1. A Clinician’s View of Next-Generation Remote Healthcare System

There are few critical questions to answer in relation to remote healthcare systems and the pertinent technologies implied in transferring surveillance and care next to the patients: (1) will they help reducing and/or at least rationalizing care and lower hospitalizations and connected high costs?; (2) will this be really at hand in the near future?; and (3) what are the relevant parameters to obtain and follow in order to make remote healthcare an impacting reality on health systems? “There will be titanic changes ahead—Medicine can and will be rebooted and reinvented one individual at a time”: cultural, technological and scientific features will have a stronger relevance and impact on orienting the future revolution and decision than administrative and merely technological processes. However, the future remote healthcare model should be based not only on Darwin’s selection of a more and more powerful market (hundreds of billions in Europe), or cumbersome, restrictive, national (or even local) rules. It should start from strong ethical and scientific bases. The great potential benefits should be addressed on humans and on processes of care. Continuity of care, prevention and healthcare throughout the person’s life are an excellent beginning. The future will not depend on our technological capacities but on our decision-making capacity of creating systems based on a global approach, in order to cope with the complexity of healthcare environment. Remote healthcare should involve physicians, patients, academics, health service organizations and industries, integrating all their different points of views, not neglecting the final user’s needs. Use case scenarios are reviewed here, from pre- to post-hospitalization and from the management of congestive heart failure to chronic obstructive pulmonary disease, hypertension and diabetes and renal diseases. It seems that future remote health system should provide the parameters to evaluate trends and short-term predictive indexes and may thus help paving the road for a great revolution in Medicine, based on decision-logic module that computes in an automated way the potential risk of an impending episode by information fusion of heterogeneous sensor, demographic data and evidence-based clinical diagnosis process.