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Aspetti medico-legali della teleradiologia. Che cosa ci hanno insegnato i casi di Marlia e Barga

Grazia Carosielli, Concetta Brugaletta, Alessandra De Palma



Telemedicine is the use of information and telecommunications technology to provide, support and supplement traditional health care services at a distance, thus overcome the presence of physical, geographical, social and cultural barriers, and ensure effective and equitable availability of access to healthcare. However, in spite of the opportunities granted by the Telemedicine, its spread in the country is still affected by the presence of medico-legal problems.

Teleradiology, the sector with the most large application e-Health service, uses integrated systems capable of transferring multimedia remote radiographs, ultrasound and computerized axial tomography and magnetic resonance imaging, for their interpretation, to ask for a second opinion in particularly complex cases, for a collegial review of a case and, finally, for a diagnosis in cases of emergency.

In 2013, doctors and medical technicians of Radiology, working in two hospitals posted of AUSL 2 Lucca (“Marlia” and “S. Francesco di Barga”), were indicted for the crime of the unauthorised practice of the medical profession and for the violation of legal obligations relating to radiation protection. During the trials it was found that in the two hospitals were provided, after prescription, radiological basic building blocks, and the images were interpreted by a radiologist not present in the place, but using computer technology (RIS-PACS System).

Criminal trials under review, in which all defendants were acquitted as requested by the prosecution, suggest that if the evidence and the law had been further enhanced, already under preliminary investigation, criminal prosecution would not have even started.

In addition, the changes introduced by the Telemedicine services – among them the reorganization of the mode of service delivery, and the revolution of the doctor-patient relationship – impose a reflection on how to evaluate the responsibility of the professionals involved.

Parole chiave

Telemedicine; Technology; Quality of care; Legislation; Liability

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