(by Giancarlo De Leo) The introduction of new digital technologies in Healthcare is one of the main objectives of Italian and European institutions. It is clear that the cost of traditional health care is destined to become unsustainable and therefore being able to adopt measures that are able to contain expenditure without compromising the level of assistance has become an absolute priority.
Chronic diseases increasingly widespread and an increasingly elderly population require an epochal transformation with the transition from a medicine based on diagnosis and treatments to 4P medicine (Predictive, Preventive, Personalized and Participatory). The growing diffusion of Information and Communication Technology (ICT) in the National Health System (Electronic Health Record, Electronic Medical Record, Telemedicine, Clinical Decision Support Systems, 3D Printing, Artificial Intelligence, Robotic Surgery, Biomedical Apps, Augmented Reality, etc.) requires overcoming not only structural but above all cultural obstacles.
Furthermore, adequate training and continuous updating of health professionals is necessary, as well as the active involvement of citizens, patients and caregivers in clinical decisions that can only be made thanks to the provision of clear and reliable information.
Of particular note is the expertise of the information experts which is essential and cannot be substituted. In the organization of scientific knowledge, more and more experts are needed in content and quality management, also to produce health sites aimed at professionals, patients and citizens. These are transversal skills such as those of computer scientists for the technical part. There is no sector where the supply of documentation is not necessary, we think of the medical record that should be linked to the most up-to-date information for the professional, as is already the case with clinical decision support systems.
The same patient, in the part that belongs to him (diary), within the Electronic Health Record should also receive information from quality portals in order to better manage their illnesses and problems. It is precisely in the integration between IT and documentation tools that the future of medicine is at stake.
During the most demanding months of COVID-19, the need led to the rediscovery of Smart Working in Italy (which provides for the absence of space constraints) and a great help came from Telemedicine, which allowed, among other things, to support chronic patients, to speed up technical and bureaucratic meetings and to save lives.
COVID-19 has put the urgency to rapidly innovate the National Health System and to carry out those technological reforms which it has been discussing for years (see document "Initiatives for the relaunch" Italy 2020-2022 ", called the" Colao Plan ", Worksheets n.73" National digital health plan "and n.74" National health monitoring).
The "Colao Plan" for Healthcare focuses, in particular, on the shortcomings of the Digital Health System at national level, which too often has proved obsolete and unable to give quick and efficient responses to citizens. The challenge for the next few months is therefore to be able to connect all the players in the Healthcare System, digitize the sector and implement welfare services.
The COVID-19 emergency highlights the need for the application of Telemedicine (a method of providing health care services through the use of innovative technologies that brings the doctor's service directly to the patient's home, without leaving the office and without the patient himself being forced to move), not only for COVID, but above all to ensure access to care for all other patients.
The use of Telemedicine, representing a new and very important frontier as it implies a set of organizational and technological processes that allow to eliminate barriers of distance, time and costs for access to treatment, has already offered a method regularly and for some time to be close to patients even from a distance and, with the ability to remotely view the data transmitted from home, involved an involvement of the patient and his family in sharing practices that allowed savings on travel and long waits.
In the post lockdown, follow-up visits and scheduled checks gradually resumed, so as to facilitate the containment and management of the epidemiological emergency from COVID-19.
In reality, most healthcare professionals still use technologies in a form that is not recognized by healthcare facilities and also lacks legally valid traceability.
It should be noted that the use of technological tools for the processing of health information or the online sharing of data and / or health information does not in itself constitute a Telemedicine service, such as e-mail, social networks and forums. Furthermore, Telemedicine must be subject to an accreditation system that guarantees patients, operators and the payer.
In conclusion, digitalization and virtualization of care could be the only possible solution to the problem. It is necessary to encourage the transition, as far as possible, from the current and expensive system that places the hospital at the center to a model of assistance distributed throughout the territory and centered on the patient with assistance that dematerializes and becomes digital. Therefore it is important that from this extraordinary situation the National Health System becomes more and more qualified and accustomed to Telemedicine, analyzing the regulatory framework that needs an update of the National Guidelines, identifying the advantages and paying attention to the training and updating of digital skills of personnel working in the healthcare sector, giving importance to data protection and security. Technology must support healthcare professionals and patients. Only in this way will it be possible to make a leap forward that Italian health care has been waiting for for years.
Giancarlo De Leo - Consultant in Medical-Scientific Publishing and Digital Healthcare, Partner and Secretary of the Digital Health Observatory of the Italian Digital Revolution Association (AIDR)