the eight objectives to create treatments that are truly equal and accessible everywhere and by everyone – breaking latest news

The World Health Organization wrote it black yes white, in the document Global digital health strategy 2020-2025: to improve health of everyone and in every place on the planet, there is a need to accelerate the development and adoption of digital health solutions

aimed at the person that are «appropriate, accessible, safe, scalable and sustainable». Digital health, in turn, will add value if it is able to ensure “universal and equitable access to quality health services”. Even the European Commission focuses on digital health as a tool for “equality” in care. And the “social” dimension of digital healthcare, which becomes a challenge, requires serious reflection and adequate choices.

Which? and how? The Italian Association of Clinical Engineers, which this year celebrates its 30th anniversary, e CittadinanzAttiva have joined forces and are launching the Manifesto «Technologies as a social challenge: 8 objectives for technologically advanced healthcare».

1) OF THE RIGHT TO HEALTH: YES TO THE TECHNOLOGIES TO REALIZE ARTICLE 32 OF THE CONSTITUTION TODAY The reference value of Italian healthcare is represented by theArticle 32 of the Constitution: the Republic protects health as a fundamental right of the individual and in the interest of the community. The realization of the right to health today passes through the correct, vast and timely implementation of technological innovation and the correct management of health technologies: this political, cultural and social challenge must be accepted in Italy by national and regional institutions, agencies, universities, professions, citizens and their representatives, the media.

2) ACCESS: YES TO TECHNOLOGY AS A TOOL FOR UNIVERSAL HEALTHCARE Biomedical technologies represent an indispensable answer for universal and uniform access to health answers throughout the national territory. The technological challenge can represent a leap forward for universalism and for the equality of services. It is unacceptable that advanced technologies are concentrated only where healthcare is already of excellence. If the technological response in healthcare is not guaranteed and accessible throughout the territory, penalizing the south of the country, rural areas, small islands, mountain areas, the same technologies will become a new reason for imbalance and differentiation, increasing the phenomenon of mobility healthcare, one of the first critical points of the NHS.

3) PROGRAMMING: YES TO THE ACCURATE AND CONCRETE APPROACH OF TECHNOLOGICAL INVESTMENTS A homogeneous availability of technologies can only be obtained through rigorous territorial planning, which takes into account the catchment area and the skills actually present and not through a “sprinkled” distribution of advanced technologies. Proper planning therefore means targeted investments for the benefit of all, obtaining the maximum response in terms of services offered. The challenge of programming healthcare technologies must include a holistic approach to the conscious use of technology and must pay maximum attention to concrete operations to avoid distorting phenomena. Technology thus becomes an opportunity to be used in an adequate, forward-looking and appropriate way.

4) SOCIAL-HEALTHCARE INTEGRATION: YES TO TECHNOLOGY AS A TOOL OF NEARBY HEALTHCARE The entire NHS is rethinking itself in territorial terms, with a renewed centrality attributed to proximity healthcare. Technologies also become central in this area, allowing – even in telemedicine formats, mobile applications and devices with remote control – a new approach to chronic conditions, to the needs of the third and fourth ages, nursing homes and integrated home care. The challenge of social and health integration is therefore that which, both at a central level and at a regional and territorial level, must be supported, organised, planned and monitored as a radical innovation, also thanks to the concrete, extensive and timely involvement of citizens’ forces and civic activism.

5) PERFORMANCE: YES TO THE MEASURABLE TECHNOLOGICAL PERFORMANCE Technologies that are useful and consistent with health needs offer measurable performance within the diagnostic-therapeutic pathways. It is necessary that the challenge of measuring outcomes – also through the definition of Essential Levels of Technological Performance – you become, in the evaluation process, one of the fundamental axes through which to pass the quality paradigm, not only as compliance with technical and regulatory criteria, but also of coherence with the choices of socio-health, economic and health planning policies.

6) OF THE ORGANIZATIONAL MODEL: YES TO THE INTEGRATION OF TECHNOLOGIES INTO THE CARE PROCESSES A correct technological culture and useful and available healthcare services require the affirmation of an organizational model based on new operational and decision-making processes in which the integration of technologies “upstream” of the care processes is affirmed. It is the challenge of identifying new models that pave the way for a “management” that sees skills as a distinctive element of this new process, including management, of implementing technologies in health policies.

7) SKILLS: YES TO RETHINKING TRAINING The introduction of new organizational models generates a new challenge: that linked to training of health professionals who use the technologies and of the specialists who are called to choose, evaluate and manage them. It is an internal challenge to the National Health Service, without which there is the risk of creating or widening gaps between territories and between professionals. This challenge puts both academic training in the health sector at the center of attention and training as a continuous strategy, for which it is necessary both to re-launch the opportunities for updating also offered by the industrial sector in an open and transparent way, and to provide more agile mechanisms for the training of professionals at other structures of the NHS.

8) OF DEVELOPMENT: YES TO THE INDUSTRIAL-TECHNOLOGICAL SECTOR AS AN ELEMENT OF THE COUNTRY SYSTEM Life-saving technologies and innovations must be available and sustainable also in a logic of production system. The industrial sector of health technologies must be observed, evaluated and judged as an element of system development and must be encouraged in its presence, research, production, distribution and implementation. It cannot and must not be penalized due to shortcomings in programming, management or expenditure control, nor due to a changed European regulatory context which, while setting itself the right objective of security, risks constituting a brake on innovation in our continent .

A concrete job perspective

“We have done a joint job with the aim of bringing together the sensitivity of professionals in the sector with that of civic activism”, they comment Stefano Bergamasco and Giovanni Guizzetti, who led the Aiic team that worked on the Manifesto. «It seemed necessary to offer everyone a concrete work perspective that could emerge from our 2023 Conference. A perspective of clear commitments, which could be platform for socio-political engagement for all those who care about the real implementation of technologies at the service of health needs. Today, technological performance is often surrounded by a technical aura, however it seemed dutiful and necessary to remind us that innovations in the sector are one of the cornerstones of the realization of the right to health throughout the National Health Service”.

“As an association we have contributed to this document in a convinced way,” he underlines Elio Rosati, coordinator of Cittadinanzattiva Lazio, who followed the creation of the Manifesto step by step. «We have been present on the topic of healthcare technologies and the digitization of healthcare for some time and we are convinced that we are facing a crucial moment: a correct and “social” implementation and diffusion of technological innovation can make the difference and allow even less performing territories to offer high quality health services. But for this to happen, the eight contents that we have included in the Manifesto must be created, which in our opinion are the essential steps to achieve a new Italian health system”.

«Indispensable stages that we intend to travel together also in the immediate future», specifies the AIIC president Umberto Nocco“because the messages that are launched by our Conference have the objective of remaining over time, creating a virtuous action at the level of central and regional institutions, civil society, representatives of the professions and of the entire health system”.