MEDICAL INFORMATICS and TELEMEDICINE: 50 Years of Developments

Francesco Sicurello
President of IITM (International Institute of Tele-Medicine)
@ITIM (Italian Association of Telemedicine and Medical Information)
Professor of Medical Informatics and Telemedicine, University of Milano – Bicocca, Italy

Summary

The applications of Medical Informatics and Telemedicine systems are growing very much in the last 50
years and they can permit a more cost-effective solutions, providing clinical outcomes as well as improving
the patient’s quality of life by large diffusion of electronic management of health information during the
process of treatment and care (in GPs ambulatory, outpatient clinics, hospital wards, diagnostic divisions,
etc.) and in diseases prevention, monitoring, rehabilitation, etc. In particular it very useful and important now
during this emergency and after the dramatic Covid epidemy.
Technological innovation in health care, as the development of medical informatics and telemedicine, is
necessary due to the big amount of information coming from the new and powerful digital diagnostic
equipments and also to high quantity of patients, related to the ageing population, affected by several chronic
diseases (diabetes; cardiologic, cognitive and neurological diseases, respiratory problems, etc) and today also
to coronavirus diseases. That can support and solve relevant social, epidemiological and financial aspects in
developed and developing countries. In particular now the development of telemedicine and telecare services
can permit continuous monitorin of this patients even at home (telehomecare),
The use and diffusion of integrated health/hospitals information systems, electronic patients records, health
smart cards, systems and services of telemedicine are a reality in the world and even in Italy. Many projects
and applications on Medical Informatics, Telemedicine and e-health have been developed in the frame of
Regional, National, European and international Programs. So intra/extranet tools in healthcare and integrated
medical information systems (between hospital, health districts, GPs and the same patient home) are now
implemented. These systems based on medical records linkage and telemedicine services have many socio-
economic benefits and can generate new sources of revenues for providers and can optimize the use of
availability of resources (health operators and medical devices) in order to follow a more great number of
patients and citizen need of personalized care. The benefits are clear, but there may be some legal problems
(security and pricacy aspects) yet to be defined and solved.

Introduction

Medical Informatics is the scientific and technological discipline relating the study, use and application of
computer processing of information in the medical and health field for the automatic management and
treatment of data collected in the Medical, Hospital and Health Information Systems (patient records, clinical
data bases, epidemiological registries, genomic data banks, medical Knowledge bases, Decision Support
Systems, etc.). So Medical Informatics involves several aspects of health activities in particular the
diagnostic and therapeutic processes for the Computerization of medical data, development of HW/SW
Architecture in Hospital and Health information Systrems, Data Base Management Systems in Medicine and
medical oriented programming languages, clinical expert systems, etc.
Telemedicine as “medicine at distance” regards the interactive transmission of medical data, signals and
biomedical images by means the use of telecommunication networks. There are several definitions of
telemedicine and in particular we consider these two:
The IOM (Institute Of Medicine) of American National Academy of Science on 1996, in the “Guide to
accessing telecommunications for Health Care”, defined telemedicine as “the use of electronic information
and communications technologies to provide and support health care when distance separates the
participants”.
The World Health Organization (WHO) in Geneva on 1997 asserted:
“Telemedicine is the delivery of health-care services, where distance is a critical factor, by health-care
professionals using information and communication technologies far the exchange of valid information far
diagnosis, treatment and prevention of disease and injuries, and far the continuing education of health- care

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