Using eHealth platforms and Apps to support monitoring and management of home-quarantined COVID-19 patients. Insights from the experience of the Province of Trento, Italy.

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Italy was the first country to largely experience the COVID-19 epidemic among Western countries during the so-called first wave of COVID-19 pandemic. Proper management of an increasing number of home-quarantined citizens created a significant challenge for healthcare authorities and professionals. This was especially true when considering the importance of remote surveillance to detect signs of disease progression and consequently regulate access to hospitals and intensive care units on priority basis.In this paper authors report on an initiative promoted to cope with the first wave of COVID-19 epidemic in the Spring/Summer of 2020, in the province of Trento, Italy. A purposely-built app named TreCovid19 was designed to provide dedicated healthcare staff with a ready-to-use tool for remotely monitoring patients with progressive symptoms of COVID-19, who were home-quarantined during the first wave, and to focus on those patients who, based on their data, required a quick response from the healthcare professionals.TreCovid19 was rapidly developed to facilitate the monitoring of a selected number of home-quarantined patients affected by COVID-19 during the very first epidemic wave. The app was built on top of an existing e-health platform, already in use by the local health authority to provide home care, having the following functionality: (i) securely collect and link demographic and clinical information related to the patients; (ii) provide a two-way communication between a multidisciplinary healthcare team and home-quarantined patients. The system supported patients to self-assess their condition and update the multidisciplinary team on their health status. The system was used between March and June 2020, in the Autonomous Province of Trento, Italy.A dedicated multidisciplinary group of healthcare professionals adopted the platform over a period of approximately 3 months (from end of March to June 2020) to monitor a total of 170 patients with confirmed COVID-19 while in home-quarantine. All the patients used the system until the end of the initiative. The TreCovid19 system has provided useful insights of possible viability and impact of a technological-organizational asset to manage a potentially critical workload for healthcare staff involved in the periodic monitoring of a relevant number of quarantined patients, notwithstanding its limitations due to the rapid implementation of the whole initiative.The technological and organizational model adopted in response to the pandemic, was developed and finalized in a relatively short period of time during the initial few weeks of the epidemic. The system successfully supported the healthcare staff involved in the periodic monitoring of an increasing number of home-quarantined patients and provided valuable data in terms of disease surveillance.Not applicable.

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Authors: Lorenzo Gios, Giulia Crema Falceri, Luigi Patil, Sara Testa, Stefano Micocci, Simona Sforzin, Ettore Turra, Diego Conforti, Giulia Malfatti, Monica Moz, Andrea Nicolini, Paolo Guarda, Alessandro Bacchiega, Carlo Mion, Michele Marchesoni, Rosa Maimone, Pietro Benedetto Molini, Alberto Zanella, Venet Osmani, Oscar Mayora-Ibarra, Stefano Forti