What will the electronic health record and the role of the family doctor be like?
Mercer's study, coordinated by the former Minister of Welfare Maurizio Sacconi, analyzes how to intervene in future territorial social and health services also through the redefinition of the family doctor and tools such as electronic health records
The pandemic has shown that it is essential to redefine both the role of the family doctor in the context of the new territorial social and health services and the organization of the national health services themselves.
Mercer , a consultancy company in the field of human resources and investments, carried out a study with the coordination of the former Minister of Welfare Maurizio Sacconi entitled "General practitioner in the new territorial social and health services" to analyze the situation and propose solutions to be implemented thanks to the huge resources of the National Recovery and Resilience Plan (Pnrr).
BECAUSE IT IS NOT CONVENIENT TO TRANSFORM THE GP IN AN NHS EMPLOYEE
The study, going against what some regions are asking , warns of the risks that would be incurred if the more than 40,000 family doctors were transformed into employees of the NHS. Today, in fact, they are freelancers affiliated with the NHS.
“The originality of this employment relationship – reads the paper – lies in the indefinite period and in the national collective agreement as a regulatory source. Typical characteristics of subordinate work but which, combined with the flexibility and responsibility of self-employment, have given rise to a long positive experience precisely for these profiles ".
Therefore, if the family doctor were transformed into an employee, the study states, there would be a risk of less assistance to the patient (with whom the relationship of trust would also be lost), a decrease in organizational flexibility and higher costs, as well as greater rigidity. contracts that provide for more limited hours of availability.
FOCUS ENPAM
Furthermore, the NHS itself would pay the costs of this choice with the social security institution for medical personnel (Enpam).
"The effects of the transfer of a multitude of professionals from Enpam (pension management of general practitioners, pediatricians of free choice and employees of continuity of assistance and territorial emergency services) to the specific Inps Fund would be truly destructive of the financial balance. ”, Adds the study.
Coming to the numbers, "according to simulations carried out by Enpam, the transition to the dependence of Mmg and Pls [pediatricians of free choice, ed ] would generate a chasm of 84 billion euros in the time frame of verification of the sustainability of the institution required by the current regulations ".
WHAT IS OFFERED
The study states that it would be better, instead, to provide for forms of obligation to associate so that the studies, with various doctors and technologies inside, together with the future community houses provided for by the Pnrr, become active centers of care on the territory 12 hours a day.
THE ELECTRONIC FILE
The pandemic pressures, the study continues, have highlighted significant asymmetries between the regional health services and within them, with particular regard to the fragility of the "first line" constituted by the territorial services. In much of the territory, regional services are organized on hospitals, often small and dangerous, with the consequence of strong pressure on first aid.
The "federal" system, explains the paper, is justified by the necessary proximity of prevention, assistance and treatment activities. But the autonomy of regional services should not have justified the chaotic procurement of information technologies that still do not allow connections within the same company.
For this, a control room is needed that monitors territorial asymmetries, defines homogeneous standards for all information systems and connects all distribution centers to one another.
The interoperability of current information systems is the necessary condition for the Electronic Health Record, "the emblem of the uniqueness of the system, a true personal data account capable of effectively accompanying the citizen 'from cradle to grave'".
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/come-sara-il-fascicolo-sanitario-elettronico-e-il-ruolo-del-medico-di-famiglia/ on Sat, 19 Feb 2022 07:17:34 +0000.