(by Giancarlo De Leo, AIDR Member and Digital Health and Medical Publishing Consultant) In this period of full Sars-CoV-2 pandemic, health services around the world are facing fundamental and disruptive changes.

The aging of the population, with the corollary of chronic diseases and disabilities, the availability of new treatments and technologies, the demand for quality by users, increase the costs of health systems.

To contain health care spending, governments have implemented a series of measures both at national and local level.

The Reform process of the Italian National Health Service has established that the essential levels of assistance are bound to the objectives of the national and regional health planning and to the amount of the insured financing.

The introduction of binding elements in the Italian healthcare organization has consequently entailed the assumption of managerial responsibilities by professionals who reach positions of responsibility for clinical and / or technical skills.

Healthcare professionals are traditionally trained in patient care but not in resource management; they are thus called upon to face management challenges for which preparation was brief or almost non-existent.

It follows that the way of managing people and activities is often linked to rigid and inefficient schemes, based on personal culture or instinct rather than on a rational and strategic choice of tools and styles; on traditional, top-down rather than participatory management planning.

In a healthcare organization, people represent the majority of resources.

Their skills and potential must be organized. Above all, people need to be guided and motivated. Most professionals in health care organizations, doctors, nurses, biomedical laboratory health technicians, medical radiology health technicians, clinical engineers, psychologists, biologists, etc., have a degree, a solid academic background and a clear awareness of their professionalism. .

The control of activities and people, a fundamental function in the classic description of manager, does not produce results in modern healthcare organizations.

Control must be replaced by leadership, by the ability to offer a vision, to motivate, delegate, enable collaborators to provide the service in the most effective and efficient way possible for the patient and the organization.

The success of a health organization whose purpose is to maintain and promote the health of individuals and populations increasingly depends on the ability to integrate the various professional figures into a work group (team).

The e-Leadeship in Health

The definition of e-leadership skills is not unique: alongside digital skills, transversal skills (typical of the leader) and sector-specific skills are needed.

The e-leadership skills refer to the ability to make the best use of the opportunities offered by digital technologies within any type of organization and are placed in the middle between basic skills and specialized skills.

It is a broad category of skills, difficult to define, but which represents the real challenge of innovation: IT skills that all workers (not just ICT professionals) should have, necessary to "imagine, propose, promote, animate" digital transformation in all organizations, large and small, public and private.

Skills that allow to introduce digital innovation in the specific organization (and in the specific market sector) in which it operates.

This area of ​​expertise includes the fundamental ones relating to the knowledge of what a digital transformation project represents, of which actors it involves and how much it costs, of what are the expected benefits and critical issues regarding operation, the use of networks , social networks, issues of security and life cycles, databases, privacy and cybersecurity, etc.

These skills are transversal and are valid in all contexts, such as that of Healthcare.

In its most complete expression, the e-leader is a top figure, a manager in a large organization, an executive in a public administration, an entrepreneur or a figure close to him in a small or medium-sized enterprise and in the healthcare sector. , a manager in a health organization, a manager in a hospital, a head nurse in a hospital ward, etc.

The "construction" of that professionalism is a long, complex and unsuccessful path that is not guaranteed and is the result of a continuous integration of skills:

  • learned in school and university (formal);
  • acquired both in the career path thanks to the experience accumulated on the job itself (non-formal) and thanks to structured on-the-job training (informal).

To all this is added a specific vocational attitude which is difficult to form.

Ultimately the e-leader is the result of a complex training course and a strong personal attitude: it has an extra gear.

This precious and difficult figure requires a complete and complex cultural background, ranging from fundamental knowledge of the digital world to the culture of leadership.

In fact, it may be appropriate to think of new high-level training courses that combine specialized contextual skills: eg. healthcare skills with high skills that characterize e-leadership, from digital culture to soft skills and high managerial skills.

Therefore, it would be desirable, in light of what we are experiencing, and an uncontrolled growth of big data, that we can finally hypothesize in our country the creation of a National Training Plan in Digital Health and e-leadership in Complex Systems, such as that of Health, which provides for the assessment, training and certification of the digital skills of all personnel (managerial, clinical, health, technical and administrative) who work in this sector.

And let's not forget that Good Information is the Best Medicine (Donald AB Lindberg, National Library of Medicine).

From Leadership to e-Leadership in Healthcare at the time of Covid