2023-12-16 08:58:50
by Ruggiero Corcella
The data from the Agency for Digital Italy portray a patchy situation. And a survey by Altroconsumo confirms this: out of 19 regional and provincial ESF sites analyzed only 8 received a positive evaluation
The electronic health record (EHR), a monument of digital healthcare that is still struggling to establish itself in Italy, is active in all Italian regions and provinces. According to data from dashboard of the Agency for Digital Italy (Agid) there are 418,608,790 digitized reports uploaded and 57,663,021 ESFs activated. Important numbers, which however hide a reality in which this tool is used patchily: from little or nothing to the maximum of its potential.
Dashboard data in hand, referring to the last quarter of 2023: healthcare companies use it with percentages varying from 0.5% in Molise to 100% in Lombardy, Tuscany and the Province of Trento. Doctors do it to a greater extent (from 3% in Lazio and Liguria to 100% in Emilia Romagna, Lombardy, Sardinia, the Province of Trento and Valle d’Aosta), while citizens represent a range that goes from 1% in the Marche to 81% in Emilia Romagna (data from 10 regions and provinces are missing).
In short, despite being 11 years old, and awaiting the quantum leap with the ESF 2.0 expected in 2026, the path of the ESF is still bumpy. This was revealed last May by research from the Sanit Digitale School of Management Observatory at the Polytechnic University of Milan. And he confirms it now an investigation by Altroconsumo on the state of health of the ESF, which provides a very heterogeneous picture in the various regions of Italy.
What the ESF should contain
According to the Agid website: The Electronic Health Record (EHR) is the tool through which citizens can trace and consult the entire history of their health life, sharing it with healthcare professionals to guarantee a more effective and efficient service. All the information and documents that make up the ESF are made interoperable to allow its consultation and population throughout the national territory and not just in the region of residence of the assisted person. This allows the patient greater freedom in choosing treatment and sharing information which is all available through access to the file from healthcare professionals.
In reality this is not always the case. In fact, Altroconsumo’s investigation highlights profound differences in the organization of the sites, the data contained and the services made available to citizens.
Data and documents
Let’s start with the data and documents. As designed, the ESF must contain a minimum core: the identification and administrative data of the patient, the information from the general practitioner, the laboratory reports, the summary health profile, while other information is optional. In June 2023 Altroconsumo analyzed the Health Records of 19 Regions (Molise and Valle d’Aosta are missing because it was not possible to carry out the surveys in good time) and it emerged that all the monitored records can be accessed with the Spid (Public digital identity system) or with the electronic identity card: in some cases it is still possible to enter with the health card reader (but try it and… good luck).
All the files contain identification and administrative data of the patient and printable prescriptions, a decisive improvement compared to the past because they can be used in the pharmacy or in the facilities. The reports mostly concern visits to public facilities, in several cases, however, only laboratory tests are present and the reports of specialist visits are missing.
The summary health profile
Another weak point of the Files is the summary health profile which should be filled out by the family doctor: it continues to be absent and even when the icon is present, it is actually empty. In the Health File of Marche and Sicily it is not yet possible to change the doctor online. Unfortunately, only in half of the files analyzed is it possible to pay the ticket and/or manage the exemptions.
Of the 19 sites analyzed, only 8 received a positive evaluation: these are portals which, in addition to providing the basic information typical of the ESF, offer extra services. In general, the presence and completeness of the information (data, recipes, reports…) and graphics have improved compared to the last Altroconsumo survey in 2020, notable steps forward have been made since three years ago, in several cases, there were completely empty files. The extra services, however, are not yet available for everyone: only in 13 out of 19 files it is possible to book exams and visits.
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December 16, 2023 (changed December 16, 2023 | 07:51)
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