The future of the Italian healthcare system is taking shape across the regions

When we talk about the future of the Italian healthcare system, we tend to start with the problems: an ageing population, the rise in chronic conditions, staff shortages, regional inequalities and financial sustainability. Added to these is a digital transformation that is progressing rapidly, though not always at a uniform pace. These are real and structural issues. Yet, if we continue to view the National Health Service solely through the lens of its shortcomings, we risk missing an important part of the picture: in many regions, the future of healthcare has already begun to take shape.

Within hospitals, healthcare organisations and local networks, new models of patient care are being trialled, data is being used to improve decision-making, services are being developed that are more in tune with people’s needs, and processes and organisational structures are being rethought. The issue, therefore, is no longer simply how to innovate. It is about ensuring that what works in one area does not remain the preserve of a few, but becomes shared knowledge and the capacity for change across the entire National Health Service. This is what we have been striving to achieve for over 10 years with Forum PA Sanità, by bringing together the best examples of digital and organisational innovation. This is one of the crucial steps we now face: moving from widespread innovation to systemic transformation.

We are often inclined to imagine innovation as a process that originates at the centre and gradually spreads outwards. Very often, however, the opposite is true. The most interesting signs emerge at the ‘periphery’, in communities and organisations that grapple with practical needs on a daily basis. It is here that the contradictions of the system become visible before they do elsewhere, and that necessity can give rise to experimentation. Local areas thus become genuine sensors of change. The key is to transform local experiences into collective learning: recognising them, evaluating them, connecting them, and identifying the conditions that enable them to be adapted and scaled up.

To do this, we must first break free from the equation that equates innovation with technology. Telemedicine, artificial intelligence, platforms and data are enabling factors, but they only gain value when they have an impact on processes, organisation and the ability to meet people’s needs. Even when considering telemedicine, it becomes clear that the decisive factor is not merely the technological tool, but the organisational and implementation process.

The same applies to local access: it means making expertise and care accessible, ensuring continuity of care and building stronger links between professionals, healthcare facilities and the local community, particularly for people with chronic conditions and those who are vulnerable.