The network that improves healthcare

The Academy of Healthcare Management and Economics network, promoted by SDA Bocconi School of Management and Novartis, counts more than 40 healthcare companies and 10 regions in Italy as of today. These network participants have decided to tackle three major challenges to innovate this country’s healthcare system, which is the focus of particular attention at this moment in history:

• performance evaluation in healthcare companies
• chronicity management
• clinical trials

The citizens of Italy need healthcare, and national healthcare companies are expected to come up with an adequate and appropriate response to this need, which translates into an ever-sharper focus not only on the outcomes of healthcare processes and patient care management (PCM), but the dimensions of efficiency and effectiveness as well. This was the inspiration behind the idea of creating a system for evaluating and measuring healthcare companies, a system which also later served to establish regional strategies: the Academy Dashboard.

The Dashboard was tested in two regions (Lazio and Campania) and in 16 hospitals, and proved to be an invaluable tool. Not only does it foster a collaborative approach while steering decision-making on managing healthcare companies and regional systems, the Dashboard also delivers a concrete contribution to recovering economic-financial sustainability. And as a unique, added-value feature, the Academy Dashboard is customizable for healthcare companies and region; in other words, it can be tailored to suit strategic and operational uses in a specific context or timeframe.

Managing chronic illness has always represented critical testing ground for the healthcare system, since a number of different actors play various roles throughout all the processes are involved in mapping out the diagnostic-therapeutic-care pathway. To address this issue, the Academy has created an Observatory for chronicity management, focusing on chronic obstructive pulmonary diseases (COPDs), debilitating conditions impacting the respiratory system. COPD has become a paradigm of the emerging healthcare models for PCM. But are clinical processes for dealing with this type of disease adequate, and/or is there room for improvement? The answer to this question calls for two-stage intervention:

1. providing tools that reveal the weight of COPDs both in absolute terms and broken down by level of severity in a given context, and with the help of the Academy Dashboard, assessing PCM in this context;
2. discussing with institutional actors the results of process changes as they take place, based on the specific context of each individual healthcare company; this will ultimately lead to a shared position paper.

A crucial task in Phase 2 of the current crisis is to develop new skills and formulas for service provision, with input from a range of professionals in the healthcare system: from pulmonologists to general practitioners to nurses, and so on. Another critical aspect is finding organizational solutions to optimize the network of service offerings. This is where tools for constant monitoring and assessment come into play. The concrete contribution of the Academy on the question of innovation is the Laboratory on the organization and management of clinical trials. In fact, among management teams in healthcare companies there is an increasing awareness of the value of clinical research, not only for scientific advancement but in economic terms as well, in the form of revenues generated and cost savings. The Academy, along with these companies, has developed tools for evaluating these factors from an organizational and economic standpoint, highlighting the no small number of criticalities that still need to be dealt with as regards resources, personnel, and operating systems.

The collaboration between SDA Bocconi School of Management and Novartis spans the past decade. In fact, the Academy was established in 2010 with the aim of calling on all the actors in the National Healthcare Service (SSN), asking them to help contend with the major challenges the healthcare sector was facing. Academy partners committed to carving out a new space where ideas, knowhow and skills converge, and opening a dialogue that would provide the spark to energize innovation in healthcare companies and regional healthcare systems.

The first three years centered on developing a new approach to performance management. This goal was achieved thanks to constant collaboration with the healthcare companies which rose to the challenge of responding to the needs of the population without compromising sustainability.

In 2013, based on the positive response, the Academy initiated two new research streams: models for chronicity management and a laboratory for clinical trials. These two aspects are critical for the future of the entire SSN, both in terms of economic impacts and the competitiveness of individual healthcare companies.

Since 2015, the Academy has reached the maturity phase. Working side by side nonstop with healthcare companies, managerial tools are being implemented. These tools are being presented and discussed fully and extensively throughout the healthcare system, along with the concrete outcomes achieved and policy guidelines that emerge.

Academy outputs are now integral elements of the policy agenda of the SSN.

Today the Academy is playing a key role in tackling some of the major themes which are certain to become even more crucial to the future of the SSN:

• Measuring the appropriateness of resource allocation and consumption with the aim of establishing and disseminating best practices;
• Promoting closer collaboration and active participation of all the stakeholders in the healthcare system, both at a local and national level;
• Sharing knowhow with institutional players, and everyone from students, workers, and decision-makers at all the different levels of the healthcare sector.

This is the spirit of the collaboration between SDA Bocconi School of Management and Novartis which is moving forward with the Academy’s new biennial (2019-2021), with the central theme of managing waiting lists for patients. Finding and testing innovative solutions to the problem is a priority that encourages us to look for ideas and benchmarks from the experiences of other countries. Our perspective is expanding to encompass all the stakeholders responsible for Regional Healthcare Systems and the SSN as a whole. The conversation centers on the crux of the question: booking systems and platforms for matching supply and demand (CUPs), among the most powerful levers for change in the system for managing waiting lists.