Care management systems widely used in Italy

Italy's care management tool landscape is regionally fragmented but increasingly converging around shared standards. The Piano Nazionale di Ripresa e Resilienza (PNRR) has accelerated digital health investment, while regional autonomy continues to shape which platforms gain traction where. For decision-makers evaluating clinical infrastructure, understanding the actual tool landscape is a prerequisite for any informed procurement decision.

How Italian healthcare is organised, and why it shapes tool adoption

Italy's Servizio Sanitario Nazionale (SSN, or National Health Service) is not a monolithic system. It operates across 21 regions, each with significant administrative and financial autonomy over health IT procurement. Platform adoption is rarely national in scope. It is typically regional, and sometimes sub-regional, determined by the priorities and budgets of individual Aziende Sanitarie (regional health authorities).

The practical consequence is a fragmented market. A platform that dominates in Lombardia may have minimal presence in Calabria. Regional health IT initiatives, such as SISS in Lombardia, SOLE in Emilia-Romagna, and various CUP regionali (regional booking systems), have created distinct technology ecosystems that vendors must integrate with to compete for contracts.

The care setting also matters. Italy distinguishes between:

• Primary care, delivered largely by Medici di Medicina Generale (MMGs, or general practitioners), who operate semi-independently and use dedicated practice management software

• Secondary care, delivered in hospitals (Aziende Ospedaliere) and specialist outpatient settings, where full hospital information systems and clinical record platforms are deployed

• Integrated community care, increasingly delivered through the emerging Case della Comunità network, a PNRR-funded model designed to coordinate chronic disease management and preventive care outside hospital walls

Tool adoption differs significantly across these settings, and decision-makers should be clear about which care context they are procuring for.

What "care management system" means in the Italian context

The term "care management system" does not map neatly onto a single product category in Italy. In practice, it spans several overlapping tool types:

• Cartella Clinica Elettronica (CCE), the Italian equivalent of a clinical record system, used to document clinical encounters, manage patient records, and support care coordination within a facility

• Fascicolo Sanitario Elettronico (FSE), the national patient health summary accessible across providers and regions, distinct from the CCE but increasingly interconnected with it

• Hospital Information Systems (HIS), administrative and operational platforms managing admissions, scheduling, billing, and resource allocation

• Primary care management software, practice-level tools used by general practitioners for daily clinical documentation and patient management

• Telemedicine and remote monitoring platforms, increasingly funded through PNRR and integrated into chronic disease pathways

It's important to distinguish the CCE (a clinical documentation tool within a facility) from the FSE (a longitudinal patient record accessible across the system). Decision-makers evaluating platforms should be precise about which function they are procuring. Conflating the two is a common source of confusion in Italian procurement discussions.

According to data from the Osservatorio Sanità Digitale 2025 at the Politecnico di Milano School of Management, 85 per cent of Italian healthcare facilities now have an active CCE, and digital health investment reached €2.47 billion in 2024, a 12 per cent increase on the previous year. The CCE remains among the top investment priorities for healthcare organisations nationally.

The most widely used care management platforms in Italy

Dedalus

Dedalus is widely regarded as the leading health IT provider in Italy and across Europe. Its portfolio spans CCE, radiology information systems, laboratory systems, and care coordination platforms, with installations across public hospitals, regional health authorities, and diagnostic networks throughout Italy.

Its Dedalus DC4H (Digital Connect 4 Health) platform is built on an open, FHIR (Fast Healthcare Interoperability Resources) based architecture designed to integrate clinical data across care settings, a relevant feature given FSE 2.0 interoperability requirements. Dedalus has historically absorbed several Italian and European health IT businesses, including Agfa HealthCare's clinical software division, giving it significant installed-base depth across Italian public health organisations.

The company is also a named partner of the Osservatorio Sanità Digitale at Politecnico di Milano, reflecting its central position in the Italian market's research and policy ecosystem.

