This study aims to detect if and how big data can improve the quality and timeliness of information in infrastructural healthcare Project Finance (PF) investments, making them more sustainable, and increasing their overall efficiency. Interactions with telemedicine or disease management and prediction are promising but are still underexploited. However, given rising health expenditure and shrinking budgets, data-driven cost-cutting is inevitably required. An interdisciplinary approach combines complementary aspects concerning big data, healthcare information technology, and PF investments. The methodology is based on a business plan of a standard healthcare Public-Private Partnership (PPP) investment, compared with a big data-driven business model that incorporates predictive analytics in different scenarios. When Public and Private Partners interact through networking big data and interoperable databases, they boost value co-creation, improving Value for Money and reducing risk. Big data can also help by shortening supply chain steps, expanding economic marginality and easing the sustainable planning of smart healthcare investments. Flexibility, driven by timely big data feedbacks, contributes to reducing the intrinsic rigidity of long-termed PF healthcare investments. Healthcare is a highly networked and systemic industry, that can benefit from interacting with big data that provide timely feedbacks for continuous business model re-engineering, reducing the distance between forecasts and actual occurrences. Risk shrinks and sustainability is fostered, together with the bankability of the infrastructural investment.

This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public-private partnerships (PPPs) is significant due to the consistency of digital platforms with health issues and the complexity of the stakeholder's interaction. In infrastructural PPPs, public and private players cooperate, usually following PF patterns. This relationship is complemented by digitized supply chains and is increasingly patient-centric. This paper reviews the literature, analyzes some supply chain bottlenecks, addresses solutions concerning the networking effects of platforms to improve PPP interactions, and investigates the cost-benefit analysis of digital health with an empirical case. Whereas diagnostic or infrastructural technology is an expensive investment with long-term payback, leapfrogging digital applications reduce contingent costs. "Digital" savings can be shared by key stakeholders with P4P schemes, incentivizing value co-creation patterns. Efficient sharing may apply network theory to a comprehensive PPP ecosystem where stakeholding nodes are digitally connected. This innovative approach improves stakeholder relationships, which are re-engineered around digital platforms that enhance patient-centered satisfaction and sustainability. Digital technologies are useful even for infectious disease surveillance, like that of the coronavirus pandemic, for supporting massive healthcare intervention, decongesting hospitals, and providing timely big data. not due to population aging per se, but to the increase in demand for new medical technologies that improve and/or extend life as real per-capita incomes grow [3,4].Within this evolving framework, technology is a double-edged sword, since it increases healthcare expenditure [5] but can also bring savings and quality-of-life improvements [6]. The relationship between medical technology and spending is complex and often conflicting. The impact of technology on costs differs across technologies, in that some (e.g., cancer drugs, invasive medical devices) have significant financial implications, while others are cost-neutral or cost-saving [7]. Medicine in the 21 st century is increasingly dependent on technology. Unlike in many other areas, the cost of medical technology is not declining, and its increasing use contributes to spiraling healthcare costs. Many medical professionals equate progress in medicine to the growing use of sophisticated technology, which is often expensive and beyond the reach of the average citizen [8].Whereas technology concerning tangible items, such as diagnostic equipment or physical infrastructure, has an uncertain cost-benefit trade-off, digital investments have a shorter payback, are typically cheaper, and show sounder benef...

BackgroundRural populations experience several barriers to accessing clinical facilities for malaria diagnosis. Increasing penetration of ICT and mobile-phones and subsequent m-Health applications can contribute overcoming such obstacles.MethodsGIS is used to evaluate the feasibility of m-Health technologies as part of anti-malaria strategies. This study investigates where in Uganda: (1) malaria affects the largest number of people; (2) the application of m-Health protocol based on the mobile network has the highest potential impact.ResultsAbout 75% of the population affected by Plasmodium falciparum malaria have scarce access to healthcare facilities. The introduction of m-Health technologies should be based on the 2G protocol, as 3G mobile network coverage is still limited. The western border and the central-Southeast are the regions where m-Health could reach the largest percentage of the remote population. Six districts (Arua, Apac, Lira, Kamuli, Iganga, and Mubende) could have the largest benefit because they account for about 28% of the remote population affected by falciparum malaria with access to the 2G mobile network.ConclusionsThe application of m-Health technologies could improve access to medical services for distant populations. Affordable remote malaria diagnosis could help to decongest health facilities, reducing costs and contagion. The combination of m-Health and GIS could provide real-time and geo-localized data transmission, improving anti-malarial strategies in Uganda. Scalability to other countries and diseases looks promising.

This article addresses the relationship between Public-Private Partnerships (PPP) and the sustainability of public spending in smart hospitals. Smart (technological) hospitals represent long-termed investments where public and private players interact with banking institutions and eventually patients, to satisfy a core welfare need. Characteristics of smart hospitals are critically examined, together with private actors’ involvement and flexible forms of remuneration. Technology-driven smart hospitals are so complicated that they may require sophisticated PPP. Public players lack innovative skills, whereas private actors seek additional compensation for their non-routine efforts and higher risk. PPP represents a feasible framework, especially if linked to Project Financing (PF) investment patterns. Whereas the social impact of healthcare investments seems evident, their financial coverage raises growing concern in a capital rationing context where shrinking public resources must cope with the growing needs of chronic elder patients. Results-Based Financing (RBF) is a pay-by-result methodology that softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. In this study, we examine why and how advanced Information Technology (IT) solutions implemented in “Smart Hospitals” should produce a positive social impact by increasing at the same time health sustainability and quality of care. Patient-centered smart hospitals realized through PPP schemes, reshape traditional healthcare supply chains with savings and efficiency gains that improve timeliness and execution of care.

This paper explores innovative governance models in the healthcare sector. Patients are a key albeit under-investigated stakeholder and smart technologies applied to public healthcare represent a trendy innovation that reshapes the value-driving proposition. This study contributes to the best practice improvement in this sector, showing how health governance can balance the interests of conflicting stakeholders (patients, staff, politicians, private providers, banks, suppliers, etc.) when technology-driven (smart) investments are realized. Characteristics of smart hospitals are critically examined, and governance solutions are considered, together with private actors’ involvement and flexible forms of remuneration. Smart hospitals are so complicated that they may require sophisticated Public-Private Partnerships (PPP). Public players lack innovative skills, whereas private actors seek additional remuneration for their non-routine efforts and higher risk. PPP represents a feasible governance framework, especially if linked to Project Financing (PF) investment patterns. Results-Based Financing (RBF) softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. Patient-centered smart hospitals reshape traditional healthcare governance, with savings and efficiency gains that meliorate timeliness and execution of cares. Transformation of in-patients to out-patients and then home-patients represents, whenever possible, a mighty goal.

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This paper describes some of the main aspects of microfinance (MF) in under-developed countries, showing why it has succeeded in reaching the poor, while traditional banks have not, using innovative devices such as group lending with self-monitoring, short repayments instalments and small loans. The aim of the paper is to show how microfinance institutions (MFIs) can fill the lack of traditional banks in under-developed countries, proposing unconventional products and innovative business models. This study also investigates about possible synergies between banks and MFIs, avoiding overlaps and mission drift. It is shown that MFIs can improve their outreach using technological devices such as M-banking. Innovative questions and proposals are illustrated, so as to give an updated and synthetic picture of the state-of-the-art, which might prove useful for researchers and practitioners.