Healthcare and innovation: MiMS looks at the future of precision medicine

The MiMS – the Master in Management per la Sanità (Master's in Healthcare Management) program concluded with a motivational and inspirational graduation ceremony that highlighted the journey of students to becoming alumni and looked at the innovative transformations taking place in healthcare management.

The graduation ceremony of the 11th edition of MiMS – the Master in Management per la Sanità (Master's in Healthcare Management) opened with a greeting from Director Valeria Tozzi. She emphasized the symbolic significance of the event, which marks the class's transition from students to alumni, a network that includes around 800 people. This subtle yet profound step follows the establishment of relationships already made in class and the fact that participants are already young professionals working in the healthcare industry.

Following that, Enzo Baglieri, Associate Dean for Master Division, highlighted the important role that questions, curiosity and passion play in everyone's professional growth and that they stand at the basis of what makes us do "good things" even as professionals, each in his or her own field. Questions, curiosity, and passion were the ingredients that not only drove the journey of the master for students, faculty, and staff, but were at the heart of the main subject matter addressed during the ceremony: precision medicine and its managerial implications.

"How does the organization of care change when choices about what to do for diagnosis and treatment depend on one's genetic makeup? This is a question that simplifies all the complexity behind the label of precision medicine or personalized medicine," said Tozzi, who used the definition of the National Human Genome Research Institute ("an innovative approach that uses information about an individual's genomic, environmental and lifestyle information to guide decisions related to their medical management") to point out how the managerial implications of this still developing branch of medical knowledge are not yet entirely clear. This shows how this very important branch of research is emerging for management experts.

Giuseppe Aprile, Director of the Department of Clinical Oncology of Ulss 8 Berica and representative of the Collegio Italiano dei Primari Oncologi Ospedalieri (CIPOMO), illustrated how oncology is a field in which precision medicine finds real applications and, as often happens in medicine, what has been tested in one discipline in terms of service organization lends itself as a prototype for others. Aprile mentioned how precision oncology is a great opportunity for treatment, especially for certain health conditions for which there were no other therapeutic opportunities in the past. The organization and management of services, oncological and otherwise, is a crucial element in bringing innovation closer to patients in the right ways and at the right time.

"Oncology is leading the way in terms of the organization and management choices of precision medicine,” said Tozzi, presenting some intermediate milestones from research developed by Cergas (Center for Research for Health and Social Care Management), the research center at SDA Bocconi directed by her. “The models that are observed in Italy and abroad are extremely varied. In this country, there is a tendency to propose highly centralized models and homogenize solutions without considering the structure of each region's supply network and existing practices and expertise. Perhaps the ends should be homogeneous in terms of contexts more so than the organizational responses."

 Oncology is transforming its model of care, which is marked by a multidisciplinary and muti-professional approach, expanding the number of professional skills in cancer care and building close relationships with second-level laboratories that deal specifically with genetic testing. These are skills and services that are rarely found in the same hospital where there is the pathology group taking care of the patient. Tozzi then outlined the four models of organizing "precision" cancer care that can be observed in both the national and international landscape. They are characterized by two distinct elements: the first is the multiplication of decision-making processes on patient diagnosis and treatment thanks to the Molecular Tumor Board. The second element is the relationship between oncology services and second-level laboratories that need significant and large-scale expertise, technology, and volumes of activity.

The panel discussion also involved Massimo Annicchiarico, General Director of the Health and Social Care Department of the Veneto Region, who explained how precision medicine is a challenge for regional and corporate systems. Any transformation must be reconciled with the sustainability of care, a challenge that all regions and healthcare companies are dealing with also thanks to the proposals of DM 77/2022, which is also leading a review of existing models, especially of local services. Annicchiarico pointed out that all work meant to redesign the provision of care, both that driven by innovations in the clinical field and that prompted by the institutions themselves, must focus on the patient experience of care and an interpretation of equity that starts from the knowledge of the citizen because when faced with the same healthcare needs, some might need differently organized services. 

SDA Bocconi School of Management