he example set by the public sector can do much to encourage innovation in services – or to discourage it. Largescale public procurement acts as a powerful stimulus in its own right. But it can also speed up market acceptance of a new technology by reducing the perceived risks of adoption.
These effects are rarely the primary objective of a procurement project, of course. In developing a regional service card – the Carta regionale dei servizi (CRS) – Lombardy’s regional government wanted first and foremost to improve the quality and efficiency of its healthcare administration, simplifying its dealings with citizens and saving costs. But it also intended the project to stimulate the adoption of information technologies in the region’s public and private sectors. Specifically, it views the card as the first step towards the creation of a ‘wired region’, and plans to extend the card to education, social services and other branches of the administration in due course. Indeed, the project may also be extended nationally, as the basis for an Italy-wide health card.
Promotion and training
The CRS project set out to create a platform for the electronic handling of all the data involved in the processes of diagnosis, prescription, treatment and rehabilitation. The system’s key component is a ‘personal smart card’ distributed to every citizen. This gives patients and authorised healthcare professionals secure access to the central repository of administrative and clinical data. Special terminals in surgeries, hospitals and pharmacies can be used to retrieve records of past examinations, reports, treatments and hospitalisations.
While staying closely involved as the ‘customer’, the regional government delegated day-to-day project management to the public sector software house, Lombardia Informatica (LI). LI created a consortium of technology providers including Ericsson, Elsag, Sema and Sun Microsystems which, in 1999, launched the two-year design phase. This was followed in 2001 by pilot implementation in the area around Lecco, and a progressive roll-out across the region, which is due to be completed by the end of 2005.
A users’ committee representing doctors, pharmacists and healthcare administrators has played an active part in each decision-making step. In parallel, the project has invested heavily in communication and training in order to explain the benefits of CRS and to help professionals and citizens to use the system effectively.