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

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 countries have recognized digital technologies as a critical factor to deliver adequate care while reducing contact among individuals. Accordingly, the Italian Recovery & Resilience Plan (PNRR), as encapsulated within the Next Generation EU funds, focuses on digital health to enhance the protection of health as a fundamental 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 potentialities, 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 healthcare 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.