title: Telemonitoring in Cystic Fibrosis: A 4-year Assessment and Simulation for the Next 6 Years.
abstract: BACKGROUND
  Innovative technologies and informatics offer a wide range of services to health districts, doctors, nurses, and patients, and is changing the traditional concept of health care. In the last few years, the availability of portable devices, their easiness to transport and use, and the capability to collect and transmit various clinical data have resulted in the fast development of telemedicine. However, despite its potential impact in improving patient conditions, and its cost effectiveness reported in literature, telemedicine is not in daily practice.
  
  
  OBJECTIVE
  The aim of this study is to provide evidence of the positive impact of telemonitoring proving the sustainability of an application by sending spirometry outcomes from patients' homes to the hospital doctors via the Internet, and from doctors to patients by an additional phone call solution.
  
  
  METHODS
  We examined collected data related to clinical improvement of patients with cystic fibrosis (CF). The patients were followed-up at home using telemonitoring for a period of 10 years, with the aims to prove the sustainability of the methodology (transmissions of spirometry from the patients' home to the doctors and feedback from the doctors to the patients by phone call from the hospital). We stored and analyzed all spirometry transmissions received, and tested the possible presence to decrease the costs between the standard clinical trial (only ambulatory visits) and standard clinical trial with telemonitoring for the follow-up of patients with CF (telemedicine). This was done through an economic analysis of the costs for patients followed at home by telemonitoring. We assessed four years of observation and a simulation of total long-term costs between 2010 and 2020.
  
  
  RESULTS
  We discovered a potential saving of €40,397.00 per patient for 10 years, actualized at €36,802.97 for the follow-up of all patients enrolled.
  
  
  CONCLUSIONS
  The results from the study suggest that telemedicine can improve the health of patients with CF. It is a relatively cheap and potentially sustainable solution, compared to standard clinical trials. However, to establish and prove the long-term effectiveness and cost-effectiveness, more controlled psychological and behavioral studies are needed.
authors.affiliation: Pediatric Hospital, Scientific Direction, Research Area of Clinical-Healthcare and Management Innovations, Pediatric Hospital Bambino Gesù, Roma, Italy. irenetagliente@hotmail.com.
authors.forename: Irene
authors.identifier: http://orcid.org/0000-0002-7516-1453
authors.initials: I
authors.lastname: Tagliente
authors.forename: Leopoldo
authors.identifier: http://orcid.org/0000-0003-2236-2419
authors.initials: L
authors.lastname: Trieste
authors.forename: Terje
authors.identifier: http://orcid.org/0000-0001-8874-7106
authors.initials: T
authors.lastname: Solvoll
authors.forename: Fabrizio
authors.identifier: http://orcid.org/0000-0002-8874-2417
authors.initials: F
authors.lastname: Murgia
authors.forename: Sergio
authors.identifier: http://orcid.org/0000-0002-4302-2600
authors.initials: S
authors.lastname: Bella
keywords: cost effectiveness; cystic fibrosis; eHealth; follow-up; telemonitoring