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  1. Article ; Online: Will the COVID tsunami be able to impose tele-rehabilitation as a system opportunity?

    Vitacca, Michele

    Pulmonology

    2020  Volume 26, Issue 6, Page(s) 338–339

    MeSH term(s) COVID-19 ; Humans ; SARS-CoV-2 ; Telerehabilitation
    Keywords covid19
    Language English
    Publishing date 2020-09-06
    Publishing country Spain
    Document type Editorial
    ZDB-ID 3009651-0
    ISSN 2531-0437 ; 2531-0429
    ISSN (online) 2531-0437
    ISSN 2531-0429
    DOI 10.1016/j.pulmoe.2020.08.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Hidden biases in clinical decision-making: potential solutions, challenges, and perspectives.

    Vitacca, Matteo / Giardini, Anna / Gazzi, Lidia / Vitacca, Michele

    Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

    2022  Volume 93, Issue 2

    Abstract: Every day, we must make decisions that range from simple and risk-free to difficult and risky. Our cognitive sources' limitations, as well as the need for speed, can frequently impair the quality and accuracy of our reasoning processes. Indeed, cognitive ...

    Abstract Every day, we must make decisions that range from simple and risk-free to difficult and risky. Our cognitive sources' limitations, as well as the need for speed, can frequently impair the quality and accuracy of our reasoning processes. Indeed, cognitive shortcuts lead us to solutions that are sufficiently satisfying to allow us to make quick decisions. Unfortunately, heuristics frequently misguide us, and we fall victim to biases and systematic distortions of our perceptions and judgments. Because suboptimal diagnostic reasoning processes can have dramatic consequences, the clinical setting is an ideal setting for developing targeted interventions to reduce the rates and magnitude of biases. There are several approaches to bias mitigation, some of which may be impractical. Furthermore, advances in information technology have given us powerful tools for addressing and preventing errors in health care. Recognizing and accepting the role of biases is only the first and unavoidable step toward any effective intervention proposal. As a result, our narrative review aims to present some insights on this contentious topic based on both medical and psychological literature.
    MeSH term(s) Humans ; Cognition ; Decision Making ; Delivery of Health Care ; Bias ; Clinical Decision-Making
    Language English
    Publishing date 2022-09-07
    Publishing country Italy
    Document type Review ; Journal Article
    ZDB-ID 1160940-0
    ISSN 1122-0643 ; 1120-0391
    ISSN 1122-0643 ; 1120-0391
    DOI 10.4081/monaldi.2022.2339
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  4. Article: Telemedicine as a Means to an End, Not an End in Itself.

    Vitacca, Michele / Scalvini, Simonetta

    Life (Basel, Switzerland)

    2022  Volume 12, Issue 1

    Abstract: Telemedicine (TM)-the management of disease at a distance-has potential usefulness for patients with advanced respiratory disease. Underscoring this potential is the dramatic expansion of its applications in clinical medicine. However, since clinical ... ...

    Abstract Telemedicine (TM)-the management of disease at a distance-has potential usefulness for patients with advanced respiratory disease. Underscoring this potential is the dramatic expansion of its applications in clinical medicine. However, since clinical studies testing this intervention often provide heterogeneous results, its role in the medical management of respiratory disorders remains inconclusive. A major problem in establishing TM's effectiveness is that it is not a single intervention; rather, it includes a number of divergent diagnostic and therapeutic modalities-and each must be tested separately. Reflecting the discord between the need for further documentation of its approaches and effectiveness and its rapid utilization without this needed information, a major challenge is the lack of international guidelines for its integration, regulation, operational plans, and guidance for professionals. Tailored TM, with increased flexibility to address differing healthcare contexts, has the potential to improve access to and quality of services while reducing costs and direct input by health professionals. We should view TM as a tool to aid healthcare professionals in managing their patients with respiratory diseases rather than as a stand-alone substitute to traditional medical care. As such, TM is a means rather than an end.
    Language English
    Publishing date 2022-01-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life12010122
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  5. Article ; Online: The cruel journey through the COVID-19 INFERNO.

