Community-based medicine and inclusive care in Tesino and Lower Valsugana Valley, an innovation laboratory

18 November 2025 By Marzia Lucianer

Monday, November 17, at Castello Tesino, the closing meeting of the Tesino Area Interna project. Tonina: “A model of local integrated and digital healthcare”

A meeting with the community, health professionals and administrators of Tesino and Bassa Valsugana, to provide a feedback on results achieved and present the organizational models experimented on this area, the initiatives and activities undertaken in the Internal Area of Tesino and discuss future prospects, in continuity with the actions provided for by Ministerial Decree 77 and the PNRR for local health. Palazzo Gallo, in Castello Tesino, yesterday hosted the conclusion of the “Tesino Internal Area – Community-based Medicine and Inclusive Care” project, promoted as part of the National Internal Areas Strategy (SNAI) and carried out between 2019 and 2025 by the Autonomous Province of Trento together with the Trento Province Healthcare System and TrentinoSalute4.0. A journey that has led Tesino to become a provincial laboratory of innovation, anticipating elements that are now central to the reorganization of community health: locally accessible and multidiciplinary care, networking, integrated use of digital media.
The opening remarks were entrusted to the Councillor for Health, Social Policies and Cooperation of the Autonomous Province of Trento, Mario Tonina, the President of the Valsugana and Tesino Community, Claudio Ceppinati, and the Mayor of Castello Tesino, Lucio Muraro. The meeting was attended, among others, by Denise Signorelli, member of the Board of Directors and director of the Northern District, Enrico Nava, the director of the Eastern District, and the mayors of Bieno, Pieve and Cinte Tesino. The moderator was Diego Conforti from the Health and Social Policies Department.
“The Internal Area of Tesino was one of the first areas in Trentino, together with Val di Sole, to experiment with a new idea of health: a health system that is closer to people, more integrated, capable of using technology to ensure responses, continuity, safety and local accessibility. To reverse the trend of depopulation of mountain towns. Two areas that have already implemented what is provided for by Ministerial Decree 77 and that we will implement in the coming months with the Case di comunità (Community clinics), to start a service that must be close and attentive to the local areas” the councilor said.

Tonina then recalled the importance of the work done in Tesino and Valsugana: “It is not just a project that ends, it is a model that in recent years has given concrete results: we are talking about local services that has involved dozens of patients with chronic diseases, a network of professionals who work together, digital tools that allow people to follow their health independently. These are the aspects on which Trentino can make a difference. ” Finally, the councilor highlighted how Tesino has been a valuable laboratory: “The solutions developed here – from telemonitoring to the role of the family and community nurse – have become a reference for the entire province, as part of the actions envisaged by the PNRR and DM 77. I thank health professionals, town administrations, associations, volunteers and all citizens: community-based health works when everybody participates, feels involved, are motivated. This is the way to go. Let us now look to the future, committing ourselves to maintain and strengthen what has been built”.

Mayor Muraro highlighted that “This pilot project on the Internal Area has achieved important results in terms of services for those who live in the Tesino area and aims to provide more and more opportunities for residents but also to attract new families”, recalling that work is being done for the implementation of the CUP (centralized appointments) service. President Ceppinati also stressed the attention of the Province to the local communities through the desire to invest and create services that help people stay, avoiding depopulation: “Now it is important to take the project beyond the Internal Areas stage”.

The event included talks by the professionals of the Province, Apss and TrentinoSalute4.0 who worked on the project: Elisa Menguzzo, the family and community nurse of Apss in Tesino, Sandro Inchiostro for the Diabetology community-based model, Dimitri Peterlana and Elisabetta Perna for the experience of the cardiology network.

Main achievements

The intervention was built around two main components: a skills package, which focused on strengthening residents’ digital skills, training healthcare professionals in telemedicine and digital tools, and delivering health education initiatives; and an innovative services package, which included the launch of a Family and Community Nurse clinic, pilot testing of local care delivery supported by telemedicine, home telemonitoring, and integrated follow-up with specialists, as well as the development of the TreC+ app modules for diabetes and heart failure.

Community-based care: currently, there are about 70 patients taken care of by family and community nurses in Bassa Valsugana and Tesino, 10 are followed by telemonitoring. There is a remote follow-up of 111 patients discharged from the Borgo Hospital and 22% of the target population, equal to 152 residents.

Since 2024, family and community nurses have been active in Pieve Tesino, Borgo Valsugana and Tezze di Grigno.

Digital skills 37% of the population of Tesino is active on the TreC+ app (the Trento Province average is 26.8%), an increase that is also the result of the promotion activities carried out locally.

Telemedicine As of 2022, the telecooperation service for the digitization of the entire process for the evaluation, prescription and testing of aids for guests of the Valsugana and Tesino nursing homes (Abilita project) has startred. This service has been extended to the other health districts and will be completed by November with the 22 RSA offices in the Southern District. In the past 18 months alone, it has allowed 800 requests to be managed remotely, with a considerable reduction in user trips and prescription times for aids.

The joint work of general practitioners, Bogo’s Internal Medicine, Trento’s Cardiology, Borgo’s Diabetes Care and Family and Community Nurses has allowed the development of an integrated care model at two levels (based on the needs and complexity of the patient) for the management of chronic diseases for patients with heart failure, diabetes, respiratory and neurological diseases. The model has been later adopted as a reference for Val di Sole and progressively for the entire province as part of the regional reform. (m.c.)