Telemedicine Implementation Between Innovation and Sustainability: An Operating Model for Designing Patient-Centered Healthcare

Abstract

An aging population and new illnesses are contributing to increasing incidences of chronic diseases, multi-pathologies, and new syndromes. This jeopardizes the sustainability of worldwide National Healthcare Systems (NHSs), which are involved in providing high-quality healthcare under cost containment. To address this challenge, especially in the post-pandemic context, OECD coun-tries have recognized digital technologies as a critical factor to deliver adequate care while reducing contact among individuals. Accordingly, the Italian Recov-ery and Resilience Plan (PNRR), as encapsulated within the Next Generation EU funds, focuses on digital health to enhance the protection of health as a funda-mental public right. Within the sphere of digital transition of NHSs, coherently with the Value-Based Healthcare principles and user-centric innovation theories, telemedicine can be considered as able to increase access to healthcare and to reduce its related resource consumption. Nevertheless, despite its high potential-ities, diffusion of telemedicine is struggling to gain access current practices of healthcare institutions. Notwithstanding the copious technology availability, this seems to be due to the organizational changes (operational assets, know-how, and operative processes) needed to adopt an innovation that requires a radical modification of cost and organizational structure for healthcare providers. Thus, the analysis of processes and resources involved in this modernization of health-care supply structures is a prerequisite for its improvement and implementation. Based on the literature background (both peer-reviewed and technical reports) in the field of eHealth, this chapter wants to sketch features (actors, roles, responsibilities, and flowcharts) for designing human-centered services based on telemedicine. By formalizing both an operational definition of telemedicine and designing a general model for its operation, this contribution aims to support healthcare organizations’ decision-making about implementation of investment in telemedicine infrastructures by fostering awareness of management about financial and organizational issues, related to the necessary changes, connected to the intervention.