High altitude mountain telemedicine

Introduction: An innovative teleconsultation platform has been designed, developed and validated between Summer 2017 and Winter 2018, in five mountain huts and in three remote outpatients clinical centres of the Italian region Valle d'Aosta of the Mont Blanc massif area. Methods: An ad hoc video- conference system was developed within the framework of the e-Rés@mont (Interreg Alcotra) European project, to tackle general health problems and high altitude diseases (such as acute mountain sickness, high-altitude pulmonary and cerebral edema). The system allows contacting physicians at the main hospital in Aosta to perform a specific diagnosis and to give specific advice and therapy to the patients in an extreme environment out-hospital setting. At an altitude between 1500 and 3500 meters, five trained nurses performed clinical evaluations (anamnesis, blood pressure, heart rate, oxygen saturation), electrocardiographic and echography monitoring on both tourists and residents as necessary; all the collected data were sent to the physicians in Aosta. Results: A total of 702 teleconsultation cases were performed: 333 dismissed (47%), 356 observed (51%), 13 immediate interventions (2%). In 30 cases the physicians decided there was no need for helicopter and ambulance rescue intervention and hospital admissions. The main physiological measures, the classified pathologies, the severe cases, and cost savings are described. Discussion: The e-Rés@mont teleconsultation platform has been discussed in terms of treated cases, feasibility, proactivity in reducing complexities, direct and indirect advantages, and diagnostics help; moreover general and specific pros and cons have been debated, and future steps have been exposed.