Proximity Care, a study published in npj Digital Medicine, proposes a new model for local healthcare, centered on the citizen, that uses digital technologies and guarantees social and environmental sustainability
Lo studio della Scuola Superiore Sant’Anna di Pisa propone e applica un metodo rivoluzionario per la programmazione di servizi sanitari, che parte dai bisogni dell’utente e non dell’organizzazione che eroga, che è sostenuta da tecnologie digitali, che considera la sostenibilità ambientale e che ha un impatto positivo sull’accesso da parte dei cittadini. L’ambito di applicazione riguarda il multi-screening oncologico nelle aree interne, realizzato mediante un'unità mobile e tecnologie digitali adeguate. L’impatto stimato indica una riduzione delle emissioni di CO₂ superiore al 90%
Services tailored to the user and not designed for the organizational convenience of the provider, which use digital technologies and make it possible to reduce by more than 90% the equivalent carbon dioxide emissions in the territory of intervention: this is what emerges from research by the Health Science Interdisciplinary Research Center of the Scuola Superiore Sant'Anna in Pisa, published in the international journal of the Nature npj Digital Medicine group. The study concerns the implementation of a new model for carrying out cancer screening, tested as part of the Proximity Care project in the inland areas of the Serchio Valley, where citizens were able to carry out all three cancer screenings close to their homes in a single appointment, in a specially designed and built camper van. Thanks to the mobile unit, the digital medicine system and the collaboration with local actors, the new system has demonstrated, on the one hand, the benefits for the population in terms of accessibility to health services, with an increase in the number of people who have been able to perform preventive diagnostic tests in a single session and close to home (multi-screening model), and on the other hand, a decidedly significant impact on environmental sustainability. In particular, this reduction is due to the travel saved by citizens and caregivers who live in areas far from services, the so-called internal areas.
“The study makes a significant contribution to the debate on how to design and deliver healthcare services, ensuring environmental sustainability is one of the key elements of their planning, together with quality of care, equity of access and economic sustainability” says Vera Benedetto, post-doc at the Sant'Anna School and one of the authors of the study.
Proxy Screening, the mobile unit for cancer prevention
Proximity Care, a project created by the Scuola Superiore Sant'Anna and co-financed by the Fondazione Cassa di Risparmio di Lucca, in partnership with the Azienda USL Toscana Nord Ovest, the Third Sector Organizations operating in the territory, the Municipalities and the Tuscany Region, was created with the aim of developing experiments aimed at drastically modifying the operating paradigm of health, social and socio-health services in the “inland areas” which are increasingly the last to be touched by innovation and where the gap in outcomes and access opportunities tends to increase compared to large urban centers. In this context, the Proxy Screening intervention represents a real revolution in the traditional methods of planning and carrying out cancer screenings. In the district of the Serchio Valley, where the highest mortality rate for oncological problems is recorded, a mobile screening campaign has been developed in collaboration with the Screening UOC of the North-West Tuscany Local Health Authority and ISPRO, and a mobile unit has been designed to carry out multiple screenings in a single appointment. The use of cutting-edge digital technologies for cancer screening and the active involvement of healthcare personnel and the local third sector have made it possible to conduct the experiment successfully. The mobile unit visited various municipalities in the inner area of Garfagnana and the Media Valle del Serchio, allowing citizens to undergo examinations for the prevention of breast, cervical and colorectal cancer, even in a single appointment.
In this way, the “prevention camper close to home” has reduced the distances usually traveled to access screening programs, positively impacting both the percentages of participation in the activities and environmental sustainability.
“The mobile unit is to all intents and purposes a tool for proximity care... it's like having several specialized clinics in a single room close to home for multi-screening management with qualified and dedicated staff. The “prevention camper van close to home” integrates cutting-edge diagnostic machines and is connected in real time with central management systems for the continuous exchange of data,” explains Gastone Ciuti, professor at the Sant'Anna School and one of the authors of the study.
Digital Health and environmental sustainability for the healthcare of the future
The study highlights the potential of digital healthcare to align the planning and provision of healthcare services with environmental and social objectives, contributing to the broader discussion on the development of models adapted to contemporary needs for sustainability and proximity to the patient. The integration of digital healthcare technologies and joint planning between public services, local authorities and third sector associations are useful levers for transforming the current configuration of the healthcare system. From a supply-based vision to an integrated planning approach oriented towards sustainability, including environmental sustainability, Proxy Screening's experience is proposed as an extensible model for building the healthcare system of the future.
Change starts at a local level, also through actions to make local authorities and citizens aware of the importance of prevention programs.
“Thanks to the interdisciplinary skills of our research group and the alliance with local stakeholders, we have succeeded in making an entire territory, with its people and its specific characteristics, the subject of a large-scale experiment in which to effectively integrate digital healthcare, new technologies and new organizational models, no longer for professional silos but starting from the user in his entirety, including social and environmental needs.” emphasizes Sabina Nuti, rector of the Sant'Anna School of Advanced Studies and author of the study.
The authors of the study
The study, published in Nature npj Digital Medicine, is the result of interdisciplinary research involving the following authors: Vera Benedetto, post doc at the Health Science Interdisciplinary Research Center, Vanessa Mainardi, PhD student at the BioRobotics Institute, Francesca Pennucci, researcher at the Health Science Interdisciplinary Research Center, Angelo Damone, researcher at the BioRobotics Institute, Gastone Ciuti, full professor of Bioengineering at the BioRobotics Institute, and Sabina Nuti, rector of the Sant'Anna School of Advanced Studies, full professor of Business Economics and Management at the Health Science Interdisciplinary Research Center.
It was created thanks to the collaboration of the entire Health Science group and that provided by the professionals of Ausl Toscana Nord Ovest, the Tuscany Region, the local municipalities, third sector organizations, and ISPRO, and with co-financing from the Fondazione Cassa di Risparmio di Lucca.
