Lesson learned from the Coronavirus: entropy is a problem, not the solution


In emergency management creativity can be a resource, but it can easily become another problem to manage.

The COVID-19 emergency has given the world of telemedicine a stage we would have gladly done without for obvious reasons, but in any case, it has done so.

Excellent from the point of view of spreading awareness and knowledge among a generalist public, but let’s try to look optimistically at the “after“.

Now, in these convulsive days made of hackatons and call for ideas, it’s all a flourishing of project drafts of more or less original ideas, of proposals put forward by surely very good developers probably a little without specific skills in the health field.

I tried to read some of the hundreds of ideas and Apps, more or less already realized, and I must say some thrills came to me.

Good ideas, I repeat. Fascinating interfaces, excellent user experience. But no idea what “everything behind it” looks like.

Integration with health information systems behind: zero.

Knowledge of hospital and territorial processes: zero.

Awareness of regulatory and clinical constraints: zero.

For years now, all those involved in ICT applied to the world of Healthcare have been outraged by the fact that the current hospital and territorial information systems used in Italy are too fragmented. Imagine how it would be tomorrow if we had not only the current application silos but also the great sea of Apps developed by good creatives.

Alongside all this technological fantasy there are the minimalists: those who “just use Skype and WhatsApp and everything is solved”.

I read about “how to make a television using Skype”. All beautiful in this moment of total emergency, where the need to do everything quickly and to be able to start making TVs tomorrow morning reigns supreme.

But let’s not make it a habit.

There is probably a reason why in that almost half world, where telemedicine is not only a theoretical debate but is done daily, ad-hoc platforms are used. It can’t be that we Italians are smarter than them, and we found the free egg of Columbus.

It’s not so much a question of GDPR: competent jurists have explained to us how even Skype or similar can be used without breaking a rule and a sacrosanct right to personal data protection.

It is, again, a question of integration.

If I make a televisit, there has to be a definite identification of the patient: “Mario Rossi” is not enough.

The report and the prescriptions at the end of the medical act (the televisit is a medical act, let’s remember it well) must end up in the Folder, and maybe also in the Electronic Health Record. And they should end up there without leaving a platform, enter the application and retype everything all over again.

The market of Apps and telemedicine platforms exists, above all there is a set of ICT companies that have been dealing exclusively with Healthcare for decades and know it in all its ravines.

I try to make a macabre example, also to exorcise this complicated moment: do the creative people of the Apps know which are the information flows that are unleashed when a patient has died?

Or: do they know what are the competences and flows within the territory? What role do Public Hygiene offices play in an epidemic situation? How should they turn the information produced by their fantastic Apps?

I don’t want to seem too critical of all this unleashed fantasy (sometimes, unfortunately, unleashed by institutions – see the recent call from the Ministry of Innovation) but, in the end and despite everything, the wisdom of proverbs prevails.

There’s a saying, “pie maker, do your job.”

It takes a little less imagination and a little more respect for the professionalism and for the companies that have been investing to increase their skills in the service of health care in this country.

Healthcare is a serious and complex field.  Let’s all remember that.

2 – to be continued

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