Examining South Tyrol’s Experience: Digital Health Adoption and Workforce Issues in Implementing Italy’s Primary Care Reform Under Ministerial Decree No. 77/2022

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Examining South Tyrol's Experience: Digital Health Adoption and Workforce Issues in Implementing Italy's Primary Care Reform under Ministerial Decree No. 77/2022

Thanks for the opportunity to review this significant review evaluates frailty assessment tools, digital health innovations, and workforce challenges in the Autonomous Province of Bolzano, South Tyrol, focusing on trust and collaboration issues from recent surveys.

The article addresses a topic of significant importance that has the potential to make a substantial contribution to the field. Nevertheless, the article is deficient in several respects, which I will proceed to elucidate. It is recommended that the essential points be corrected in one of the following ways:

Abstract and Introduction:

1)     The objective of the article is not readily apparent. In other words, the issue in question lacks sufficient clarity.

2)     What is the rationale for including all the data/ information in a single article?

3)     This article attempts to address a multitude of topics while encompassing a substantial amount of information. It would be beneficial to divide the article into discrete sections to facilitate focused reading.

4)     As the article progresses, an increasing amount of information is presented, yet the distinction between descriptions and an examination of a case related to the reform or the reform of the workforce/GPs is not fully elucidated.

 

Method:

There is a description of the narrative customer review and how the authors use the SANRA checklist, assessed literature on D.M. 77/2022 and etc.  

It is useful to explain how the custom review allows flexibility in integrating various types of qualitative and quantitative evidence to synthesise findings relevant to frailty assessment and digital health innovations in South Tyrol.

 

Table 1:

The table appears to present a good summary. It would be beneficial to include a research question and objective at the outset of the article, followed by an explanation of how the presentation of information in the table facilitates comprehension of the findings.

Ddiscussion and Conclusions:

There is no discussion of the findings in relation to other articles in the field or reviews that have been carried out. The conclusions are very general and not based on an in-depth discussion of the findings. It would be preferable to present conclusions in a more sophisticated manner than simply stating: "This review emphasises the importance of the further development of the South Tyrol General Practice Research Network (SAMNET) as a platform for continuous research and collaboration, facilitating the integration of evidence-based practices and digital health innovations in the region. By implementing proactive measures to resolve these challenges, South Tyrol can be adequately prepared to meet the objectives of D.M. 77/2022 553 by 2026, ensuring a more equitable, resilient, and modern healthcare system for its population."

 

In conclusion, the article displays considerable promise and potential. However, further work is required regarding its composition and organization.

It is recommended that the article be divided into two sections, with each section addressing a specific issue in greater depth. Ultimately, this decision rests with the authors. Should they decide not to split the article, it would be beneficial to implement improvements to enhance its quality and focus.

It is recommended that the text be revised. It would be advisable to reinforce the article by concerning its weakness.

I wish you the utmost success with the article.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

• Thank you for the opportunity to review this paper on - "Examining South Tyrol's Experience: Digital Health Adoption and Workforce Issues in Implementing Italy's Primary Care Reform under Ministerial Decree No. 77/2022". The paper is well-structured and provides a comprehensive analysis of the issues related to digital health adoption and workforce challenges in South Tyrol. The use of multiple data sources and the integration of findings from various studies enhance the robustness of the conclusions.

 

While the paper is thorough, it could benefit from a few improvements as suggested below: 

 

Abstract: The results in the abstracts section could be more summarised and shortened and needs to include a conclusion section. 

 

1.        Introduction: Introduction is too long and can be made more succinct.

 

2.        Methods: The study employs a narrative custom review methodology, which is appropriate given the complexity of the topic. The use of the SANRA checklist ensures a systematic and rigorous approach. The literature search strategy is well-documented, with a comprehensive list of search terms and sources. The inclusion of both qualitative and quantitative evidence is a strength. This section can benefit from a visual aid/figure outlining the steps in the methods and the data sources included. 

 

3.        Results: The results seem to have organised into themes presented as section headings 3, 4, and 5 which are further explored. However, its not clear how these themes were identified. Could the authors please describe the method how these themes were extracted and provide reasoning as why these particular themes were chosen. It would also be good to see an exclusive results section/ provide a description in the methods section to indicate that the results will be presented as sections.

 

Good luck!

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The article has been revised by the researchers and is now suitable for publication.