The future becoming the present



With the technologies already available, it is possible to redesign the care and treatment network, leaving behind the paradigm on which today’s healthcare is based.

Let’s imagine hospitals entirely focused on the high and very high intensity of care: Emergency Room, Intensive and Sub-intensive Care, Operating Block and a few ordinary hospital beds for post-operative care.

Let’s imagine a network of “provincial” health facilities, designed for the low intensity of care and hospitalization of patients discharged from the hospitals mentioned above but in need of a clinical continuum difficult to manage at home. Let’s imagine a network of associated General Practitioners with diagnostic equipment, day hospital places and a small operating room for routine operations.

Let’s imagine a surgical patient discharged on the second day and taken home, assisted at home by nursing staff for the few necessary operations (infusion therapy feeding, surgical wound dressing) and medical devices connected to the network that transmit vital parameters in a continuum.

Let’s imagine the surgeon connecting once a day in an audio/video conference to monitor the patient and reassure family members. Patients doing rehabilitation while staying at home, connected with telematic tools and augmented reality platforms.

What you just imagined was, until a few weeks ago, a scenario on the borderline between the futuristic and science fiction. Even though all the necessary technologies are already widely available.

Today, in conditions of major health emergencies, serious consideration is arisen to accelerate the adoption of new treatment processes based on the information and telematics technologies.

Today’s problem is not only to “remotely visit” subjects potentially affected by the Coronavirus. The problem is to empty the hospitals as much as possible in order to cope with an unwanted escalation of the epidemic. The problem is also to safeguard hospitalized patients from possible infection, and to manage all human and technological resources in the best possible way.

From a strongly critical moment, a new sensibility and the consequent tension to solve problems are always born.

The infamous “black death” of 430 B.C. remarkably contributed to open a critical review of that time’s customs, too exposed to pathologies attributable to a lack of consideration of hygiene by the Greeks and to the development of the Hippocratic School.

The Antonine Plague (which was a devastating pandemic of smallpox) offered Galen the opportunity to study the phenomenon in depth, laying the foundations of the first infectious diseases.

The arrival in Italy of the Black Plague of the 14th century AD (born between China and Mongolia) developed a lively discussion among doctors and – especially in Venice – gave rise to a real systemic policy of Public Hygiene.

The epidemics of the last century were tackled – and largely eradicated – thanks to a huge effort by the pharmaceutical industry to find definitive remedies. It is a rule of history: every crisis generates (even) enormous opportunities.

Today it is the turn of information technology and telecommunications, able to decouple a medical or nursing act from the physical presence of the actors involved and to strongly limit the movements with – as a consequence – the occasions of contagion.

We are seeing it in non-clinical fields too: schools organize themselves with virtual lessons, companies apply telework on a massive scale. Governments worldwide are thinking about financial contributions to the introduction of telematic technologies capable of reducing the mobility of human beings to a minimum.

So why not extend this reasoning to Healthcare? Why not imagine an extraordinary financing plan for the development of telemedicine?

Taking care not to consider exclusively its “tactical” use, aimed at the management of the Covid-19 epidemic.

With less than 20 million Euros we are able to activate teleconsultation and television platforms in all Italian public hospitals; with another 20 million Euros we can equip all the main cardiological and pneumatological rehabilitation facilities with augmented reality devices to be entrusted on free loan to the patients managed.

40 million for the whole of Italy.

In these days, the Lombardy Region alone has allocated the same amount of money to purchase surgical masks to be distributed to regional health personnel.

This is the opportunity to ride to seriously transform, once and for all, the processes of diagnosis, therapy and treatment. Let’s not miss this train!

Paolo Colli Franzone

President IMIS – Institute for the Management of Innovation in Healthcare

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