Telemedicine in Psychiatry: Benefits and challenges of the Home-Hospital Care system (COD20) project

Introduction: Amid the COVID-19 outbreak, Telemedicine (TM) has demonstrated its potential to connect with individuals unable to access traditional in-person services. To facilitate this process, the University of Milan, in partnership with local health institutions, developed the Home Hospital Care System (Cure Ospedaliere Domiciliari; COD20), a video consultation service. Our study aims to evaluate preferences, user experiences, and the potential benefits and applications of TM among psychiatric patients. Methods: 350 consecutive patients from the ASST Fatebenefratelli-Sacco outpatient clinic in Milan were interviewed using an online anonymous survey, in the period between November 2022 and March 2023. Results: The total sample was 350 subjects, of which 39.5 % received psychiatric evaluations via TM. The inclination towards future TM use was significantly higher among individuals with a university degree (p < .05), as well as those who had previously used the COD20 platform (p < .05). Younger age (p < .05), having an anxiety disorder (p < .05), a reliable internet connection (p < .05), ownership of a smartphone or a computer (p < .05), and possessing an ECDL certificate (p < .01) correlated with higher ease of use for TM. Patients with schizophrenia showed a higher probability of lacking skills in information and data literacy, communication and collaboration, digital content creation, problem-solving (p < .001), and safety (p < .01). This group also had significantly lower ownership rates of smartphones (p < .001), tablets (p < 0.05), computers (p < .001), and adequate internet connections (p < .01). Conclusions: TM showed high levels of user satisfaction and ease of use. This technology may enhance access to care by overcoming common barriers, including distance, travel costs, and time constraints.