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The Role of Digitalization in Healthcare Within the National Health...
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The Role of Digitalization in Healthcare Within the National Health System: Opportunities and Challenges for a More Efficient System

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 31 August 2026 | Viewed by 4716

Special Issue Editors

Dr. Alessandro Perrella

E-Mail Website
Guest Editor
Emerging Infectious Disease at High Countagiousness, AORN Ospedali dei Colli—P.O. D.Cotugno, 80131 Naples, Italy
Interests: infectious disease; transplants; immunology; AI; healthcare management; antimicrobial stewardship
Special Issues, Collections and Topics in MDPI journals
Dr. Pierino Di Silverio

E-Mail Website
Guest Editor
Regional Transplant Center, Campania Region, AORN Ospedali dei Colli—P.O. D.Cotugno, 80131 Naples, Italy
Interests: solid organ transplants; organ procurement for transplants; national health system consultant; healthcare management

Special Issue Information

Dear Colleagues,

This Special Issue explores how the digital transformation is reshaping healthcare management within national health systems, highlighting both the immense opportunities and the inherent challenges. As healthcare systems worldwide face increasing pressure to deliver high-quality, efficient care amidst resource constraints, digital tools and technologies offer innovative solutions to streamline processes, enhance patient care, and optimize resource allocation. Topics in this Special Issue include critical areas such as electronic health records (EHRs), telemedicine, artificial intelligence (AI), data analytics applications in healthcare setting, and interoperability, examining how these advancements can improve decision-making, reduce administrative burdens, and support personalized treatment plans.

This Special Issue also investigates challenges such as data privacy concerns in healthcare management, technology integration across varying healthcare settings, and the digital divide impacting equitable access to digital healthcare services. Through case studies, research articles, and expert analyses, this Special Issue aims to provide healthcare professionals, policymakers, and researchers with insights on how to leverage digitalization to build a more resilient and efficient healthcare system. The ultimate goal is to identify ways to harness digital technology for sustainable improvements in patient outcomes, operational efficiency, and overall system resilience within the national healthcare context.

We look forward to receiving your contributions.

Yours faithfully,
Dr. Alessandro Perrella
Dr. Pierino Di Silverio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital medicine
  • AI
  • GPT
  • healthcare management
  • epidemiology
  • national healthcare system

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Published Papers (2 papers)