    Vitacca, Michele / Ambrosino, Nicolino

    Pulmonology

    2021  Volume 27, Issue 4, Page(s) 281–282

    MeSH term(s) COVID-19 ; Drama ; Health Services Needs and Demand ; Health Workforce ; Humans ; Medicine in Literature ; Pandemics
    Language English
    Publishing date 2021-05-28
    Publishing country Spain
    Document type Editorial
    ZDB-ID 3009651-0
    ISSN 2531-0437 ; 2531-0429
    ISSN (online) 2531-0437
    ISSN 2531-0429
    DOI 10.1016/j.pulmoe.2021.05.001
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  6. Article: Rehabilitation complexity scale and reimbursement of in-hospital pulmonary rehabilitation.

    Vitacca, Michele / Paneroni, Mara / Ambrosino, Nicolino

    Multidisciplinary respiratory medicine

    2023  Volume 18, Issue 1, Page(s) 936

    Abstract: Background: The use of case-based reimbursement for medical rehabilitation is greatly discussed. The investigators explored the relationship between disability and reimbursement opportunities in individuals with respiratory diseases undergoing in- ... ...

    Abstract Background: The use of case-based reimbursement for medical rehabilitation is greatly discussed. The investigators explored the relationship between disability and reimbursement opportunities in individuals with respiratory diseases undergoing in-hospital pulmonary rehabilitation (PR), considering the correlation (if any) between the Rehabilitation Complexity Scale (RCS-E v13) scores used at admission and the actual reimbursement.
    Methods: This study is part of a larger prospective multicenter study conducted by eight Pulmonary Rehabilitation Units in Italy. Here, investigators considered only data from the Lombardy Region. On January 30
    Results: Three hundred and sixteen participants were evaluated. Patients were elderly, in the majority of cases with CRF, presenting comorbidities, disability, dyspnea, and reduced effort tolerance. At admission, RCS-E v13 showed an average moderate value of complexity. The median (IQR) HS reimbursement/stay was different among groups. RCSE v13 evaluated at admission was weakly (r=0.3471), but significantly related to the HS reimbursement/stay (p<0.0001) mainly due to TX/V and miscellaneous subgroups, while no relationship was found for COPD and CRF patients. After PR, all outcome measures improved significantly in all groups (p<0.001 for all). Higher RCS-E v13 scores at admission did not correspond to a proper amount of reimbursement, being this latter under- or over-estimated if compared to needs assessed by RCS-E v13. RCS-E v13 at discharge decreased for all subgroups (range from -6 to -11) reaching a low value of complexity.
    Conclusions: The RCS-E v13 disability score does not fully mirror the HS reimbursement for patients undergoing inhospital PR.
    Language English
    Publishing date 2023-11-30
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2677839-7
    ISSN 2049-6958 ; 1828-695X
    ISSN (online) 2049-6958
    ISSN 1828-695X
    DOI 10.4081/mrm.2023.936
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  7. Article ; Online: Proposal of a multidimensional strategic-management dashboard for use in a rehabilitation respiratory unit.

    Vitacca, Michele / Vitacca, Mauro

    Medicine

    2019  Volume 98, Issue 20, Page(s) e15728

    Abstract: Health information systems are the core support to decision-making in health organizations. Economic and clinical managements often function separately, while a governance system for quality and safety functions with quality checks and performance ... ...

    Abstract Health information systems are the core support to decision-making in health organizations. Economic and clinical managements often function separately, while a governance system for quality and safety functions with quality checks and performance accountability, could improve efficiency. The aims of this study were, within a respiratory rehabilitation unit (RRU), to: develop a management-strategy dashboard based on key performance areas (KPAs), identify key performance indicators (KPIs) for each KPA which allow multidimensional assessment; estimate the expected results from the implementation of this dashboard using the balanced score card (BSC) method.In December 2017, a working group was set up at the RRU to develop the dashboard by selecting criteria for KPA and determining the KPIs with their rationale, weight, calculation method, measurements, supply system, target values, and working rules.After 3 meetings, 6 KPAs and 12 KPIs for the financial area, 3 KPAs and 15 KPIs for internal processes, 6 KPAs and 8 KPIs for innovation and growth, and 4 KPAs and 5 KPIs for the Clients' Perspective were approved. A strategic map showing the cause/effect relations between the different KPAs was drawn.A BSC-based quality measurement integrating economic and clinical management dimensions is possible also in an RRU. The proposed dashboard can improve communication, strategy, information dissemination, information communication technology management, budget negotiations, organizational quality, and accountability to stakeholders.
    MeSH term(s) Benchmarking ; Decision Making, Organizational ; Health Information Systems/standards ; Humans ; Quality Indicators, Health Care ; Rehabilitation Centers/organization & administration ; Respiratory Care Units/standards
    Language English
    Publishing date 2019-05-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000015728
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  8. Article ; Online: Hidden biases in clinical decision-making

