Healthcare Archives - Politecnico di Milano School of Management

The quest for living longer at any cost – the dream to live for 150+ years – has been replaced by the search of how to improve life quality for better ageing, in order not to lose self-suffiency as well as physical and cognitive capabilities.

Emanuele Lettieri
Full Professor of Health Care Management at the School of Management of Politecnico di Milano
Scientific Director of the Permanent Observatory of Digital Innovation in Healthcare at Politecnico di Milano

Population ageing is a double-edged sword. On the one hand, this is definitively good news. We live longer and life expectancy at birth is increasing generation after generation. This is the result of paramount discoveries in medicine and ground-breaking innovations in medical technology. On the other hand, this is very bad news. Disabilities and chronic diseases will probably characterize the last years of our lives, limiting our possibility to live a full life. Moreover, a significant portion of healthcare expenditure – that is expected to increase year after year – is currently allocated to the management of elderly fragility and chronic diseases. This obliges to reduce the financial resources that could have been allocated to the younger citizens.

But how to jump out of this vicious circle?
A straightforward solution comes from what has already happened in other industries – e.g., in the automotive industry. The healthcare system must treat citizens when they are still healthy, helping them postpone as long as possible the moment when they will need specialized treatment for either fragility or chronic diseases. This vision requires healthcare professionals to turn upside down their current approach to health care delivery. Prevention, lifestyle improvement, empowerment and co-responsibility are the “silver bullets” to help citizens live longer and be healthier.

This is the challenge of Healthy Ageing. This challenge is of paramount relevance for the sustainability over time of our society and it is fully coherent with the Societal Development Goal number 3 – ensuring healthy lives and promoting well-being for everyone at all ages.
In 2015, the World Health Organization (WHO) introduced the concept of Healthy Ageing, intended as the process through which an individual can maintain or enhance her/his well-being within the ageing process. The WHO launched the Decade of Healthy Ageing (2021-2030) that is intended as a decade of concerted global actions on Healthy Ageing. The motivation is that populations around the world are ageing at a faster pace than in the past and this demographic transition will have an impact on almost all aspects of society.
In this view, finding previously unexplored pathways for enhancing the ability of citizens aged 50+ to live a longer and healthier life is top of the agenda for policymakers, professionals, entrepreneurs and management scholars. The initiatives on the table are numerous and they are contributing to the growth of the so-called Silver Economy. This term was coined to describe the economy linked to products and services targeted at citizens aged 50+. Its extent has been estimated in Europe at €5.7 trillion in 2025.

The ageing population can be divided into active, fragile and dependant. For a sustainable society, it is important to support active and healthy ageing among the 50+ citizens so that they can be part of the active workforce for as long as possible. In this view, healthcare must keep pace with their needs. Care delivery must become personalized, participative, preventive and predictive. This is at hand nowadays! Digital solutions might offer the extraordinary opportunity to respond successfully to the challenges of the Silver Economy. Digital technologies might contribute to the development of next-generation techniques for fragility and disease prevention, as well as new treatments to ensure a healthy, active and productive life to the population aged 50+.

The School of Management of Politecnico di Milano stands up for Healthy Ageing and is contributing through different research and educational initiatives.

First, the permanent Observatory of Digital Innovation of Healthcare is collecting data from the field about the transition toward a new paradigm of health care delivery that has been defined as Connected Care. Ageing citizens are searching for an ecosystem of healthcare services and tools that are consistent and interoperable. Considering four main phases – namely, (1) information seeking & primary prevention, (2) access to care; (3) diagnosis & therapy; and (4) follow-up & engagement into new lifestyles – the present Covid-19 pandemics has accelerated the adoption of digitally-enabled behaviours for all phases.
Four citizens out of five searched for information on the internet about healthier behaviours and disease prevention. Two citizens out of five tried smartwatches or Apps to monitor their physical activity, improve their nutritional behaviour or test their cognitive capabilities. One citizen out of three is interested in interacting with their doctor through tele-visits. These and other data are published every year by the research team from this Observatory.

Second, the School of Management (SOM) of Politecnico di Milano is contributing to an H2020 pan-European research project – named NESTORE – aimed at developing an artificial intelligence-enabled virtual coach to help European citizens aged 65+ in their healthy ageing. The virtual coach can provide users with personalized pathways to healthy ageing that cover physical activity, nutrition, cognitive capabilities and social interaction. At present, the coach is under validation (phase 2) in three pilot countries – Italy, Spain and the Netherlands – with promising results in terms of engagement and acceptability. The SOM is chairing the development of the exploitation strategy of the solutions developed within the research project – such as a virtual coach, an App, a smartwatch to collect data, a tangible interface, a chatbot, and a series of games. At the beginning, NESTORE will adopt a direct-to-consumer business model, but with the ambition of becoming a digital therapy within two years – after a phase 3 validation study – and being approved and reimbursed by the national healthcare systems. Our data show that one citizen aged 65+ out of three is interested in virtual coaches because they are searching for 24/7 support for their healthy ageing.

Finally, the MIP Politecnico Graduate School of Business has launched in September 2020 the first edition of the Executive Master in Innovation Management in Healthcare. Multi-disciplinary professionals from hospitals and vendors from the MedTech industry are learning how to disrupt the current paradigms of health care delivery and accelerate the transition toward innovative socio-technical configurations of Connect Care.

