The Covid pandemic has spotlighted not only how essential a good healthcare system is, but also the key importance of the last mile, understood as a relationship of proximity to the patients. Getting to the citizen effectively is still an issue to be dealt with, both in treating the virus and in the vaccination campaign. The work already being done and yet to be done in order to deal with the problems arising during the current emergency period will serve as the basis for redrawing the healthcare system of the future.
It is necessary for this purpose to take various aspects into consideration. The first relates to research: on the one hand, genuine ecosystems for developing knowledge must be created; on the other, procedures and clinical trials must be simplified by increasing healthcare facilities’ competences in collecting and analyzing data. The second aspect involves the assistance models that, thanks precisely to technology and data, can be brought into the patients’ homes, with telemedicine and the Internet of Things, while, in parallel, digitalization must foster more immediate access to healthcare facilities in the event of need or urgency.
A third aspect relates to human capital: multidisciplinary and multiprofessional teams in hospitals and on the territory are and will be increasingly important in the future; in parallel, healthcare facilities and companies must go past the customer/supplier relationship to build an alliance that can take care of patients while offering them more complete responses.
Moreover, there is no redesigning the health system without reasoning over the logistics. In the past, the large distribution network of pharmacies was too often seen as fertile ground for consolidation and commodification processes. The emergency has restored these activities to the centre, as a point of articulation for the territorial healthcare system.
The capacity for logistics and for getting closer to citizens – which pharmacies regularly show in non-emergency phases (for example with anti-influenza vaccine campaigns) – is also the result of a large availability of data. These are skills that must be placed fruitfully at the service of the healthcare system which, precisely in the fragmentation and spread of data and information, has seen its most critical points in recent months.
In fact, bringing healthcare services and products closer to the territory does not mean fragmenting the health system. And yet, one of the clearest collateral effects of the reform of Title V of the Constitution was its creation of regional systems that risk not communicating with one another, thereby causing distress for and in several cases even damage to citizens. This is a problem not only of constitutional architecture, but also of state capacity: at any rate, managing pandemics is a clear national and not regional prerogative, and ought to be treated as such.
To sum up, a new healthcare system that learns from the errors emerging during this past year can only exist with a capacity for guidance and central management, articulated on the territory thanks to broad collaborations among various public and private outfits capable of reaching that last mile – that is, the patient in his or her own home – together, even in emergency situations. This is all with investments in digitalization to make more efficient – but also simpler and more immediate – communication between citizens and healthcare professionals.