Incentivizing ICT in healthcare: A comparative analysis of incentive schemes in Italian Regions

Background: The use of Information and Communication Technologies (ICTs) in healthcare has been presented as a potential solution to the current challenges that healthcare systems have to face. The introduction of ICTs may need initial investments and, moreover, may produce changes in the routine practice of the healthcare system. Financial incentives are expected to be an effective managerial tool to communicate a strategic vision and a mandate, to improve the adherence to the strategy and to promote a consistent individual behaviour. In this perspective, financial incentives are assumed to accelerate the ICTs adoption and use in healthcare. The aim of this study was to investigate whether and how Italian Regional healthcare systems use the Chief Executive Officers’ (CEOs) reward scheme to stimuli the implementation of ICT in healthcare. Materials and methods: A content analysis was conducted on the Italian Regional acts on healthcare CEOs incentive schemes, that were approved in the period 2010–2012 and with a legal validity that ranged from 1 to 4 years (until 2014). The acts cover around 60% of the Italian Regions. ICT goals were identified, categorized, and compared using descriptive statistics. Results: This study identified two areas on which financial incentives related to ICTs were mainly focused: (i) ICT infrastructure and architecture; (ii) flows and processing of economic and financial data. The use of technology to better store and process medical data (i.e. EHR-like systems) were only marginally present. Use of e-Health and mHealth solutions for providing healthcare services, valorization of ‘health big data’ in a community care perspective, more advanced applications of technology for monitoring or preventing diseases were not incentivized for CEOs in Italy. Conclusion: The use of ICTs in healthcare appears to be of general interest in Italy: a great number of Italian Regions introduced specific goals into CEOs financial schemes. Efforts in this field seem to be not linked to the objectives of better care at sustainable cost, while it appears important to ensure a better and wider presence of enabling environments and to implement ICT-based control systems. Keywords: ICT, Financial incentives, Incentive scheme, Healthcare CEO, Italy, Regions