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The healthcare system in Italy is articulated. By constitution, the roles and responsibilities are clearly defined for the state and region. The state defines policies and provides guidance supporting health policies, while the regions are autonomous and are responsible for the implementation of the health policies.

The National Healthcare Information System or NHIS facilitates the evaluation of health phenomenons policies, investments and efficacy of resources employed. This system thus supports planning at both national and regional level. The support has been made possible by the significant health database at national level.

e-Health has been a priority for the Italian Ministry of Health. It plans to achieve efficacy, transparency and sustainability of the NHS through digital innovation. As a response to the new demographical, epidemiological and economic trends, the regional governance models for ICT in healthcare systems were born. These models aim to promote new innovative solutions to rationalise and bring homogeneity of service and processes into regional boundaries.

The practice of supporting medicine and public health with mobile devices, applications of telecommunications and multimedia technologies for the delivery of healthcare and health information in the field of prevention is referred to as mHealth. Numerous mHealth initiatives and applications have proven their efficacy as a means of entering patient data into the National Health Information System and identification of health needs in a cost effective manner.

COVID-19 has accelerated transformation of the healthcare system. The use of mHealth technology has played a key role in early detection of cases thus allowing for more efficient clinical interventions. A combination of various mHealth technologies can provide an integrated, holistic and end-to-end solution. This solution can help in better  screening, risk profiling, achieving early detection, generating referrals for testing, tracking infections, tracking isolation management/quarantine, assuring social distance compliance and more.

Health Technology Assessment supports regions in planning and evaluating the introduction and management of technological innovations. A variety of factors have been found that affect the integration and success of a digital solution.

The experiences in four diverse policy areas from three provinces of Tuscany, Campania and Piedmont along with the Autonomous Province of Trento are found in this paper. A description implementation options, implementations, legal constraints, examples and analysis has been provided for each of these policy areas.

Tuscany has developed its integrated information system  to support hospitals, health care units, Crisis Units and Emergency Response Task Force. This system allows for complete, unambiguous and rapid analysis of  data, which further helps in the management of emergency phenomena in conjunction with the Crisis Unit and the regional Task Force.

Campania concentrates on innovation management given the constant need of the health organisations to increase their capacity to adopt and exploit innovations. They share their experience and lessons learnt from their implementation of innovation policies.

Piedmont emphasises on the usefulness of Health Technology assessment in assessing the impact of innovation in various healthcare facilities. Health Technology Assessment provides evidence-based input to the policy-making processes thus ensuring evidence informed policy making.

Autonomous province of Trento covers their governance model and the establishment of their Center for Digital Health TS4.0. TS4.0 clearly defines boundaries, roles of the stakeholders and more through its regulatory framework.