Pennestrì Federico, Banfi Giuseppe
IRCCS Istituto Ortopedico Galeazzi, Via Belgioioso 4, 20161 Milan, Italy.
School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy.
Healthcare (Basel). 2023 Jul 27;11(15):2147. doi: 10.3390/healthcare11152147.
The Italian Government planned to invest €15 billion of European funds on National Health Service digitalization and primary care enhancement. The critical burden brought by the pandemic upon hospital care mean these investments could no longer be delayed, considering the extraordinary backlogs of many treatments and the ordinary gaps of fragmented long-term care, in Italy and abroad. National guidelines have been published to standardize interventions across the Italian regions, and telemedicine is frequently mentioned as a key innovation to achieve both goals. The professional resources needed to run the facilities introduced in primary care are defined with great precision, but no details are given on how digitalization and remote care technologies must be implemented in this context. Building on this policy case, this paper focuses on what contribution digitalization and telemedicine can offer to specific primary care innovations, drawing from implemented technology-driven policies which may support the effective stratification, prevention and management of chronic patient needs, including anticipatory healthcare, population health management, adjusted clinical groups, chronic care management, quality and outcomes frameworks, patient-reported outcomes and patient-reported experience. All these policies can benefit significantly from digitalization and remote care technology, provided that some risks and limitations are considered by design.
意大利政府计划投入150亿欧元的欧洲资金用于国民医疗服务数字化和加强初级保健。考虑到意大利国内外许多治疗的积压情况以及长期护理碎片化的常规缺口，疫情给医院护理带来的巨大负担意味着这些投资不能再拖延。意大利已发布国家指南，以规范各地区的干预措施，远程医疗经常被提及是实现这两个目标的关键创新。运营初级保健中引入的设施所需的专业资源有非常精确的定义，但未给出在这种情况下必须如何实施数字化和远程护理技术的细节。基于这个政策案例，本文聚焦于数字化和远程医疗能为特定的初级保健创新做出什么贡献，借鉴已实施的技术驱动政策，这些政策可能支持对慢性病患者需求进行有效的分层、预防和管理，包括预期性医疗保健、人群健康管理、调整后的临床分组、慢性病管理、质量和结果框架、患者报告结果以及患者报告体验。只要在设计时考虑到一些风险和限制，所有这些政策都能从数字化和远程护理技术中显著受益。
