Maturity models: a testing ground for healthcare in Italy

Linda Rider

Approximately seven billion euros has been planned for the development of proximity networks, facilities and telemedicine for territorial healthcare assistance, and €8.6 billion for innovation, research and digitalisation of the National Healthcare Service. In addition, who determines their level of technological advancement? Why is it that an international “certification” such as the EMRAM model (Electronic Medical Record Adoption Model), which could objectively evaluate this degree of maturity, is not widely taken up in Italy? This was discussed during the ‘Evidence-based investments in digital health. Instruments for measuring the maturity level for a strategic vision of evolution’, organised by the HIMSS Italian Community at the Catholic University of Rome earlier this month (12 November).


Investments in digital healthcare are a central theme in the scenarios for developing the national healthcare systems in Europe after the impact of the pandemic. To guide and monitor these investments, it is essential to apply digital maturity assessment metrics in healthcare facilities and regional systems. To this end, HIMSS launched EMRAM in 2005. It is a path that offers guidance, assessment and benchmarking in the computerisation of clinical-care processes. Updated in 2018, the model is undergoing a further evolution of the standard which will be operational from January 2022. “In the new model, the focus shifts from the process to clinical outcomes, including patient involvement and the clinical use of EMR,” explained Ronan O’Connor, Vice President, Analytics – EMEA, HIMSS.


Nearly 65,000 health organisations have engaged in maturity model assessments in 50 countries around the world. Some 2,739 institutions have been validated at EMRAM Stage 6 or 7. These healthcare institutions have the potential to impact the care of over half a million people around the world. In Germany, for example, the government has invested €4.3 billion in the digitalisation of the health service and has started the evaluation of its more than 1,800 hospitals to understand the maturity level they are at. The funds of the national NRRP will arrive on the basis of a maturity path certified by a third party, namely HIMSS. 


“What fascinated me very much about this approach, which other countries such as France and Germany are also pursuing, and which we have begun to make a central issue in Italy both at the central and regional institutional level, is precisely this: a neutral model, an international benchmark used globally, and therefore an absolute standard that helps to measure the real maturity of information systems in our healthcare organisations”, said Elena Sini, of HIMSS Italian Community.

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