The Ministry of Health asks: Is Nuvola Sanità, the Fimmg system that offers the possibility of reading the various family doctor management software, a useless expense, disconnected from regional information systems? The doctors' union replies: No, we made it available to the database of a region just yesterday, we are establishing ways to interface with regional programs. Replication of the ministry: the risk is to fragment investments. Fimmg: it won't be like that. The exchange of jokes between the ministerial exponent Rossana Ugenti and the head of the Fimmg study centre Paul Mercy, which took place in Milan at the presentation of the 7th Research of the Ict Observatory in health, reveals the desperate need for public health to develop e-health with few resources. Which, according to the report of the School of Management of the Milan Polytechnic, will be less and less, due to the spending review: this is the opinion of the 53% of the local health authorities questioned in the survey, while a 27% is optimistic and a 20 relies on the capacity of the tenders to select the least expensive suppliers.

In 2013, GPs invested three times more in IT than the state despite being, as Misericordia points out, a category that is certainly not digitally native: 65 million euros against 800 from the local health authorities and hospitals, 295 from the regions, just 19 from the Ministry of Health. «Apart from the fact that the 68% of Italian GPs ranges from 55 years of age upwards, at least two problems prompted us to experiment with a system for interfacing the various software (hesitant in the very recent creation of Nusa, the Nuvola Sanità Foundation together with Federsanità Anci , ed.); the first is the fragmentation of management study programs for GPs - forty on the market - and the second is the difficulty for continuity of care colleagues to interface with us, with their tools even before their software. To achieve the objectives requested by citizens, we are equipping ourselves with a "cloud", a shared system accessible via PC, web and mobile, intended for the entire category. We trust that the other institutional databases will also come to our aid and their programs will interface with our "cloud"».

The outburst of the ministry is indicative of an NHS where one imagines the mmg reluctant to share the health data of the patients. Adriano Marcolongo director of social and health services of FriuliVG invites doctors to overcome the barriers of ownership on patient data. But in the press release in which he presents the NuSa Fimmg Foundation, he has already stated that he can share what he defines as "the largest national health network" with healthcare companies.

Mauro Miserendino

Friday, 09 May 2014 – Doctor33

Health: Fimmg, family doctors' offices open 24 hours a day

(ANSA) - ROME, MAY 08 - Introducing the figure of a specially trained assistant who works alongside the family doctor and practices open 24 hours a day, equipped with diagnostic machinery to carry out non-complex tests related to prevention and chronic diseases. This is the heart of the programmatic lines for the reorganization of primary care, presented today, in view of the renewal of the collective agreement of general practitioners. 'Local medicine at the service of the patient: from critical issues to concrete solutions' is the title of the document prepared by the Federation of general practitioners (Fimmg) and by FederAnziani, focused on three key concepts: "humanisation of the relationship, synergy between actors and 'patient at the centre'”, explains Fimmg secretary Giacomo Milillo. A document in which, according to Giuseppe Pozzi, president of the People's Court of Justice for the Right to Health, "for the first time the needs of the general practitioner and the patient find a common purpose". A patient who increasingly returns to the Third Age. "The 67% of pharmaceutical expenditure paid by the State is consumed by the over 65s and the 99% of the over 65s have at least one chronic disease", explains Roberto Messina, president of FederAnziani, an association that has about 3 million members and protects the rights of 10 millions of seniors. These data are enough to understand why, in taking charge of chronic conditions, only by replacing hospitalization with local care can the system be made sustainable. From a study conducted on 28,000 type 2 diabetes patients residing in Turin, for example, explains Roberto Venesia, general secretary of Fimmg Piemonte, "it has been seen that by carrying out an integrated work between specialist general medicine, the average survival of 80% of patients increased by 4 years and with system savings equal to approximately 30%". (ANSA).

Paid Mmg visits? The proposal comes from England

Do you also charge patients for visits to the family doctor? This is being discussed in England, where there is a health system that has been the model for our NHS. The hypothesis appears as a symptom of the numerous problems afflicting the National health service, rather than a solution to them Florence Corti, communications manager of the Italian Federation of general practitioners, seems more like "a cry of pain that has a minimal probability of finding application".

The proposal was explained to the British newspaper Daily mail by the medical committee of Wiltshire, an area not far from Bristol in western England, which is one of the promoters: patients would be charged up to £25 (about 30 euros) for each visit , in order to reduce the excessive use of family doctors for trivial reasons, to avoid patients not showing up for appointments and, above all, to finance the network of family doctors' clinics which is increasingly suffering from cuts in public spending.

«It is a question of understanding well how it could work from a technical point of view – comments Corti – it does not appear to be a solution, but it is certainly the sign of suffering and has the merit of stimulating a debate. It is a fact that many studios are frequented by people, the so-called frequent attendants, who often show up without a real need, who often clog up the studios and create a disservice by increasing the burnout level of their colleagues. From an organizational point of view, it would be necessary to segment patients on the basis of needs and the doctors who suffer the most are those who do not have a study collaborator available to act as a filter even with respect to an excess of demand».

But, according to the Fimmg exponent, the idea of his British colleagues would risk clogging emergency rooms, it would not even be useful from an economic point of view and would undermine the gratuitousness and universality of the public service, which must be preserved.

Renato Torlaschi