Health systems are increasingly put under pressure by social changes in recent decades. The lengthening of the average lifespan and the general aging of the population, especially in Western countries, lead to the spread of chronic diseases. This problem also affects the Italian healthcare system: in 2017, as many as 25 million Italians, almost 40% of the population, have been affected by chronic diseases. «The projections made on the basis of future demographic scenarios are not reassuring; in fact, in 2028 the number of people with serious motor deficits among the over 65s will rise to over 3,5 million and to over 4,1 million in 2038, while the number of people with serious vision deficits will be over 800 thousand in 2028 and 959 thousand in 2038», we read in Osservasalute Report 2018.
TECHNOLOGIES FOR HEALTHCARE SERVICE
In Italy, the healthcare system is combining the challenges of these changes with those resulting from the economic situation. The latest report from the Court of Auditors on the state of healthcare finances certifies that our country spends less than three percentage points of GDP on healthcare compared to France and Germany, a figure that still exceeds 115 billion euros and is close, in percentage terms, to 9% of what is produced in ItalyHowever, as highlighted by the website il quotidianosanità.it, what is particularly high in our country is out-of-pocket spending, that is, medical expenses incurred out of pocket, generally for specialist visits, a nest egg that excludes insurance costs paid directly by private individuals. In this case, the EU average is around 15%, while in Italy it reaches 22%. While on the one hand, the increase in the cost of co-payments has pushed families to turn to private facilities, on the other, queues and inefficiencies of the health system and the waiting times in public hospitals have discouraged a large number of users.
FINANCIAL SUSTAINABILITY AND PUBLIC HEALTH
2030 Agenda, the document that sets out the commitments that the world will have to fulfill within the next decade to ensure a Sustainable Development, identifies among the 17 priority objectives (the Sustainable Development Goals, or SDGs) the goal "Health and Well-Being, ensuring healthy lives and well-being for all at all ages". Agenda 2030, which was signed by 192 countries at the United Nations Headquarters in New York on 25 September 2015, underlines, in fact, that between 2005 and 2016 only 10% of the least developed countries managed to have one doctor for every 1000 inhabitants, while there is also a shortage of nurses and obstetric staff. A problem that also affects our country. Recently the Bari Medical Association raised the alarm: Puglia is destined to lose more than 2600 doctors in the next few years between specialists and non-specialists, putting the sustainability of the entire regional system to the test.
TECHNOLOGIES FOR THE HEALTHCARE SYSTEM
In this context of staff shortages, population ageing Given the lack of funding, new strategies need to be developed. For example, streamlining ever-increasing patient flows, building databases capable of profiling patients to predict the most likely pathologies, and simultaneously developing personalized therapies could represent a lifeline for national healthcare systems worldwide.
NANOTECHNOLOGY AND START-UPS IN THE HOSPITALS OF THE FUTURE
New management models are gaining ground around the world. Last October 1st, Northern Care Alliance, the hospital company that manages several hospitals in the United Kingdom, signed an agreement with the Japanese giant. Hitachi to make theSalford Hospital fully digitalizedThe goal of the collaboration is to create an intelligent system that helps meet patient needs, providing care and freeing staff from non-clinical tasks. The new approach will use the digitalization and automation To provide staff with the medical information they need reliably and timely, thus optimizing service. Staff will thus be able to better meet the needs of all users and minimize waste and waiting times. The benefits will be significant, explain the initiative's promoters. "The change will impact staff throughout the organization and will be positive," explained the hospital's CEO, Raj Jain. The tool that will enable this evolution will be a Digital Control Center Created specifically for the hospital, the Center will analyze clinical needs in real time, correlating them with economic issues, such as resource constraints and bed availability. This will also allow for the creation of a database that improves decision-making, streamlines processes, and reduces delays. All this will enhance the patient experience.
RESEARCH AND HOSPITALS: NOT JUST MEDICINE
Hospital research in the field of nanotechnology is used as a tool for financial sustainability also from the Israeli hospital Sheba Medical Center in Tel Aviv, which has made innovation a true model. As reported in an investigation published in Tutto Salute, a supplement to the daily newspaper La Stampa, for two years the hospital has hosted a campus that attracts not only medical staff but also businesses and engineers. The aim of this "Innovation Center" is to try to optimize the process problem solving, tightening the supply chain and encouraging an ongoing relationship between doctors and researchers.
Over the past two years, the Israeli hospital has managed to activate a network of 20 start-ups, working in six different development areas: precision medicine, telemedicine, virtual reality, Big Data and Artificial Intelligence, surgical innovation and rehabilitation. The key to the success of this model is the speed with which it allows for decision-making: for each area, doctors and surgeons are supported by experts in law and bioethics, while every two weeks organized meetings where you can submit your application for a project. For this reason, the slogan from which the project takes its name is Accelerate. Redesign. Collaborate. (Arc).
Thanks to research conducted on the campus, Tel Aviv Hospital now has a world-leading rehabilitation center. Researchers and doctors have developed a virtual reality system that allows patients to practice their skills in a safe, virtual environment that faithfully mimics reality. This experiment is also bearing fruit in terms of scientific resultsThe research conducted by the Dr. Meir Plotnik from the Israeli hospital that would explain how we humans calculate gravity when we move: "Using advanced virtual reality technology, we demonstrate that exposure to the inclinations of a virtual road induces the patient to modulate his or her gait in a manner consistent with the expected gravitational forces (i.e., acting on a free body), thus suggesting that the perception of gravity is vision-based."
START-UPS IN THE HEALTHCARE SECTOR IN ITALY
Even in our country, public and private players in the sector are trying to collect the best ideas coming from the reality of start-upBayer, for example, has started the G4A Milan, the Italian version of an international program that offers support to companies around the world. However, this general interest in new technologies, adequate investments do not always follow.
An example of this is artificial intelligence: although it is gaining ground in the national healthcare system, according to research by the Digital Innovation Observatory in Healthcare at the School of Management at the Polytechnic University of Milan, investments are slow to take off, hovering around seven million euros. In turn, the use of the technology remains experimental. "Although digital technology is a priority for Italian healthcare facilities, the level of maturity emerging from the current situation shows a still disorganized picture, despite slow, yet steady, growth compared to recent years," comments Cristina Masella, scientific director of the Digital Innovation Observatory in Healthcare. The adoption of digital technologies and their proper integration, if fully exploited, would allow us to truly leverage the potential of digital healthcare. patient at the center of the ecosystem, making its relationship with healthcare professionals and the health system more appropriate and sustainable, with significant savings in time and public resources.
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