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

Background: The use of Information andCommunication Technologies (ICTs) in healthcarehas been presented as a potential solution to thecurrent challenges that healthcare systems have toface. The introduction of ICTs may need initial investmentsand, moreover, may produce changes in theroutine practice of the healthcare system. Financialincentives are expected to be an effective managerialtool to communicate a strategic vision and amandate, to improve the adherence to the strategyand to promote a consistent individual behaviour.In this perspective, financial incentives are assumedto accelerate the ICTs adoption and use in healthcare.The aim of this study was to investigate whether andhow Italian Regional healthcare systems use the ChiefExecutive Officers’ (CEOs) reward scheme to stimulithe implementation of ICT in healthcare.Materials and methods: A content analysis wasconducted on the Italian Regional acts on healthcareCEOs incentive schemes, that were approvedin the period 2010–2012 and with a legal validitythat ranged from 1 to 4 years (until 2014). Theacts cover around 60% of the Italian Regions. ICTgoals were identified, categorized, and comparedusing descriptive statistics.Results: This study identified two areas on whichfinancial incentives related to ICTs were mainlyfocused: (i) ICT infrastructure and architecture; (ii)flows and processing of economic and financialdata. The use of technology to better store andprocess medical data (i.e. EHR-like systems) wereonly marginally present. Use of e-Health and mHealthsolutions for providing healthcare services,valorization of ‘health big data’ in a communitycare perspective, more advanced applications oftechnology for monitoring or preventing diseaseswere not incentivized for CEOs in Italy.Conclusion: The use of ICTs in healthcare appearsto be of general interest in Italy: a great number ofItalian Regions introduced specific goals into CEOsfinancial schemes. Efforts in this field seem to benot linked to the objectives of better care at sustainablecost, while it appears important to ensure abetter and wider presence of enabling environmentsand to implement ICT-based control systems.Keywords: ICT, Financial incentives, Incentivescheme, Healthcare CEO, Italy, Regions