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Chronic diseases represent a growing challenge for healthcare systems worldwide, particularly in aging populations like Italy, where multimorbidity and functional decline significantly impact care needs. This paper analyzes the epidemiological, clinical, and organizational aspects of chronic disease management, focusing on type 2 diabetes and heart failure. It reviews national care models, including the Chronicity National Plan and Diagnostic-Therapeutic Care Pathways (PDTA), and explores the integration of digital health tools, such as telemedicine, in addressing continuity of care and patient empowerment. Within this framework, the paper presents the TED – The intElligent Doctor at your home project, developed by DIPMED UNISA, as an innovative response to the need for home-based, patient-centered chronic care. TED integrates certified medical devices, telemonitoring platforms, virtual voice assistants, and Internet of Medical Things (IoMT) technologies to enable real-time health monitoring and AI-driven decision support. Designed using a Patient-Centered Design methodology, TED is currently undergoing a controlled clinical trial involving patients with type 2 diabetes and heart failure. The system aims to improve therapeutic adherence, quality of life, and reduce social isolation. In line with Italy’s National Recovery and Resilience Plan (PNRR), TED proposes a scalable, sustainable, and technologically advanced care model for frail and chronic patients.

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TED – The intElligent Doctor at Your Home

  • 会议论文

  • 发表日期：

    2026年

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  • Massimo Giordano,
  • Rosaria Del Sorbo,
  • Elisa Anna Contursi,
  • Chiara Maria Ragusa,
  • Maria Pia Di Palo,
  • Andrea Marino,
  • Giuseppe Del Sorbo,
  • Gabriele Mongelli,
  • Colomba Pessolano,
  • Simona de Santis,
  • Marianna Bartolomeo

摘要

Chronic diseases represent a growing challenge for healthcare systems worldwide, particularly in aging populations like Italy, where multimorbidity and functional decline significantly impact care needs. This paper analyzes the epidemiological, clinical, and organizational aspects of chronic disease management, focusing on type 2 diabetes and heart failure. It reviews national care models, including the Chronicity National Plan and Diagnostic-Therapeutic Care Pathways (PDTA), and explores the integration of digital health tools, such as telemedicine, in addressing continuity of care and patient empowerment. Within this framework, the paper presents the TED – The intElligent Doctor at your home project, developed by DIPMED UNISA, as an innovative response to the need for home-based, patient-centered chronic care. TED integrates certified medical devices, telemonitoring platforms, virtual voice assistants, and Internet of Medical Things (IoMT) technologies to enable real-time health monitoring and AI-driven decision support. Designed using a Patient-Centered Design methodology, TED is currently undergoing a controlled clinical trial involving patients with type 2 diabetes and heart failure. The system aims to improve therapeutic adherence, quality of life, and reduce social isolation. In line with Italy’s National Recovery and Resilience Plan (PNRR), TED proposes a scalable, sustainable, and technologically advanced care model for frail and chronic patients.