Il Progetto “Digital Driven Diagnostics, prognosis and therapeutics for sustainable Health care”, in sigla “D3 4 Health”, ha per oggetto la realizzazione di interventi compresi nel quadro di attuazione del Piano complementare al Piano Nazionale di Ripresa e Resilienza (decreto-legge n. 59 del 2021, convertito, con modificazioni, dalla legge 1° luglio 2021, n. 101) (“PNC”).

In seno al Progetto, lo IEMEST opera in qualità di affiliato per gli Spoke 2 e 4 della “Fondazione D3 4 Health”, soggetto attuatore e referente unico (“HUB”) nei confronti del Ministero dell’Università e della Ricerca, appositamente costituita per l’attuazione, il coordinamento e la gestione dell’“Iniziativa” finanziata con il Fondo Complementare previsto dal Decreto Direttoriale n. 931 del 6 giugno 2022 “avviso per la concessione di finanziamenti destinati ad iniziative di ricerca per tecnologie e percorsi innovativi in ambito sanitario e assistenziale”.

La Fondazione – costituita da 28 partner tra Università pubbliche e private, Istituti di ricerca e Imprese – svolge attività di potenziamento della ricerca sulle tecnologie digitali in ambito sanitario, attraverso un sofisticato processo di data mining, al fine di migliorare diagnosi, monitoraggio e cure.

Abstract

Public health systems worldwide rely on limited resources and suffer the high costs of cure. This is especially true for Italy, where the universalistic system represents a precious asset for citizenship. The adoption of value-based healthcare (VBH) may mitigate these critical issues. In this scenario, the Digital Driven Diagnostics, prognostics, and therapeutics for sustainable Health care (D3 4 HEALTH) initiative aims at developing digital and biological twins to improve, through a data mining approach, reference diseases care.

D3 4 HEALTH initiative will deliver, adopting VBH, novel, non/minimally invasive predictive, diagnostic and therapeutic pathways for reference diseases: metastatic colon cancer, liver and bile duct cancer, central nervous system cancer, diabetes type I and multiple sclerosis. The project will be structured in four interlinked core Spokes, highly interrelated either at technical or translational level.

The deployment of the D3 4 HEALTH technologies will represent a tool for the achievement of National and European policy objectives combining the skills of referral with non-referral centres in Italy, for the development of cutting-edge service delivery systems. Specific objectives span from high-performance computing, such as AI solutions on a comprehensive interoperability data platform, development of innovative technologies and methods (wearable devices, biosensors and biomarkers) to obtain a cluster of digital information prototypical of the Digital and Biological Twin. The collection of digital data will be accomplished retrospectively at the beginning for a fast data accessibility from all referral centres. Then, the advanced devices and biomarkers will be further implemented in simulation tests and prospective longitudinal studies. Simulation strategies on Digital Twins, exploiting clusters of patient’s digital data, based on the query of AI and mathematical models, may generate predictive, prognostic and therapeutic response solutions. The simulated predictive algorithms may be validated by in-vitro developing biological simulation platforms, the Biological Twins, and by monitoring of the patient’s health condition, through advanced wearable technologies.

Sustainability of this approach will rely on the creation of research infrastructures (RI) equipped with stateof-art instrumentation for design, realization, and characterization of in-vitro biological twin of diseases and the development and testing of wearable sensors, biosensors and biomarkers for the digital twin. The RIs will be constituted by a headquarter and a few local nodes, open for research and technology services to the internal community of the D3 4 HEALTH initiative and to all interested stakeholders of the developed technologies.

From D3 4 HEALTH we envision successful technological solutions, the Digital and Biological twins, supported by a research infrastructure for reference diseases care. 

The scientific and technical feasibility of the project relies on the high-level skills and international experiences of project partners and their ability to participate in multidisciplinary research involving enterprises. The duration of the project and the strong interaction with industries will ensure a successful implementation and sustainability of the project in the long-term. Communication, dissemination, and education will be promoted for public engagement and stakeholder involvement.

The deployment of the proposed solutions will have direct and indirect effect on the three axes around which the NRRP was built: promote digitalization and innovation, improve the Italian ecologic transition and advance social inclusion, especially concerning the North-South gap and ensuring equality in accessibility to the best care to all citizens.

An increase in public and private investment in R&D is expected given an effective collaboration between the public scientific base and the industrial world and the development of researchers’ skills, particularly in digital technologies, environmental transition and management models provided in D3 4 HEALTH.

The digital and biological twins proposed in the D3 4 HEALTH initiative will lead to better patient management and care, both in the shortand long-term. D3 4 HEALTH will achieve the goals of the national health system through the development of a research and clinical care digitized infrastructure, merging highly specialized technological centers and human expertise, based on an innovative model of integration of health data, for the development of state-of-the-art service delivery systems.

Finally, D3 4 HEALTH will strengthen the position of Italy in the landscape of European technological advancement for the diagnostic and therapeutic reference diseases pathways and will impact the centrality of the person, the protection of the right to health, the collaboration between different levels of government, the optimization of resources and the return of health to the population.