Digitalization, a hot topic throughout the healthcare and life sciences industry, is having a major effect in Italy through more personalized home care for patients, allowing the government to cut costs, and enabling greater public access to innovative medical technologies.
Telemedicine, a key differentiator in tender processes, is not yet used widely in Italy due to the expense
Many private sector stakeholders see mobile health and telemedicine technologies as a great tool to cut costs through promoting community and homecare solutions and reducing patient visits to medical facilities. Phillips Italy CEO Stefano Folli highlights one study from the UK and Netherlands where “they have successfully reduced the percentage of readmissions for patients with certain chronic diseases by roughly 70 percent,” by enabling “doctors to check on patients remotely with data collected in the home, relayed via mobile health technologies to their physician at the hospital who could then give feedback.”
Yet, according to ResMed’s commercial director Nadia Cortesi, thus far “telemedicine, a key differentiator in tender processes, is not yet used widely in Italy due to the expense.” She explains that while “hospitals and patients are very interested in getting access to telemedicine, and conceptually people know it will likely reduce costs holistically in the long run,” unfortunately “payers are not very open to making the necessary investments today.”
Indeed, KPMG partner Alberto de Negri concurs that “institutions are often reluctant or anyways slow to take innovation as an opportunity to change the way diseases are treated,” however he also argues that life science companies can do more to “adjust their “global” value propositions to the local situations and to become an actor in national/regional discussion about the improvement of the whole “value chain” of the treatment of diseases.”
ResMed, who produce innovative devices to treat respiratory pathologies such as sleep apnea and COPD, is doing just that. Cortesi underscores that her primary goal is to “help the public administration to understand that they need to think for the long-term, which they are not doing at the moment.”
First, ResMed has more than validated their value proposition by conducting “long term clinical trials and health economics studies that demonstrated that patients treated with high performance devices exhibit lower rates of re-hospitalization and less prevalence of correlated diseases,” and is currently “conducting studies in conjunction with our headquarters to demonstrate conclusively and precisely the benefit our telemedicine solutions can bring to healthcare providers, hospitals and patients.”
However, the firm is also striving to have an impact on how sleep apnea is handled in Italy in general. Cortesi explains that her main task is “to increase awareness, but we cannot do it as ResMed alone; it requires a cooperative effort involving all stakeholders,” and ResMed is “leading this effort [to coordinate different stakeholders], and has started interacting with select companies, sharing a plan of awareness with support of the scientific societies.”
Second, she is arguing for stakeholders “to change and simplify the way tests are administered giving access through for example mobile solutions,” because at present “patients seeking a diagnostic test, a polysomnography, they have to wait in some cases even eight months,” which is certainly a contributing factor behind the fact that “70 to 80 percent of people [with sleep apnea] are not diagnosed.”
Institutions are often reluctant or anyways slow to take innovation as an opportunity to change the way diseases are treated
Some headway is being made, as Cortesi asserts that while “the Ministry of Health has not seen sleep apnea as a priority, as companies in this segment have been able to increasingly demonstrate the cost resulting from not treating sleep-disorders effectively, they starting to consider it a much higher priority.”
So far it has been “somewhat easier to convince the authorities to invest in our products for chronic patients who depend on our products in their day-to-day life,” according to Cortesi. However, it seems that convincing the authorities to go with innovative respiration products is a barrier that Resmed must overcome before investing significant resources in persuading institutions to subscribe to telemedicine monitoring services.
For hospital IT solutions and digitalization in general, Samsung’s Dario Guido sees a barrier, which “is that most stakeholders have only a general understanding, not specific knowledge of how implementation [of integrated digital solutions] would proceed, and what tangibly it would change.” As such, he explains that “currently we are mainly working with the private sector, where we can have a lot of collaboration with big institutes to create a model to replicate in the public sector.
We have such a collaboration with the Humanitas Group, the most important private health group in Italy, to digitize a hospital that will serve as a model and showpiece going forward.” This showpiece facility will provide a much needed tangible example of how innovative medical technologies can revolutionize the way medical facilities and the professionals within them can function.
Most stakeholders have only a general understanding, not specific knowledge, of how implementation [of integrated digital solutions] would proceed, and what tangibly it would change
There are other approaches to encouraging investment in medical technologies, namely public-private partnerships, and innovative outcome-based or risk-sharing agreements as seen with increasing frequency in the pharmaceutical sector. Marco Campione, president and CEO of GE Healthcare Italy, explains that “the healthcare system in Italy is asking for help, being squeezed by growing demand, finite resources, poor quality and the worst economy for 50 years.
That is why we developed the outcome-based approach to help the national healthcare system with very particular issues, entering risk- and profit-sharing agreements.” He argues that “companies like GE, that have a sound financial background can afford to enter these kinds of agreements to help the country’s health system effectively,” and are an effective mechanism to help improve patient access to innovative diagnostics and therapeutic devices.
Wastage [in conventional healthcare systems] stemming from a lack of transparency, mismanagement and technological deficiency can be starkly contrasted with the efficiency of digital healthcare models
Beatrice Lorenzin, Minister of Health
Nor is digital disruption just about the big ideas with lots of bells and whistles. Even comparatively simplistic digital interventions can trigger a high impact. “Wastage [in conventional healthcare systems] stemming from a lack of transparency, mismanagement and technological deficiency can be starkly contrasted with the efficiency of digital healthcare models,” affirms Health Minister Beatrice Lorenzin. “As much as EUR 2.2 billion can be saved just through the digitalization of health records, the roll out of the electronic health card and the dematerialization of prescriptions” she asserts.