With €6 billion available to support the digitalization of public healthcare organizations, the National Recovery and Resilience Plan (PNRR, Piano Nazione di Ripresa e Resilienza) presents a unique opportunity to modernize Italy’s National Health Service (SSN, Servizio Sanitario Nazionale). The OASI 2024 Report dedicates a chapter to the digitalization process, providing insights into the progress made so far, which is currently at the halfway point. Indeed, 2025 will be a decisive year. Once digital tools are in place, healthcare companies will need to learn how to use them, an effort that will primarily require adaptation at an organizational and managerial level, and will extend well beyond the PNRR timeframe.
The study provides an updated overview of the deployment of various investments as of today, under Mission 6 of the PNRR, which aims to make the Italian healthcare system more efficient, innovative, and responsive to citizens’ needs. Also examined are the perceptions of General Managers regarding the role of healthcare companies in this transformation.
The focus is on three main investment areas:
Researchers conducted a survey in collaboration with the Italian Federation of Healthcare and Hospital Companies (FIASO), involving 54 healthcare organizations. Two separate questionnaires were distributed: one for ICT managers, focusing on technical aspects to assess the level of digitalization, and another for General Managers, evaluating their perceived managerial autonomy.
Survey results indicate a growing uptake in digital clinical and healthcare solutions. For example, 98% of healthcare companies have implemented cybersecurity systems. In addition, 87% have introduced electronic health records, although most hospitals are still in the early stages of the process (levels 0-1 on a 0-7 scale). Here progress is measured by the EMRAM Index (Electronic Medical Record Adoption Model), which the Ministry of Health uses to assess digitalization levels in hospitals receiving PNRR funding.
Regarding electronic records, a transition is underway towards FSE 2.0, a more advanced model that enables structured data collection and easier information sharing. While radiology and lab reports are already widely digitized, the transmission of outpatient specialist reports and discharge summaries still lags behind, indicating that further progress is needed.
As for telemedicine, although 83% of organizations report having adopted some kind of platform (mainly for teleconsultations and televisits) these initiatives remain largely experimental. In the coming months, regions are expected to provide all healthcare companies with dedicated telemedicine platforms, requiring them to set clinical priorities and adopt organizational strategies to fully leverage these tools.
To support digitalization efforts, healthcare companies have implemented various organizational solutions, primarily assigning responsibilities to internal IT departments, though without expanding their teams.
General Managers perceive a balance between competencies and responsibilities at the organizational level but express a desire for greater autonomy in key areas, such as planning digital investments and defining service models.
Healthcare companies must act swiftly—ideally by the end of 2025—to systematically integrate digital solutions while bolstering the necessary organizational capabilities for effective management. This process will vary across organizations, as they are at different stages of digital maturity.
Despite these differences, there is a clear need for strategic guidance and skills development to move beyond mere technological implementation. The role of IT departments and Chief Information Officers must evolve from managing technical systems to leading digital transformation, supporting strategic decision-making at the highest levels.
Finally, a balanced approach between institutional levels is essential. While regional governance models differ (with varying degrees of centralization in investment management and organizational autonomy) only effective coordination between regions and healthcare organizations can ensure successful digitalization at this critical moment for Italy’s SSN.
Paola R. Boscolo, Gianmario Cinelli, Francesca Guerra, Francesco Petracca, Paolo Petralia, & Nicola Pinelli. “La trasformazione digitale delle aziende del SSN: tra investimenti del PNRR e spazi di autonomia manageriale,” in OASI Report 2024, pp. 469-491.
Read other articles in the OASI Report 2024 series:
Ricc and Longo - Tell me the truth about the Italian NHS: Four steps toward sustainable universality.
Bobini, Compagni, & Rotolo - Sustainability in healthcare: A new model for the future
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