1. Narne E, MAST 5th May 2010, Berlin How will decision makers of Azienda Ospedaliera of Padova/ Padova University Hospital use MAST in practise?

2. Narne E, MAST 5th May 2010, Berlin Azienda Ospedaliera of Padova University Hospital of Padova Azienda Ospedaliera di Padova is a national referral hospital, in charge of teaching, care and research, linked with the School of Medicine of Padua University. ITS MISSION IS : to contribute to the promotion, recovery and maintenance of health; to deliver specialistic outpatient and inpatient care in the framework of health national and regional planning; to work for a system approach to patient-centred care

3. Narne E, MAST 5th May 2010, Berlin Outcomes useful for decisions on investment in telemedicine application Outcomes weighting could depend on the kind of telemedicine application! –Azienda Ospedaliera of Padova as third level specialized centre for other regional hospitals (as for neurosurgical teleconsultation) (clinical effectiveness, safety as reduction of delays in care ) –Azienda Ospedaliera of Padova as deliver of Services (lab exams, specialistic visit) integrated with primary and secondary points of care (as for periferic monitoring of anticoagulation therapy) (patient accessibility) –Azienda Ospedaliera of Padova as deliver of Education Services (improvement of staff performances, efficiency of provider and staff satisfaction)

4. Narne E, MAST 5th May 2010, Berlin Primary/secondary Hospital Azienda Ospedaliera di Padova Emergency Consultation required Consultation performed Neurosurgical teleconsultation More than 3500 teleconsultation since 2004 (12 Hospitals Net) With kind permission of Ing. De Nardi

5. Narne E, MAST 5th May 2010, Berlin Surgery on line: live and on demand With kind permission of Giancarlo Pengo In Azienda Ospedaliera of Padova: 299 surgical videos published 1525 hours of surgical intervention recorded 493 hours of Video conferences (live)

6. Narne E, MAST 5th May 2010, Berlin 7 Domains of MAST and specific outcomes of telemedicine applications 1.Health problem and characteristics of the application 2.Safety: Lower severity and frequency of harms compared to conventional methods; Reduction of delays in care. 3.Clinical effectiveness: Improvement of quality of care; Increased appropriateness of hospitalization; Reduction of rehospitalization; Increased efficiency of provider. 4.Patient perspectives: Reduction of barrier to access, Increased patient satisfaction.

7. Narne E, MAST 5th May 2010, Berlin 7 Domains of MAST and specific outcomes of telemedicine applications 5.Economic aspects : Reduction of overall health care costs (considering Hospital, staff, administrative, equipment costs of telemedicine application and its consequences), Reimbursment from Health System. Measurement with health indicators as QALYs; 6.Organizational aspects: Identification of different steps in workflow process and organizational relations, Effective address of access problems. 7.Socio-cultural, ethical and legal aspects: Compliance with legal regulation and with regional and local ethics committee reccomendations.

8. Narne E, MAST 5th May 2010, Berlin MAST and Azienda Ospedaliera di Padova In conclusion: MAST can produce useful informations for assessing a telemedicine application for AOP Strenghts: –Multidisciplinary approach, –Broad evaluation, –Standardization with other countries, Weekness: –Limitation in evaluating new application

9. Narne E, MAST 5th May 2010, Berlin Thank you to: Dott. G. Rupolo, Health Director of Azienda Ospedaliera di Padova Ing. P. De Nardi, Director of Information and Clinical Technology Unit, AOP Dott. M. Castoro, Director of Health Technology Assessment Unit, AOP Mr G. Pengo, Surgical Video Producter, collaborating with AOP. And thank you for the attention