BACKGROUND. The Covid 19 pandemic has thrown us into an unexpected health, social and economic crisis, a precious opportunity to reorganize the healthcare system. Welfare gaps have progressively worsened, with a territorial network often unable to take care of all those who need it. Our National Health Service must evolve towards an organization that integrates hospital care with local care through . Telemedicine identifies the set of techniques used to carry out remote diagnoses and treatments, innovating traditional methods of examination and therapy.

ENDPOINTS. The project achieves hospital-territory integration through the opportunity to extend pain therapy consultations to home settings. The new model from a One Health perspective aims to create local territorial assistance to respond to health needs as close as possible to citizens, in a company like ASLRoma6 with a population of around 600,000 inhabitants and a various territory.

ORGANIZATIONAL CLINICAL PATH IN TELEMEDICINE FROM THE HOSPITAL TO THE TERRITORY:

1 the healthcare operator, CPSI, contacts the patient/caregiver by telephone to define the televisit methods (time), checks the ability to use the digital systems.

2 The day before the televisit, in Skype chat mode, the doctor plans the call, the patient will respond with a confirmation of the appointment and will use the Skype chat to send the documentation, collects the documentation in the patient's possession (if necessary, the patient has an electronic record from the CAD (home care center) the Doctor can view clinical data), the doctor sends the consent in PDF format and the patient/guardian will return it signed..3 On the day of the visit, the doctor makes the video call from Skype         4 At the end of the video call, the patient/caregiver is asked for a satisfaction rating (using Skype tools) or notes on problems encountered.

DISCUSSION . The benefits offered by the use of Telemedicine, as a healthcare tool, essentially aim to improve health outcomes compared to pre-existing standards of care but at a lower cost. The presence of social and personal data protection implications in the use of technology, patients' perception of their quality of life, equity of access to care and privacy represent the issues analysed. The complexity of health demands induced by the continuous growth of chronic-degenerative diseases. The proposed model is based on territorial triage and aims to classify the patient with pain based on the degree of complexity to identify the best diagnostic-therapeutic path.

REFERENCES

1. State-Regions Agreement sanctioned on 20 February 2014 (Rep. Acts no. 16/CSR) concerning Telemedicine, national guidelines.

2. State-Regions Agreement sanctioned on 17 December 2020 (Rep. Acts n. 215/CSR) Containing national indications for the provision of telemedicine services 22-6-2022 OFFICIAL JOURNAL OF THE ITALIAN REPUBLIC General series - n. 144

3. https://www.agendadigitale.eu/sanita/telemedicina in Italy after emergency

4. National Recovery and Resilience Plan M6C1 – Proximity networks, structures and telemedicine for local healthcare - n.2 Home as the first place of care and Telemedicine

5. https://www.agenas.gov.it/organizational impacts what telemedicine means in departments, professions and healthcare continuity

6. www.dati-sanita.it telemedicine manuals Archives - Data management in healthcare (dati-sanita.it).