Engineering Group (Engineering Sanità)

Engineering Group is one of Italy's largest IT services companies and a major supplier of hospital information systems and care management software to public health organisations. Its AREAS suite, covering ADT (admissions, discharge, and transfer), emergency department management, and clinical workflow, is deployed across multiple Italian regional health authorities and hospital networks.

A procurement document from AULSS 9 Scaligera in Veneto lists Engineering's AREAS-ADTWeb and AREAS-PSWeb systems as active in the trust, alongside platforms from Dedalus, GPI, and Exprivia. This illustrates the multi-vendor reality typical of Italian public health IT environments.

Engineering is also a named partner of the Polimi observatory, and its presence in integrated care and administrative workflows makes it a significant player in any regional digital health tender.

GPI S.p.A.

GPI is an Italian health IT company with a strong focus on clinical software, digital health, and social care management. It has secured some of the largest CCE procurement contracts in Italy in recent years.

Most notably, GPI won the public tender to deliver the regional CCE for healthcare entities in Lombardia, Italy's largest region by population and GDP, and one of Italy's most digitally advanced regions in healthcare, in a contract reported to be worth €32.7 million. This positions GPI as a tier-one CCE provider at regional scale, with a reference site of significant weight for any procurement evaluation.

GPI's IE-DEA and IE-Cartella systems are also listed as active in Veneto's AULSS 9 Scaligera procurement documentation, suggesting multi-regional deployment.

Exprivia

Exprivia is an Italian technology group with a dedicated healthcare division. Its CCE suite manages the full patient journey from admission to discharge, and its ERIS RIS/PACS system handles radiology information and imaging workflows. Exprivia is listed among the key vendors in the Polimi observatory's partner ecosystem and appears in active use within Veneto's regional health infrastructure.

InterSystems TrakCare

InterSystems TrakCare is an international unified healthcare platform with adoption across Italian secondary care settings. Its strengths lie in interoperability, structured clinical data management, and the ability to present a unified patient record across departments and care settings. Italian market analysis identifies InterSystems alongside Dedalus, Exprivia, and Engineering as one of the dominant systems in the Italian hospital software market.

TrakCare is particularly relevant for organisations seeking cross-departmental clinical data integration, a priority that has grown with FSE 2.0 compliance requirements.

Philips TASY and Oracle Health (Cerner)

International platforms including Philips TASY and Oracle Health (formerly Cerner) have a presence in specific Italian hospital networks and private care groups. Their core use cases centre on clinical documentation, care coordination, and hospital operations management. These platforms tend to appear in larger private hospital groups or in public institutions that have pursued international procurement frameworks, rather than in the typical regional health authority context where domestic vendors predominate.

Oracle Health is listed as a named partner of the Osservatorio Sanità Digitale 2025, indicating an active commercial presence in the Italian market.

The FSE 2.0: Italy's national health record framework

The Fascicolo Sanitario Elettronico 2.0 is not a care management platform in itself, but it functions as the foundational interoperability layer that all care management tools in Italy must now integrate with. It is a national initiative that gives patients access to their longitudinal health record across providers and regions, and requires all clinical systems to share structured data in standardised formats. This requirement for consistent clinical documentation across providers is central to how the FSE 2.0 functions in practice.

Analysis of Italy's post-PNRR digital health landscape identifies the FSE 2.0, alongside the CCE and telemedicine platforms, as one of the three pillars driving Italy's healthcare digitalisation. FSE 2.0 compliance has become a de facto procurement requirement. Vendors that cannot demonstrate integration with the national framework face significant barriers to winning public contracts.

Despite progress, a 2026 update from the Polimi observatory notes that only 48 per cent of specialist doctors had accessed the FSE, and that lack of integration between hospital systems and the FSE remains a key barrier to care continuity.

Tools commonly used in primary care and general practice

Italian general practitioners operate in a distinct procurement environment from hospitals. They typically select practice management software independently or through their regional health authority, and the tools they use differ markedly from secondary care platforms.

