Digital-health

The current limitations of digital healthcare are complicating the Coronavirus emergency. In this new series of articles, we will try to highlight the most important ones.

Many people, I among them, have argued in the past that the integration of care is a theme first of all organizational, then technological. When the Coronavirus tsunami arrived, however, we realized that, without digital tools and infrastructures, setting up a care network integrated with paper or electronic forms is inefficient, insecure and ineffective.

The lack of hospital-territory integration, the approach to the territory with silo systems that do not communicate with each other (GPs with the home care, general practitioners with those of continuity of care, the home care with prevention and so on), divide and isolate the many professionals who today are engaged in the fight against the Coronavirus, who are unable to team up.

Good will, unfortunately, is not enough. Email and WhatsApp are not enough to manage processes that involve many operators and, unfortunately, many people. The numbers are really huge, and it is not possible to rely on communication tools to deal with a health emergency of this magnitude.

Many now define the Coronavirus pandemic as a war that, unlike the real ones, we are fighting with logic and tools of more than thirty years ago. Already for several years, wars have been fought with a net-centric approach and all defence systems were connected and interoperable. In healthcare we have an army of disconnected professionals who use a lot of paper and do not share information and processes.

The responsibilities for this situation are many and widespread at all levels:

• the management of institutions, regions and health care companies that have underestimated the importance of the integration of care and have not defined and undertaken a path in this direction
• the computer scientists who have not been able to leave their world of technology to enter the more complicated world of clinical processes and welfare models
• the medical and nursing staff who have often seen computerization as a problem or a nuisance
• general practitioners, jealous of their data and their autonomy, reluctant towards any model of information integration
• software manufacturers who have adapted to a divided and fragmented demand and developed their own silo applications.

It is to be hoped that, when the crisis is over, a serious discussion will open on how to set the health care of the future, which must be net-centric, both on organisational and technological level.

However, the lack of integration of care is not the only problem.

1 –to be continued