Country profile: Italy

Italian health policy is decided on the national level and implemented on the regional level. The regions, assigned with providing a homogenous level of care (LEA) throughout all local health units, follow the plan, budget and regulatory framework laid out on the national level - a process which they actually take active part in through the Permanent Conference for the Relationships between State, Regions and Provinces.

ICT use and eHealth strategy

Italy is among the average eHealth performers in the EU-27: while most GPs use a computer and have Internet access, only 50 percent utilize a broadband connection. Most Italian GP practices store electronic patient data, and more than half use Decision Support Systems during patient consultations, thereby ranking Italy slightly above the EU average.   The exchange of patient data remains an extremely rare ocurrence, as does the exchange of administrative data with reimbursers. ePrescriptions and the electronic transfer of lab / radiology data remain comparatively rare as well.

Italy currently doesn’t have an integral national eHealth strategy. Instead, the principle of LEA, determining the essential level of care, motivates the development of numerous individual regional and national technical and organisational solutions to achieve a homogenous standard of healthcare.

Examples of solutions implemented so far include:

• NSIS: New Health Information System: a health information network, making standardised information available to regional actors throughout Italy. It includes data on healthcare service interactions by citizens as well as financial data on healthcare facilities
• TSE: Permanent eHealth Board: a discussion and consultation setting intended to harmonize and coordinate individual eHealth solutions. The TSE produces policy documents intended to support the creation of a cohesive eHealth landscape, making patient data available everywhere in a reliable, secure and interoperable manner - it is expected that results from TSE activities will become the keystone for a future national eHealth policy.
• CRS-SISS: an eHealth implementation currently in use in Lombardia, composed of a patient eID implementation, an EHR back-end and a complex health data network interlinking healthcare providers throughout Lombardia.

Legal Framework

There is legislation regarding health-related data processing in accordance with EU Directives, but legal regulation of eHealth and telemedicine is very limited. The broader legal framework surrounding healthcare and privacy does, however, include provisions relevant for eHealth implementations. The Italian Data Protection Authority emphasizes the obligation to respect the dignity and privacy of patients and sets forth a strict set of rules guaranteeing privacy in health data exchange scenarios, thereby surpassing the relevant EU Directive in many regards; consent is an absolute necessity in healthcare scenarios, even when the data exchange is initiated by a public institution. Thereby, Italy has one of the most tightly regulated privacy frameworks in Europe.