Abstract:Ageing has significant impacts on the organization of healthcare systems and on social inclusion-especially for elderly people affected by Cognitive Impairment (CI). These people are significantly exposed to undeniable risks that can affect their health and wellbeing (falling, malnutrition, hygiene issues, etc.) -especially when living alone. This paper defines a Business Model (BM) allowing independent living for elderly people affected by CI. This BM include: (i) an up-to-date, modular, flexible and scalable organizational model describing the activities to be accomplished by regulators and service suppliers; and (ii) a digital platform based on innovative and easy-to-replicate information and communication technologies. The organic approach to the development of the BM is then focused in an Italian use case as a part of "DECI", a "Horizon 2020" project with four pilot projects in Israel, Italy, Spain and Sweden.

Rare cancers represent about 20% of the total number of cancers diagnosed in Europe, with an occurrence of less than 6 per 100.000 individuals annually. Despite the impact of each rare disease is limited, rare diseases collectively are a true challenge for public health authorities. In particular, rare cancers face specific challenges that include late/incorrect diagnosis and lack of clinical expertise. In this context, rare cancers networks play a central role in linking national designed centres of expertise far from each other. These collaborations among clinical centres aim to improve the care quality of rare cancers in terms of patients' survival and of life quality. Moreover, the presence of a national collaborative network should induce a reduction of health migration and social costs. To foster these networks, it is important to use ICT solutions not only to support network collaborative processes, but also to monitor the overall collaboration process and to assess the related system impact. This paper describes the project "Italian Rare Cancer Network -Process Monitoring and System Impact Assessment" that aims to strengthen the collaborative Italian network Rete Tumori Rari (RTR) developing its quality system through an information system. The project results can be used as input for the definition of the organizational model and of the information system of the new Italian network of rare tumours (Rete Nazionale Tumori Rari) and to strengthen Italy

In the last years, global healthcare is going through a consistent growth and a significant transformation of its information systems and supply chains. This evolution affects the traditional medicines and medical devices logistics and operating models and the integration of healthcare systems and healthcare information management systems. Digital solutions show to play an important role in tackle the abovementioned issues but these applications are generally focused on one or few specific aspects. The project "LIFEMED-Integrated Logistics of Medicines and Medical Devices" aims at introducing an innovative integrated platform that manages all the logistics components of medicines and medical devices and enables an improved clinical governance. In particular, together with a set of telemedicine, traceability, clinical management and transport monitoring platforms for the monitoring and management of the logistics and clinical processes, the solution will be also characterized by an evidence-based decision making system and by an effective risk management module so to strategically analyze all the gathered data. In this regard, attention must be paid in considering the wide heterogeneity of the processed data and the privacy, ethical and security implications.

The continuous growth of the healthcare sector is followed by a corresponding demand to reduce costs and to improve the quality of its management processes. One way to meet these requirements is to leverage on a better management and traceability of medicines and medical devices through ICT, not only at the hospital but also at the patient's home. The project "LIFEMED -Integrated Logistic of Medicines and Medical Devices", aims, indeed, at the realization of an innovative digital model for medicines and medical devices logistic management. In particular, for the management and the traceability of medicines and medical devices at home, the solution will be characterized by a telemedicine platform together with a traceability platform based on RFId and barcode labels and readers. The telemedicine and traceability platforms will allow for a better monitoring of respectively the patient's correct medicine administration and the medicines and medical devices logistic, as demonstrated by the example of the peritoneal dialysis, a domiciliary treatment addressed in the project. Despite all the advantages, attention must be paid during the platform design in considering crucial factors like digital illiteracy of older people and the privacy, legal and ethical issues.

The possibility to access healthcare fairly and equally among all the patients can be enhanced with the development of collaborative networks. To achieve their goals and exchange relevant information, they must be combined with a proper digital support. Several works dealing with this aspect can be found in literature; however, works defining a general methodological approach to design a digital solution for a collaborative network were not found. In addition to this, to assess the impact of a pathology network and its digital support, and ensure quality improvement as well as proper clinical outcomes, a suitable panel of key performance indicators (KPIs) should be designed. This paper describes a methodology to design a digital support of a collaborative pathology network, together with a set of KPIs to assess the impact of the pathology network and its digital solution. This approach was specifically applied for the Italian Rare Cancer Network in the context of the project “Italian Rare Cancer Network: Process monitoring and System Impact Assessment”.