People speak about mobile Health (mHealth) as something will arrive in future: that’s a real myopia.
Probably the expected future is already here and we are not aware, so it is important to “adapt to adopt” new technology, also in healthcare industry.
In the public procurement pathway, preferably at regional level, the term public tender refers to a formal and well-defined contract which is published by a public organisation to invite competing offers from more providers who can offer products, services or utilities that the public sector requires with the decision made on the basis of price and quality.
The public tender will be published and the process is open to all qualified bidders. The tender process is rigorously defined by law and all the procedures in place to ensure that the selection process is fully compliant with the law, transparent, and definitely fair.
So, a tender is the current bid that is submitted by a business, a company, an organization to try win the work: the public tendering process starts with a publication of the tender (issue), which is published by a public regional organisation in order to increase and generate competitive offers to meet the specific requirements outlined in the contract notice (public needs).
And till now, nothing new if you have – as public organization – clear in mind your needs but if you probably don’t know exactly what do you want? what’s happen? This could be the case of Mobile Technologies in Healthcare (m-Health).
The m-Health world is a specific field of e-Health (Electronic or Digital Health) that through applications for mobile devices supports medical practice and public health. The number of m-Health App (Mobile Health) downloads in the last 3 years has more than doubled, also due to a greater tendency among healthcare professionals to recommend their use to patients.
In the specific field of Diabetes Care self-management, these applications have been able to demonstrate their usefulness especially in the glycemic control of patients. However, despite the great evolution of technology on this front, today there is still an unjustified resistance to consider m-Health as an effective tool for treatment probably because there are not – or are coming in recent years – the first clinical evidence to support.
Diabetes and Endocrinology Specialists have realized that Digital Applications installed on the smartphones of patients can be a valuable tool to support the treatment of chronic diseases such as diabetes mellitus, which is even more important in emergency conditions such as pandemic. In these situations, the technological aid can not only be considered to all intents and purposes the solution to enable the adequacy and appropriateness of prescriptive care, but also be a tool that can promote and help the maximum safety of patients.
The Italian Association of Diabetologists (AMD) as early as June 2020 drew up an important Position Statement [1] in which the importance of digital systems and the importance of learning to use them to enable more advanced modalities in performance is definitively put on paper, in particular:
“Currently, diabetes care is facing several challenges: the decreasing number of diabetologists, the increasing number of patients, the reduced time allowed for medical visits, the growing complexity of the disease both from the standpoints of clinical and patient care, the difficulty of achieving the relevant clinical targets, the growing burden of disease management for both the health care professional and the patient, and the health care accessibility and sustainability.”
In this context, new digital technologies and the use of artificial intelligence are certainly a great opportunity. It is evident that the role of the clinician has necessarily evolved, not only from the digital point of view as a direct user but also as an indirect user – through the relationship with their patients – thus developing new skills to transform and enhance the contribution that Digital Applications can provide.
The continuous evolution in the field of medicine and, in particular, in the field of diabetology is strongly interconnected to a series of changes and innovations [2-3]. The very term “digital health” is a container that, grouping together information technology and telecommunication, has the common goal of being able to enable diagnosis and treatment, to monitor diseases, to maintain health and support a correct lifestyle.
Today’s diabetologists need to acquire new skills and competencies to keep up with these changes, be proactive by exploiting their potentials and advantages, limiting their risks and safeguarding the essential elements of the medical profession and of health professionals caring for chronic patients.
Last, in terms of time, but no less important, the inter-society group formed by the Italian Society of Diabetology (SID), the Association of Italian Diabetes Physicians (AMD) and the Italian Society of Endocrinology (SIE) has in fact published a real census document, constantly updatable, in which they collected information on digital systems now available to patients, trying to classify them in an objective and homogeneous way.
The purpose of the document was to facilitate the Specialist in the evaluation of the functionalities and clinical applications of the available systems (remote transmission of glycemic values, transmission of clinical and administrative data to and from the person with diabetes, electronic data storage, visualization/analysis in graphical form, interfacing with multiple and multi-brand devices, management of multi-parametric data, specific functionalities for sharing data from insulin pumps, bolus calculator function, etc.).
In the light of this evidence, it is difficult to think that the topic of m-Health and the world of Procurement, specifically to the public tenders, are not connected or connected in several different ways. The expectations will be to open the Mistery Box and put together a good recipe with the current and future ingredients. At the same time, also private bidders must put together all their efforts genuinely in order to drive the digital transformation and working on interoperability, connectivity and big data starting form Diabetes Care.
Quick References:
1. Musacchio et al. J Med Internet Res. 2020 Jun; 22(6) Artificial Intelligence and Big Data in Diabetes Care: A Position Statement of the Italian Association of Diabetologists.
2. Moskowitz A, McSparron J, Stone DJ, Celi LA. Preparing a New Generation of Clinicians for the Era of Big Data. Harv Med Stud Rev. 2015 Jan;2(1):24–27. http://europepmc.org/abstract/MED/25688383.
3. Beam AL, Kohane IS. Big Data and Machine Learning in Health Care. JAMA. 2018 Apr 03;319(13):1317–1318. doi: 10.1001/jama.2017.18391.