The most widely used GP software platforms in Italy include:

• Millewin, one of the most established and widely adopted clinical management systems for Italian GPs, covering patient records, prescriptions, referrals, and regional network integration

• Medikey, a widely used primary care platform offering clinical documentation, patient scheduling, and integration with regional health IT systems

• Lynx, used in primary care settings for clinical documentation and patient management workflows

These platforms handle daily clinical documentation, chronic disease follow-up, sick note generation, patient letters, and integration with regional CUP (Centro Unico di Prenotazione, or centralised booking) systems. Their integration with the FSE 2.0 is an ongoing development area, as the national framework requires GP-level data contribution to the patient's longitudinal record.

Emerging digital tools: telemedicine, remote monitoring, and AI

PNRR funding, totalling billions of euros directed at Italy's health system through the Missione 6 Salute programme, has accelerated investment in digital tools beyond the core CCE. Three categories are gaining particular traction.

Telemedicine and remote consultation platforms have expanded significantly since 2021, supported by national guidelines published by the Ministry of Health and regional rollout programmes. Chronic disease management pathways, particularly for diabetes, cardiovascular disease, and respiratory conditions, are increasingly incorporating structured remote monitoring.

The EU-funded GATEKEEPER project, which included Italy as one of seven European implementation sites, piloted an interoperable digital health framework for ageing populations. It tested use cases including wearable-based monitoring for chronic obstructive pulmonary disease and heart failure, glycaemic management for diabetes, and machine learning-based predictions for high blood pressure. Its methodology for selecting implementation sites and matching tools to population complexity offers a useful framework for organisations designing integrated care programmes.

AI (artificial intelligence) integration in clinical workflows is an early but growing area. According to survey data from the Polimi observatory's 2026 update, 61 per cent of surveyed specialists and general practitioners reported having used generative AI tools in some capacity, though this figure reflects self-reported usage and should be verified for sample size and methodology. Clinical decision support and AI-assisted documentation are the most common entry points, though formal integration into certified care management platforms remains limited at this stage.

Predictive analytics for care coordination, particularly for readmission prevention and chronic disease escalation, is another area of growing interest. Evidence from integrated health systems elsewhere, such as Kaiser Permanente's Transitions Program, suggests an association between predictive analytics-driven care coordination and reduced 30-day readmission rates. This provides a reference point for Italian organisations designing similar programmes within their own CCE and care management infrastructure.

Key factors driving, and slowing, adoption in Italy

Understanding the adoption environment is as important as understanding the tools themselves. Several forces are simultaneously accelerating and constraining digital health deployment across Italy.

Drivers of adoption:

• PNRR funding has created time-bound financial incentives for healthcare organisations to invest in digital infrastructure, with specific targets tied to CCE rollout, FSE 2.0 integration, and telemedicine capacity

• FSE 2.0 compliance requirements are reshaping procurement decisions, effectively mandating interoperability standards that favour vendors with proven national framework integration

• Regional health IT strategies in more advanced regions (Lombardia, Emilia-Romagna, Veneto, Toscana) are driving coordinated platform consolidation and creating reference models for other regions

Barriers to adoption:

• Legacy system dependencies are significant. As documented by Arcadia, citing ISTAT and AGENAS data, technological, training, and regulatory gaps mean digitalisation is not yet complete across many facilities

• Regional fragmentation means that even well-funded national initiatives face inconsistent implementation timelines and varying levels of local technical capacity

• Lack of integration between hospital systems and the FSE remains a persistent barrier, as noted by the Polimi observatory

• Clinician resistance to documentation burden is a documented factor in CCE adoption. Where new platforms increase administrative workload without reducing cognitive load, uptake among clinical staff can be slow regardless of organisational mandate

The evidence on digital health adoption outcomes is not uniformly positive. A systematic review of machine learning applied to administrative health records found that while the field is accelerating, studies remain largely disconnected from one another, and data quality and technique-based limitations constrain the utility of analytics tools in practice. Decision-makers should be cautious about vendor claims regarding AI-driven care management capabilities that are not yet validated in the Italian regulatory and clinical context.

