control. However, it will be necessary to follow up and record patient's data to guarantee the strict quality control on adherence, compliance, incidence of intercurrent diseases, adverse events, and complications.
The advantage of a web organization can be summarized as following:
- accessibility for a higher number of patients to a high quality management system;
- integration among different specialists and health structures;
- continuing medical record update;
- possibility to manage patients on different antithrombotic drugs.
The web gives the possibility to increase quickly connections by modulating the management in relation to different molecules, assuring clinical control for all patients.