There is an ancient Chinese curse which says “May we live in interesting times.” In this light, the School of Management of Politecnico di Milano is fully committed to making available its distinctive competencies to sustain the healthy ageing of citizens 65+, to allow them to live longer and healthier lives in interesting times.

The Place4Carers project was conceived to co-produce a new community social service, promoting the involvement of family caregivers of elderly people residing in remote, rural areas of the Camonica Valley (Lombardy Region).

Cristina Masella, Professor of Business Administration, School of Management, Politecnico di Milano

Eleonora Gheduzzi, PhD Candidate, School of Management, Politecnico di Milano

The current health emergency has provided the opportunity to reflect on the importance of community assistance and home care, especially in favour of fragile elderly people. In Italy, community assistance is entrusted primarily to 7 million family caregivers, a category that mostly goes unnoticed. Family caregivers are predominantly women aged 50 to 60. During the health emergency, more than 50% of these caregivers suspended or reduced their work activities because of the increased burden of caring for their loved ones.

“We have a thousand worries. Our life is very hard. We haven’t even the smallest moment to ourselves; a time in which to recharge our batteries. And community assistance is steadily decreasing,” Caregiver (55), Breno.

In addition to the psychological hardship of seeing a loved one suffer, family caregivers experience intense stress, a sense of impotence, and solitude due to their ‘burden of assistance’. To prevent the emergence of new vulnerabilities on the territory, a network of healthcare and social service providers must be created that can collaborate closely with family caregivers and provide them with the assistance they need in caring for the elderly. The goal of establishing such a network is twofold: to support caregivers, improving their psychological and social condition, and to strengthen the provision of community assistance to vulnerable elderly people.

“We have a greater awareness, both of ourselves and of the relationship we can establish with healthcare operators and professionals to assist our loved ones. I have matured a lot because I now realise what I can do,” Caregiver (77), Breno

The Place4Carers project has responded to these needs through participatory scientific research actions involving family caregivers who look after dependant elderly people living in the Camonica Valley. This mountainous, hard-to-reach area was chosen as the scope of the project because here, the caregivers’ assistance is truly crucial given their limited access to healthcare and social services.

The three-year project was funded by Fondazione Cariplo and coordinated by the EngageMinds HUB of the Università Cattolica, in collaboration with the School of Management (SOM) of the Politecnico di Milano, the Need Institute, and Azienda Territoriale per i Servizi alla Persona (ATSP), the local social welfare centre in Breno, Brescia.

In particular, the Politecnico di Milano’s SOM team was entrusted with mapping the needs and the psychological and social condition of family caregivers in the Camonica Valley. This study revealed that caregivers spend an average of 75 hours per week caring for their loved one, experiencing greater physical and psychological fatigue than those who benefit from greater healthcare and social services.

These and other results formed the basis for a new, co-designed service, “S.O.S CAREGIVERS: feeling well to help others feel well”, comprising four co-designed workshops involving 26 family caregivers, 6 researchers and 3 ATSP representatives.

The School of Management team supported ATSP in the implementation of the service, by evaluating its feasibility first and then its impact. The service comprises four macro-activities and has helped more than 150 caregivers:

Know more, know better: training courses aimed at providing family caregivers with know-how and practical skills for more effective management of their loved ones.
Tradition and memory: a sociable support group offering family caregivers the chance to exchange stories relating to life in the Camonica Valley, mediated by the support and supervision of a psychologist.
Information is good for the heart: the establishment of various local information channels, both online and offline, to inform caregivers about the community services available to fragile elderly people and to promote the new SOS Caregiver service.
Citizens’ Committee: a participatory organisational structure managing the service, supervising its performance and providing suggestions to improve its effectiveness. The Committee is made up of family caregivers, ATSP representatives, and researchers.

The results were more than satisfactory. For a more comprehensive, overall evaluation of the service, the School of Management team involved all the stakeholders who collaborated in implementing the service: family caregivers, ATSP representatives, researchers, trainers, professionals, and four local care homes. Overall, the service met with a very high level of satisfaction (around 90%), good understanding of course contents (around 88%), and a considerable participation rate, given the hard-to-reach context (around 20%). Moreover, the ATSP representatives, the professionals, and the managers of the four care homes involved were interested in continuing the service, highlighting the importance of supporting family caregivers in caring for the elderly at home.

“While we didn’t receive any physical help, the training and assistance we received has helped us manage better our day-to-day problems”, Caregiver (78), Breno.

“We were able to gain a better insight of the day-to-day difficulties experienced by family caregivers in caring for the elderly, and this helped us to review our services in order to address the needs not just of the elderly but of the family as a whole”, an ATSP member of staff, Breno.

This project has kicked off the establishment of a community network involving caregivers, researchers, ATSP, ATS Montagna (the mountain health protection agency), ASST Vallecamonica (the local community social healthcare company), Comunità Montana (the Italian mountain community), Assemblea dei Sindaci (the assembly of local mayors), four care homes in the Camonica Valley and a number of cooperatives.

The project may have come to an end, but Place4carers keeps on going!

For further information on the Place4Carers project, please click here to watch the project video and here to the final presentation.

Tag: Healthcare

Would you prefer to live longer or healthier? Easy! I want to live a longer and healthier life! The societal challenge of Healthy Ageing

The quest for living longer at any cost – the dream to live for 150+ years – has been replaced by the search of how to improve life quality for better ageing, in order not to lose self-suffiency as well as physical and cognitive capabilities.

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