    Matteo Vitacca / Anna Giardini / Lidia Gazzi / Michele Vitacca

    Monaldi Archives for Chest Disease (2022)

    potential solutions, challenges, and perspectives

    2022  

    Abstract: Every day, we must make decisions that range from simple and risk-free to difficult and risky. Our cognitive sources' limitations, as well as the need for speed, can frequently impair the quality and accuracy of our reasoning processes. Indeed, cognitive ...

    Abstract Every day, we must make decisions that range from simple and risk-free to difficult and risky. Our cognitive sources' limitations, as well as the need for speed, can frequently impair the quality and accuracy of our reasoning processes. Indeed, cognitive shortcuts lead us to solutions that are sufficiently satisfying to allow us to make quick decisions. Unfortunately, heuristics frequently misguide us, and we fall victim to biases and systematic distortions of our perceptions and judgments. Because suboptimal diagnostic reasoning processes can have dramatic consequences, the clinical setting is an ideal setting for developing targeted interventions to reduce the rates and magnitude of biases. There are several approaches to bias mitigation, some of which may be impractical. Furthermore, advances in information technology have given us powerful tools for addressing and preventing errors in health care. Recognizing and accepting the role of biases is only the first and unavoidable step toward any effective intervention proposal. As a result, our narrative review aims to present some insights on this contentious topic based on both medical and psychological literature.
    Keywords Precision medicine ; decision-making ; diagnosis ; cognitive errors ; rationality ; Medicine ; R
    Subject code 006
    Language English
    Publishing date 2022-09-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Telemonitoring in patients with chronic respiratory insufficiency: expectations deluded?

    Vitacca, Michele

    Thorax

    2016  Volume 71, Issue 4, Page(s) 299–301

    MeSH term(s) Chronic Disease ; Humans ; Monitoring, Ambulatory ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Telemedicine ; Treatment Outcome
    Language English
    Publishing date 2016-04
    Publishing country England
    Document type Editorial
    ZDB-ID 204353-1
    ISSN 1468-3296 ; 0040-6376
    ISSN (online) 1468-3296
    ISSN 0040-6376
    DOI 10.1136/thoraxjnl-2015-208211
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  10. Article ; Online: Telemedicine as a Means to an End, Not an End in Itself

    Michele Vitacca / Simonetta Scalvini

    Life, Vol 12, Iss 122, p

    2022  Volume 122

    Abstract: Telemedicine (TM)—the management of disease at a distance—has potential usefulness for patients with advanced respiratory disease. Underscoring this potential is the dramatic expansion of its applications in clinical medicine. However, since clinical ... ...

    Abstract Telemedicine (TM)—the management of disease at a distance—has potential usefulness for patients with advanced respiratory disease. Underscoring this potential is the dramatic expansion of its applications in clinical medicine. However, since clinical studies testing this intervention often provide heterogeneous results, its role in the medical management of respiratory disorders remains inconclusive. A major problem in establishing TM’s effectiveness is that it is not a single intervention; rather, it includes a number of divergent diagnostic and therapeutic modalities—and each must be tested separately. Reflecting the discord between the need for further documentation of its approaches and effectiveness and its rapid utilization without this needed information, a major challenge is the lack of international guidelines for its integration, regulation, operational plans, and guidance for professionals. Tailored TM, with increased flexibility to address differing healthcare contexts, has the potential to improve access to and quality of services while reducing costs and direct input by health professionals. We should view TM as a tool to aid healthcare professionals in managing their patients with respiratory diseases rather than as a stand-alone substitute to traditional medical care. As such, TM is a means rather than an end.
    Keywords e-health ; information communication technology ; integrated care ; telemonitoring ; Science ; Q
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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