What decision-makers should evaluate when assessing these platforms

For healthcare decision-makers in Italy, whether in a regional health authority, a hospital, or a private group, the following criteria are the most operationally relevant when assessing care management platforms:

• FSE 2.0 compliance and interoperability: Can the platform exchange structured clinical data with the national FSE framework using FHIR-based standards? This is a non-negotiable requirement for public sector procurement and increasingly relevant for private providers.

• Regional reference sites: Does the vendor have active, verifiable deployments in your region or in comparable regions? The multi-vendor environment documented in trusts like AULSS 9 Scaligera illustrates the importance of understanding local integration history.

• Integration with existing legacy systems: What middleware or API (application programming interface) capability does the platform offer to connect with incumbent hospital information systems, radiology, laboratory, and scheduling systems already in use?

• GDPR (General Data Protection Regulation) alignment: Where is patient data processed and stored? EU data residency is a requirement for public health organisations, and ISO 27001 certification is a baseline security expectation.

• Support for structured clinical documentation: Does the platform support structured notes and clinical coding (SNOMED/ICD) in a way that reduces documentation burden for clinicians rather than increasing it?

• Vendor stability and support model: Given the long contract cycles typical of Italian public health procurement, vendor financial stability, local support capacity, and roadmap transparency are material considerations.

• Care setting fit: Is the platform designed for the specific care context, whether primary care, secondary care, or integrated community care, in which it will be deployed? Tools designed for hospital inpatient settings may not be appropriate for Case della Comunità or GP practice environments.

Navigating Italy's care management landscape

Italy's care management tool landscape is regionally fragmented but increasingly converging around a common set of standards and expectations. The FSE 2.0 is functioning as a de facto backbone, reshaping what vendors must offer to compete in public tenders. Dedalus, Engineering, GPI, and Exprivia dominate the public hospital and regional health authority market. InterSystems TrakCare holds a meaningful position in secondary care interoperability. Primary care remains served by dedicated GP platforms including Millewin, Medikey, and Lynx.

PNRR investment has created genuine momentum, with digital health spending reaching €2.47 billion in 2024 and continuing to grow. The gap between investment and consistent clinical adoption is a reminder that technology procurement alone does not determine outcomes. Fewer than half of specialists had accessed the FSE as of 2026. Integration capability, clinician usability, and regional implementation capacity are equally consequential factors in any deployment decision.

The most important question for decision-makers is not which platform is theoretically best, but which platform has proven integration with Italy's national and regional health IT infrastructure, a credible reference base in comparable organisations, and the vendor capacity to support a multi-year deployment in a complex, multi-stakeholder environment.

Frequently asked questions

▶ Which care management platforms are most widely used in Italian hospitals?

Dedalus, Engineering Group, GPI, and Exprivia dominate the public hospital and regional health authority market in Italy. InterSystems TrakCare holds a meaningful position in secondary care interoperability. International platforms such as Philips TASY and Oracle Health appear in specific private hospital groups and larger public institutions, but domestic vendors predominate in most regional health authority tenders.

▶ What is the difference between the Cartella Clinica Elettronica and the Fascicolo Sanitario Elettronico?

The Cartella Clinica Elettronica (CCE) is a clinical record system used to document encounters and manage patient records within a single facility. The Fascicolo Sanitario Elettronico (FSE) is a national patient health summary accessible across providers and regions. The CCE is a facility-level documentation tool; the FSE is a longitudinal record that spans the whole system. Conflating the two is a common source of confusion in Italian procurement discussions.

▶ Why is Italy's care management tool market so fragmented?

