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Business Plan (ENG)

SMART HOSPITALS AND PATIENT-CENTERED GOVERNANCE

This paper explores innovative governance models in the healthcare sector. Patients are a key albeit under-investigated stakeholder and smart technologies applied to public healthcare represent a trendy innovation that reshapes the value-driving proposition. This study contributes to the best practice improvement in this sector, showing how health governance can balance the interests of conflicting stakeholders (patients, staff, politicians, private providers, banks, suppliers, etc.) when technology-driven (smart) investments are realized. Characteristics of smart hospitals are critically examined, and governance solutions are considered, together with private actors’ involvement and flexible forms of remuneration. Smart hospitals are so complicated that they may require sophisticated Public-Private Partnerships (PPP). Public players lack innovative skills, whereas private actors seek additional remuneration for their non-routine efforts and higher risk. PPP represents a feasible governance framework, especially if linked to Project Financing (PF) investment patterns. Results-Based Financing (RBF) softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. Patient-centered smart hospitals reshape traditional healthcare governance, with savings and efficiency gains that meliorate timeliness and execution of cares. Transformation of in-patients to out-patients and then home-patients represents, whenever possible, a mighty goal.

Can Public-Private Partnerships Foster Investment Sustainability in Smart Hospitals?

This article addresses the relationship between Public-Private Partnerships (PPP) and the sustainability of public spending in smart hospitals. Smart (technological) hospitals represent long-termed investments where public and private players interact with banking institutions and eventually patients, to satisfy a core welfare need. Characteristics of smart hospitals are critically examined, together with private actors’ involvement and flexible forms of remuneration. Technology-driven smart hospitals are so complicated that they may require sophisticated PPP. Public players lack innovative skills, whereas private actors seek additional compensation for their non-routine efforts and higher risk. PPP represents a feasible framework, especially if linked to Project Financing (PF) investment patterns. Whereas the social impact of healthcare investments seems evident, their financial coverage raises growing concern in a capital rationing context where shrinking public resources must cope with the growing needs of chronic elder patients. Results-Based Financing (RBF) is a pay-by-result methodology that softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. In this study, we examine why and how advanced Information Technology (IT) solutions implemented in “Smart Hospitals” should produce a positive social impact by increasing at the same time health sustainability and quality of care. Patient-centered smart hospitals realized through PPP schemes, reshape traditional healthcare supply chains with savings and efficiency gains that improve timeliness and execution of care.

© 2020 prof. Roberto Moro Visconti

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