1. Concept and type of telemedicine

1. Telemedicine consists of providing healthcare services remotely through inConcept and type formation systems and information and of telemedicine communications technologies (ICT). The use of these technologies can occur in the doctor–patient relationship and is also extendable to the relationship between health professionals within the framework of interdisciplinarity and teamwork, for example, to consult diagnostic criteria or to establish communication that, after all, contributes to the health of patients.

Synchronous, asynchronous and remote monitoring telemedicine

Synchronous telemedicine. The information is transmitted in real time (telephone and videoconference) and takes place when the professional and the patient are available at the same moment, with the advantage of saving time and travel, because there is the opportunity to provide direct interaction, which requires specific technology.

Asynchronous telemedicine. The information is transmitted in non-real time (email, chats, exchanges of images or clinical data). The professional and the patient are not available at the same moment and, in this case, clinical data are collected, stored and transmitted to be interpreted and evaluated later. The advantage is that it is not necessary for both people to be available at the same time or place, although it does not offer the immediacy of direct contact with the patient and presents the difficulty that some images may have insufficient quality and require repeated consultations if the clinical details are not complete enough.

Remote monitoring of the patient can also be considered a type of telemedicine. Device networking via the Internet allows patients to use sensors to measure all kinds of variables: systemic arterial pressure, heart rate, temperature, weight, exercise performed, medication adherence, perceived state of health, etc. This makes it easier for doctors to remotely control the health of a patient in real time, as the information is collected by technological devices and sent to the electronic medical histories of the patients, where it is stored for future evaluation and use.

Remote monitoring has led to the creation of connected health platforms, which allow the telemonitoring of patients with multiple electronic devices that are portable or wearable linked to mobile applications that, starting from the management of data in the cloud, can help to alert healthcare personnel to a possible clinical deterioration and therefore act early. However, in order for these applications to be effective, it is necessary to promote education about disease, changes in lifestyle and treatment adherence, and patient participation and empowerment must be encouraged, both in the control of chronic diseases (blood pressure, being overweight, diabetes, heart failure, arrhythmias, chronic obstructive pulmonary disease, etc.), as well as in the control of acute diseases (infections