title: The neurosurgical telecounseling network in the Veneto Region: 4 years of experience of HEALTH OPTIMUM.
abstract: BACKGROUND
  Neurosurgery is a highly specialized service that, because of high costs, is often centralized. Since 2005, a neurosurgical telecounseling service was defined and then deployed in the Veneto Region. It was aimed at creating the same range of services for head trauma by using standardized protocols at regional levels and at rationalizing the use of human and technological resources by providing a network of services that manages patients at the local level. The main objective of the study was to evaluate the use of this service.
  
  
  METHODS
  Interoperability and flexibility were granted by creating a technological framework based on international standards. Physicians of local hospitals electronically transmit patients' clinical data and images to neurosurgeons located at a central hospital. These physicians respond to the requesting physicians by providing all the necessary recommendations.
  
  
  RESULTS
  The outcomes were collected over a period of 41 months. The service is now available in 34 hospitals. Every year 3,181 telecounselings are conducted for patients with an average age of 65.5 years (55% male, 45% female) whose health status is mainly not serious. Within 30 min from the request of telecounseling, 49% of responses are sent. In 84% of cases the patient was not moved. The overall appreciation of clinicians is positive (4.3/5). Intervention time was reduced, and resources were optimized.
  
  
  CONCLUSIONS
  The service brought remarkable benefits at the organizational level. The reorganization of the processes and patient management leads to rationalization of both human and technological resources.
authors.affiliation: 1 Arsenàl.IT, Veneto's Research Centre for eHealth Innovation , Treviso, Italy .
authors.forename: Claudio
authors.initials: C
authors.lastname: Dario
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Scannapieco
authors.forename: Renato
authors.initials: R
authors.lastname: Scienza
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Carraro
authors.forename: Claudio
authors.initials: C
authors.lastname: Saccavini
authors.forename: Elena
authors.initials: E
authors.lastname: Vio
authors.forename: Sara
authors.initials: S
authors.lastname: Valongo
mesh_terms: D006259:Craniocerebral Trauma / Q000601:surgery*; D015600:Glasgow Coma Scale; D006801:Humans; D007558:Italy; D009493:Neurosurgery; D015397:Program Evaluation; D019114:Remote Consultation
keywords: e-health; neurosurgery; telemedicine; teleneurology; teleradiology