Gabbrielli (Iss): “Telemedicine? ‘For now it’s taking its first steps”

Spending on digital health in 2020 reached a value of € 1.5 billion, equal to 1.2% of public health expenditure and about € 25 for each citizen; the use of telemedicine has tripled (data from the Digital Innovation in Health Observatory of the Politecnico di Milano), “however the system is taking its first steps. We have been coming for 10-15 years during which there has never been a nationwide organization of the telemedicine system. If anything, there have been many experiences, some of value that have given the possibility to solve problems even during the Covid emergency. Faced with reality, the pandemic has found us lacking in the possibility of using digital technologies to reach patients. In many regions, the experiences made were of a specialist hospital type on specific problems, they almost never took the patient into consideration as a whole, while general practitioners have organized themselves with such an autonomous platform that they do not speak to anyone “. This is the photograph taken by Francesco Gabbrielli, director of the National Center for Telemedicine and New Assistive Technologies of the Higher Institute of Health (Iss) on the occasion of the webinar “Digital Health. Innovation in the treatment of chronic autoimmune rheumatological and dermatological diseases ”, promoted by Ucb Italia. The main innovations, as emerged from the online meeting, do not concern only the so-called telemedicine, but also electronic health records, medical apps, the management of big data, up to the so-called “digital therapies”, the last frontier of medicine. “The regions – says Gabbrielli – have developed the Electronic Health Record (ESF) systems in an apparently similar way but in reality with systems that do not speak to each other. In April 2020, as the National Center for Telemedicine we published a document on how to organize telemedicine systems based on a few very useful services. Most of the experiences were improvised in the wake of the need and willingness of doctors to reach their patients. They should be thanked, but we cannot go on like this, developing a telemedicine system based on improvisation and goodwill. Since last summer we have been working with institutions and regions at a national level on some documents that will arrive in the coming weeks to put together a series of services. ”According to Gabbrielli, digital needs interoperability to work well. “Thinking in terms of services – says the expert – can help change the mentality, overcome the fragmentation of the 21 regional health systems. Telemedicine is territorial, it is done thinking of a large territory and it is necessary that everything on the net dialogues continuously and to do so everyone must speak the same language and it is not only a technological issue (interoperability can be overcome) but also an organizational one. Both must be there for harmonious and coherent work between one location and another, between one system and another ”.