Helping to Change the Health Ecosystem: Interview with Alfredo Pascali

Alfredo Pascali is the founder of Pascali NExT-Health, a new NEtwork for the Transformation of Health dedicated to “Integrated Digital Humanism”: spaces, relationships, technologies and processes designed and managed with the user/patient at the center. Alfredo has been working for over 30 years in marketing, communication and sales for the healthcare market, for individual healthcare facilities or groups, service companies or healthcare projects. For 22 years he has collaborated with many of the best universities or business schools in Italy. Today, his focus is the development and launch of new projects, innovation, digital ecosystem and customer relationship management.

We had the pleasure to interview Alfredo and ask him about the relationship with patients, the impact of Covid-19 on Italian infrastructures and the digital innovations he sees happening in the industry. 

Is patient centrality something that you currently see in the industry or is there still room for implementation? 

In academic terms, the scenario is quite clear: Value-Based Healthcare, Service Design and Precision Medicine do nothing but push healthcare organizations to personalize health, therefore to the best centrality of the patient. My will is to bring these theoretical concepts into the operational field, analyzing what are the needs that are actually experienced, and I try to find these concepts in concrete projects. There are excellent companies and very clear trends in this sense in the healthcare ecosystem, but it cannot be said that this is the daily practice of Italian healthcare.

As we know, Italy was the first European country to be strongly affected by the Covid-19 pandemic. How do you think this affected the health structures of the country?

Unfortunately, we are still in an emergency management phase, which still involves a large part of health workers. Beyond the clinical side that we see every day in the constantly updated media, all of this will have an effect on the “untreated” people this year. I believe that hospitals, health facilities, telemedicine services, offline or online health services, will have a post-covid impact in epidemiological terms because many chronic patients have not been followed either by their choice or because of the inability of the doctors.

For example, in the first wave, there was about a 50% drop in emergency room access for acute heart attack and these are serious problems. So, if 50% fewer coronary emergency procedures have been performed, it means that many patients are neglecting heart disease and sooner or later explode in clinical terms.

So probably the most disruptive effect will be on the management of other diseases in healthcare settings. Especially in the first wave, many hospitals in Italy were closed for several weeks. Therefore, the development of telemedicine and its integration into clinical-assistance paths in Italy, certainly accelerated by Covid, is induced by the fact that the hospital crisis has pushed towards a more radical change. 

Do you think the implementation of digital innovations due to Covid will become a standard when the emergency will be over? 

I don’t think we will ever go back. What we’re doing now is a bit of a forced integration so it’s going to bring some technological and organizational problems, but this is a work in progress. I think that the more patients ask for it, the more the industry will have to adapt. From a formal point of view, at the end of the year, the National Health System formally introduced tariffs for telemedicine, which seems trivial but it’s not. These rates are essentially the same as for a face-to-face visit. Subsequently, digital services will be increasingly integrated with remote monitoring devices and systems. This is an evolution already implicit in the fact that the population is ageing and as the diseases become more and more chronic, people need to be followed by doctors and fill hospitals with people to carry out checks that can be provided remotely or the patient’s home doesn’t make much sense. Digital, however, does not only concern telemedicine but also prevention and digital therapies that have not yet been officially accepted in Italy but in some countries such as Germany and France, I know they are already starting.

I believe we will eventually move towards a hybrid model. This will affect both investments and buildings. I speak to designers and architects because it is useless to base the work 100% on the physical when in reality a significant part of the healthcare activities will be carried out both at home and digitally. There will be increasingly specialized physical structures integrated with digital systems and home or proximity systems. In terms of marketing, I definitely embrace the evolution towards tools that govern these relational complexities because otherwise, everyone will put something online (for example the recent news from Apple, Google and other major players entering healthcare) and the patient will be overwhelmed with thousands of apps or systems and no one will be there to generally care of their health.

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