Modelling and analysis of four telemedicine Italian experiences.

In the last 10 years the European population aged 65 years and over grew of 2.3%, with Italy having the highest share of elderly persons in the total population. OPLON (OPportunities for active and healthy LONgevity) is a project supported by the Italian Ministry of Education, Universities, and Research aiming to identify and prevent frailty and to improve the life quality of elderly subjects. The main goal of OPLON is to develop a "Care&Cure" model for the management of subjects with different morbidities and co-morbidities, adaptable to the subject's risk level and to the regional contexts. In this study we analyzed four Italian telemedicine experiences addressed to chronic, geriatric or partially self-sufficient subjects. Each of them was exhaustively described by means of three process modelling tools (synopsis, workflow and swimlane activity diagrams). Starting from this analysis, we defined a general model of tele-monitoring and tele-assistance of frail and pre-frail people with different needs and pathologies. The proposed model was characterized by three macro processes (enrollment, assessment and assistance) and four groups of actors (patient, general practitioner/specialist physician, multidisciplinary team, and healthcare professionals). Combining this model with a detailed analysis of regulations and legislations in force both at local and national level, it will be possible to design the complete and efficient "Care&Cure" model.