International Journal of
Environmental Research
and Public Health
Article
Green Line Hospital-Territory Study: A Single-Blind
Randomized Clinical Trial for Evaluation of Technological
Challenges of Continuous Wireless Monitoring in Internal
Medicine, Preliminary Results
Filomena Pietrantonio
1
, Antonio Vinci
2
, Francesco Rosiello
1,3,
* , Elena Alessi
1
, Matteo Pascucci
1
,
Marianna Rainone
1
, Michela Delli Castelli
1
, Angela Ciamei
1
, Fabrizio Montagnese
1
, Roberto D’Amico
4
,
Antonella Valerio
5
and Dario Manfellotto
6
Citation: Pietrantonio, F.; Vinci, A.;
Rosiello, F.; Alessi, E.; Pascucci, M.;
Rainone, M.; Delli Castelli, M.;
Ciamei, A.; Montagnese, F.; D’Amico,
R.; et al. Green Line
Hospital-Territory Study:
A Single-Blind Randomized Clinical
Trial for Evaluation of Technological
Challenges of Continuous Wireless
Monitoring in Internal Medicine,
Preliminary Results. Int. J. Environ.
Res. Public Health 2021, 18, 10328.
https://doi.org/10.3390/
ijerph181910328
Academic Editor: Oliver Faust
Received: 29 July 2021
Accepted: 24 September 2021
Published: 30 September 2021
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1
Internal Medicine Unit, Ospedale dei Castelli, ASL Roma 6, Va Nettunense, 00043 Rome, Italy;
filomena.pietrantonio@aslroma6.it (F.P.); elena.alessi@aslroma6.it (E.A.);
matteo.pascucci@aslroma6.it (M.P.); marianna.rainone@aslroma6.it (M.R.);
michela.dellicastelli@aslroma6.it (M.D.C.); angela.ciamei@aslroma6.it (A.C.);
fabrizio.montagnese@aslroma6.it (F.M.)
2
School of Hygiene and Preventive Medicine, University of Rome “Tor Vergata”,
00100 Rome, Italy; antonio.vinci.at@hotmail.it
3
Department of Infectious Disease and Public Health, Sapienza University of Rome, P. le A Moro, 5,
00185 Roma, Italy
4
Centro Oncologico Modenese, Department of Medical and Surgical Sciences, Mother and Child and
Adult Health, Modena and Reggio Emilia University, 3
◦
Piano, Azienda Ospedaliero-Universitaria
Policlinico di Modena, Via del Pozzo 71, 41124 Modena, Italy; roberto.damico@unimore.it
5
Fadoi Foundation, Piazza Cadorna 15, 20123 Milano, Italy; antonella.valerio@fadoi.org
6
Internal Medicine Unit, Fatebenefratelli Isola Tiberina, Via di Ponte Quattro Capi 39, 00186 Roma, Italy;
dario.manfellotto@afar.it
* Correspondence: francesco.rosiello@uniroma1.it
Abstract:
Background: Wireless vital parameter continuous monitoring (WVPCM) after discharge is
compared to regular monitoring to provide data on the clinical-economic impact of complex patients
(CPs) discharged from Internal Medicine Units of Ospedale dei Castelli, Lazio. Primary outcome:
Major complications (MC) reduction. Secondary outcomes: Patients who reached discharge criteria
within the 7th day from admission; difference in MC incidence at the conclusion of the standard
telemonitoring/clinical monitoring phase, 5 and 30 days after discharge; and conditions predisposing
to MC occurrence. Methods: Open label randomized controlled trial with wearable wireless system
that creates alerts on portable devices. Continuous glycemic monitoring is performed for patients
with diabetes mellitus. Results: There were 110 patients enrolled (mean age: 76.2 years). Comorbidity:
Cumulative Illness Rating Scale CIRS-CI (comorbidities index): 3.93, CIRS SI (severity index): 1.93.
About 19% scored a BRASS (Blaylock Risk Assessment Screening Score)
≥
20 indicating need for
discharge planning requiring step-down care. Globally, 48% of patients in the control group had
major complications (27 out of 56 patients), in contrast to 22% in the intervention group (12 out of
54 patients). Conclusions: Since WVPCM detects early complications during the post-discharge CPs
monitoring, it increases safety and reduces inappropriate access to the Emergency Room, preventing
avoidable re-hospitalizations.
Keywords:
wireless monitoring system; telemedicine; integrating hospital and community; acute
medicine; poly-morbidity; internal medicine core competencies
1. Introduction
In recent years, more and more patients admitted to internal medicine (IM) wards
have been reported as being in large part affected by a wide range of acute, subacute,
Int. J. Environ. Res. Public Health 2021, 18, 10328. https://doi.org/10.3390/ijerph181910328 https://www.mdpi.com/journal/ijerph