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8 pages, 1215 KB  
Article
Assessing the “Optimism–Knowledge Gap”: An Exploratory Study of AI Awareness, Application, and Educational Needs Among a Sample of Italian Clinicians
by Alessandro Perrella, Pierpaolo di Micco, Ugo Trama, Pierino di Silverio, Ada Maffettone, Gaetano Piccinocchi and Francesca Futura Bernardi
Healthcare 2026, 14(7), 847; https://doi.org/10.3390/healthcare14070847 - 26 Mar 2026
Viewed by 517
Abstract
Background: Artificial intelligence (AI) is poised to fundamentally reshape healthcare delivery, offering unprecedented advancements in diagnostics, treatment personalization, and operational efficiency. However, a growing body of international research reveals a critical “optimism–knowledge gap”: healthcare professionals are enthusiastic about AI’s potential but possess limited [...] Read more.
Background: Artificial intelligence (AI) is poised to fundamentally reshape healthcare delivery, offering unprecedented advancements in diagnostics, treatment personalization, and operational efficiency. However, a growing body of international research reveals a critical “optimism–knowledge gap”: healthcare professionals are enthusiastic about AI’s potential but possess limited technical knowledge and practical experience. This gap compromises the safe and effective implementation of AI tools. The Italian healthcare context presents a unique and amplifying challenge, as it is defined by the stringent “human-in-the-loop” oversight mandated by the Garante per la protezione dei dati personali (Italy’s Data Protection Authority). This legal framework makes clinician competence not just a goal, but a prerequisite for regulatory compliance. Objective: This study aimed to provide an exploratory quantitative assessment of AI awareness, practical application, and understanding of its limitations among a sample of clinicians in Italy. It specifically sought to compare the preparedness of hospital-based clinicians and general practitioners (GPs) and to identify the workforce’s perceived educational needs within this unique legal environment. Methods: A descriptive, cross-sectional survey was conducted from February to August 2025. Using a non-probability convenience sampling method via professional networks, the survey yielded 362 total responses. Data were analyzed descriptively and inferentially using Chi-square (χ2) tests to compare cohort responses on familiarity, practical exposure, knowledge of limitations, and interest in further training. Results: A universal and high demand for education was found, with 89.9% of all respondents being “Moderately” or “Very” interested in learning more about AI. This optimism coexists with dangerously low practical exposure. The gap was most profound among GPs, 44.1% of whom have “Never” used an AI tool—a rate significantly higher than hospital clinicians (34.9%; χ2=3.14, p = 0.045). Furthermore, 32.6% of GPs admitted that they “understand some benefits but not the limitations.” Conclusions: Italian clinicians mirror the global optimism–knowledge gap. These findings underscore the urgent need for structured, continuous education in AI literacy to address ethical and regulatory imperatives within the Italian healthcare system. Full article
(This article belongs to the Special Issue The Role of Digitalization in Healthcare Within the National Health System: Opportunities and Challenges for a More Efficient System)
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31 pages, 2308 KB  
Article
Digital Transformation of Medical Services in Romania: Does the Healthcare System Meet the Current Needs of Patients?
by Ioana-Marcela Păcuraru, Ancuța Năstac, Andreea Zamfir, Ștefan Sebastian Busnatu, Octavian Andronic and Andrada-Raluca Artamonov
Healthcare 2025, 13(20), 2549; https://doi.org/10.3390/healthcare13202549 - 10 Oct 2025
Cited by 3 | Viewed by 3314
Abstract
Background: The digitalization of medical services is promoted as a solution for improving access, quality, and efficiency within healthcare systems. In this context, the study investigates the extent to which digitalization in Romania meets the current needs of patients through a convergent [...] Read more.
Background: The digitalization of medical services is promoted as a solution for improving access, quality, and efficiency within healthcare systems. In this context, the study investigates the extent to which digitalization in Romania meets the current needs of patients through a convergent analysis of user perceptions and managerial perspectives. Based on the specialized literature, the research tests two hypotheses: (H1) the implementation of digital technologies significantly contributes to improving the quality of medical services and operational efficiency; (H2) digitalization has a positive impact on patient satisfaction by facilitating access to care and improving communication with medical personnel. Methods: The study adopted methodology is cross-sectional and mixed, including an online mixed-methods questionnaire for patients, distributed between 6 and 14 May 2025, and a qualitative questionnaire with open-ended questions distributed via e-mail to managers from public hospitals through The Administration of Hospitals and Medical Services of Bucharest, between 3 and 24 March 2025. Results: In total, 125 patients and 15 hospital managers participated in the study. Statistical analysis (χ2, ordinal regression) and data triangulation highlight a predominantly positive, yet heterogeneous, patient perception of digitalization, with Hypothesis H1 only partially supported (weak, inconsistent, and in some cases negative associations between technology use and perceived service quality). By contrast, H2 was robustly validated, with patient satisfaction strongly linked to tangible benefits, particularly easier access and online appointment scheduling. However, use remains limited to administrative functions, while advanced technologies such as telemedicine or electronic health records are poorly adopted. From an institutional perspective, hospitals predominantly use IT systems for internal purposes, without real patient access to their own data, no interoperability between medical units, and marginal implementation of telemedicine. This reveals a significant gap between user perception and organizational realities, emphasizing the lack of a patient-oriented digital infrastructure. Conclusions: The results highlight the potential of digitalization to enhance patient experience and service efficiency, while also pointing out structural limitations that hinder the full realization of this potential. Patient satisfaction is strongly associated with tangible benefits, particularly easier access and online scheduling, whereas the effect on perceived quality is weaker and sometimes inconsistent. There are significant disparities in digitalization levels between healthcare providers, perceived by patients as public–private differences, and gaps among public hospitals are also confirmed by managerial data. These findings suggest that a successful digital transformation of the medical system in Romania must address both technological infrastructure gaps and organizational barriers, within a coordinated national strategy that ensures interoperability, patient-centered design, and sustainable implementation. Full article
(This article belongs to the Special Issue The Role of Digitalization in Healthcare Within the National Health System: Opportunities and Challenges for a More Efficient System)
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