Italy's Servizio Sanitario Nazionale operates across 21 regions, each with significant administrative and financial autonomy over health IT procurement. Platform adoption is typically regional, and sometimes sub-regional, determined by the priorities and budgets of individual Aziende Sanitarie (regional health authorities). Regional health IT initiatives such as SISS in Lombardia and SOLE in Emilia-Romagna have created distinct technology ecosystems that vendors must integrate with to compete for contracts.

▶ What software do Italian general practitioners use for clinical documentation?

Italian general practitioners (Medici di Medicina Generale) most commonly use dedicated practice management platforms rather than hospital systems. The most widely used options include Millewin, Medikey, and Lynx. These tools handle daily clinical documentation, chronic disease follow-up, sick note generation, patient letters, and integration with regional centralised booking systems. Their integration with the FSE 2.0 national framework is an ongoing development area.

▶ What is FSE 2.0 and why does it matter for procurement decisions?

The Fascicolo Sanitario Elettronico 2.0 is Italy's national interoperability framework, requiring all clinical systems to share structured data in standardised formats using Fast Healthcare Interoperability Resources (FHIR) standards. FSE 2.0 compliance has become a de facto procurement requirement. Vendors that cannot demonstrate integration with the national framework face significant barriers to winning public contracts. As of 2026, only 48 per cent of specialist doctors had accessed the FSE, and lack of integration between hospital systems and the FSE remains a key barrier to care continuity.

▶ How has PNRR funding shaped digital health investment in Italy?

The Piano Nazionale di Ripresa e Resilienza (PNRR) has created time-bound financial incentives for healthcare organisations to invest in digital infrastructure, with specific targets tied to CCE rollout, FSE 2.0 integration, and telemedicine capacity. Digital health investment reached €2.47 billion in 2024, a 12 per cent increase on the previous year, according to the Osservatorio Sanità Digitale 2025 at the Politecnico di Milano School of Management. The CCE remains among the top investment priorities nationally.

▶ What are the main barriers to care management platform adoption in Italy?

Four barriers recur consistently. Legacy system dependencies mean many facilities cannot easily replace or integrate incumbent platforms. Regional fragmentation produces inconsistent implementation timelines and varying local technical capacity. Lack of integration between hospital systems and the FSE disrupts care continuity. Clinician resistance to increased documentation burden also slows uptake, particularly where new platforms add administrative workload without reducing cognitive load.

▶ What role is AI playing in Italian clinical workflows?

AI integration in clinical workflows is an early but growing area. Survey data from the Polimi observatory's 2026 update found that 61 per cent of surveyed specialists and general practitioners reported having used generative AI tools in some capacity, though this figure reflects self-reported usage. Clinical decision support and AI-assisted documentation are the most common entry points. Formal integration into certified care management platforms remains limited, and decision-makers should be cautious about vendor claims regarding AI-driven capabilities that are not yet validated in the Italian regulatory and clinical context.

▶ What criteria should decision-makers use when evaluating care management platforms in Italy?

The most operationally relevant criteria include FSE 2.0 compliance and FHIR-based interoperability, active regional reference sites in comparable organisations, integration capability with existing legacy systems, General Data Protection Regulation (GDPR) alignment and EU data residency, support for structured clinical documentation and clinical coding, vendor financial stability and local support capacity, and fit with the specific care setting, whether primary care, secondary care, or integrated community care. The key question is not which platform is theoretically best, but which has proven integration with Italy's national and regional health IT infrastructure.

▶ What are the Case della Comunità and how do they affect tool selection?

The Case della Comunità are a PNRR-funded network of community health hubs designed to coordinate chronic disease management and preventive care outside hospital settings. They represent a distinct care context with different tool requirements from both primary care GP practices and secondary care hospitals. Decision-makers procuring for these settings should assess whether a platform is designed for integrated community care workflows, rather than assuming that tools built for inpatient or GP environments will transfer directly.