title: Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement.
abstract: The estimated prevalence of ventilator-dependent individuals in Europe is 6.6 per 100 000 people. The increasing number and costs of these complex patients make present health organisations largely insufficient to face their needs. As a consequence, their burden lays mostly over families. The need to reduce healthcare costs and to increase safety has prompted the development of tele-monitoring for home ventilatory assistance.A European Respiratory Society Task Force produced a literature research based statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of these patients.Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients' needs. The legal problems associated with tele-monitoring are still controversial. National and European Union (EU) governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine. The economic advantages, if any, of this new approach must be compared to a "gold standard" of home care that is very variable among different European countries and within each European country.Much more research is needed before considering tele-monitoring a real improvement in the management of these patients.
authors.affiliation: Auxilium Vitae, Volterra, Italy nico.ambrosino@gmail.com.
authors.forename: Nicolino
authors.initials: N
authors.lastname: Ambrosino
authors.affiliation: Fondazione Salvatore Maugeri, Centro Medico di Lumezzane, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Vitacca
authors.affiliation: Dept of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Dreher
authors.affiliation: Unitat de Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain CIBERES, Madrid, Spain.
authors.forename: Valentina
authors.initials: V
authors.lastname: Isetta
authors.affiliation: Sleep Unit, Respiratory Dept, Hospital Clínic, Universidad de Barcelona, IDIBAPS, Barcelona CIBERES, Madrid, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Montserrat
authors.affiliation: Institute of Social and Preventive Medicine University of Bern, Switzerland.
authors.forename: Thomy
authors.initials: T
authors.lastname: Tonia
authors.affiliation: Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Turchetti
authors.affiliation: Faculdade de Medicina, Universidade de Porto, Portugal.
authors.forename: Joao Carlos
authors.initials: JC
authors.lastname: Winck
authors.affiliation: Dept of Pulmonary Medicine (ICR), Hospital Clínic, Universidad de Barcelona (IDIBAPS) - CIBERES, Spain.
authors.forename: Felip
authors.initials: F
authors.lastname: Burgos
authors.affiliation: Home Ventilation Service, University Medical Center Utrecht, The Netherlands.
authors.forename: Michael
authors.initials: M
authors.lastname: Kampelmacher
authors.affiliation: Auxilium Vitae, Volterra, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Vagheggini
mesh_terms: D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005060:Europe; D005062:European Union; D005240:Feasibility Studies; D017048:Health Care Costs; D006699:Home Care Services; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D010166:Palliative Care; D061214:Patient Safety; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D015272:Pulmonary Medicine / Q000191:economics / Q000592:standards*; D012121:Respiration, Artificial / Q000191:economics / Q000706:statistics & numerical data*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D013727:Terminal Care; D013997:Time Factors; D015300:Ventilator Weaning