Emanuele Lettieri

• PhD Management Engineering
• Professor (Associate) at Politecnico di Milano

Background: Current reimbursement models in healthcare overlook variations in medical procedure quality and are characterised by flat rates. This approach offers limited incentives for care providers to invest in more advanced medical technology and/or organisational practices. Methods: This study develops and applies a novel multi-parametric metho...

Introduction Rapid advancements in technology are significantly impacting the healthcare system, and decision-making regarding technology adoption occurs at multiple decentralized levels within hospitals. National bodies seek to standardize this process, yet differing visions and strategies hinder centralization. This study explores the relationshi...

Population aging is bringing new challenges to our society, especially in health protection and medical care. To this end, supportive digital technologies can definitely provide with a number of solutions to improve healthy ageing practices. Our study focuses on a specific class of supportive digital technologies, namely Virtual Coaching Systems (V...

Background Breast cancer is a global health problem, and sentinel lymph node biopsy (SLNB) is the standard procedure for early-stage breast cancer. Technetium-99 (TC-99), alone or combined with blue dye (BD) are conventional tracers for SLNB, but they have safety, availability, and cost limitations. Indocyanine green (ICG) is an alternative tracer...

Purpose: Visual impairment poses significant challenges in daily life, especially when navigating unfamiliar environments, resulting in inequalities and reduced quality of life. This study aimed to gain an in-depth understanding of the needs and perspectives of visually impaired people in sports-related contexts through surveys and focus groups, an...

Innovative work behavior A B S T R A C T While existing literature acknowledges the role of science fiction in foreseeing technological advancements, a notable gap persists in understanding the underlying factors that drive or hinder individuals from the intention to generate and promote ideas gathered through science fiction. Our research model ai...

Background The escalating prevalence of diabetes, with its multifaceted complications, poses a pressing challenge for healthcare systems globally. In response, the advent of continuous glucose monitoring (CGM) systems, offering technological solutions for daily diabetes management, presents significant opportunities. However, the widespread adoptio...

This research was aimed at developing the "Digital Health Observatory Maturity Model for Telemedicine Services" (DHO-TeleMM), as a tool for the implementation and improvement processes of telemedicine services. The model adopts a sociotechnical perspective, assuming that the technical and social elements of a system are interdependent and should be...

Background Despite the demonstrated greater efficacy of microprocessor knees (MPK) over mechanical knees (MK), the latter is still widely used by persons with transfemoral amputation. Besides motivations related to local insurance policies, quality of life (QoL) and satisfaction with the prosthesis play a key role in user preference. Objective The...

National healthcare systems face multiple challenges, including the increasing demand for care and decreasing availability of healthcare professionals. Digital health technologies represent opportunities that offer improved efficiency, accessibility, and patient care. In this scenario, Digital Therapeutics are technological advancements to treat or...

Background Digital transformation has sparked profound change in the healthcare sector through the development of innovative digital technologies. Digital Therapeutics offer an innovative approach to disease management and treatment. Care delivery is increasingly patient-centered, data-driven, and based on real-time information. These technological...

Background Digital transformation has sparked profound change in the healthcare sector through the development of innovative digital technologies. Particular attention should be devoted to Digital Therapeutics, which offers an innovative approach to disease management and treatment. The result is a landscape in which care delivery is increasingly p...

Innovating in Medical Device (MD) industry is challenging. This study aims to develop and validate an evidence-based framework that helps innovators of small and large enterprises (SEs and LEs) assess their readiness for successful MD development and deployment. We conducted a key-informant process (stage 1) where 25 international experts identifie...

The paper describes both the method and the preliminary outcomes of the “Blind-assistive aUtonomous Droid Device: BUDD-e” research experience, funded by Polisocial Award 2021 of Politecnico di Milano, and designed to exploit a multidisciplinary approach to bridge the gap of inclusive design, making spaces and services accessible, functional, and us...

Stroke is the third leading cause of death and disability overall worldwide. Upper limb impairment is a common consequence for stroke survivors, having negative impact on their quality of life. Robotic rehabilitation, through repetitive and monitored movements, can improve their status. Developed by a team of researchers at Politecnico di Milano, A...

Hemiplegia is a form of disability that affects one side of the body and has a prevalence of 0.5–0.7 per 1000 live births. It has consequences not only at the medical level but also on psychological, cognitive, and social aspects, and it prevents children from social participation, especially in sports settings. The studies demonstrating the social...

Background The rising incidence of chronic diseases among the population, further exacerbated by the phenomenon of aging, is a primary concern and a serious challenge for the healthcare systems worldwide. Among the wide realm of health digital technologies, the rise of Digital Therapeutics (DTx), which are medical devices able to deliver evidence-b...

Background The present paper aims at evaluating the potential benefits of high-energy devices (HEDs) in the Italian surgical practice, defining the comparative efficacy and safety profiles, as well as the potential economic and organizational advantages for hospitals and patients, with respect to standard monopolar or bipolar devices. Methods A He...

Digital transformation has profoundly impacted the healthcare sector by enriching service delivery, renovating business models, revising organizational configurations and processes. Through an exploratory research design, this study focuses on the interplay between institutional and individual factors to explain which ones may influence the use of...

Background: Self-monitoring of blood glucose (SMBG) is of paramount relevance for type 2 diabetes mellitus (T2DM) patients. However, past evidence shows that there are physical and cognitive issues that might limit the usage of glucometers by T2DM patients aged 65 years and over. Objective: Our aim was to investigate the physical and cognitive issu...

Purpose This study aims to offer novel insights on how industrial marketing might contribute to bringing innovations to market in the peculiar case of health care. This study aims at shedding first light on how the alignment between dissemination and exploitation activities might contribute to bringing to market innovations developed by public–priv...

The present situation of the healthcare systems worldwide strongly calls for a change in the care delivery paradigm and requires to focus more on the long-term outcomes and on what is of real value for patients and the community. This approach can be summarized with the value-based healthcare concept, which can be greatly sustained by the technolog...

Background Healthcare contexts are witnessing a growing use of applications to support clinical processes and to communicate between peers and with patients. An increasing number of hospital professionals use instant-messaging applications such as WhatsApp in their daily work. Previous research has mainly focused on the advantages and risks of What...

Past studies showed that hospital characteristics affect hospital performance in terms of 30-day unplanned readmissions, proving the existence of a “hospital effect”. However, the stability over time of this effect has been under-investigated. This study offers new evidence about the stability over time of the hospital effect on 30-day unplanned re...

Europe’s ageing demographics gave rise to the gold rush by entrepreneurs and innovators who started to investigate the market of solutions for older adults. Now joined by big players from the Information and Technology sector, the Silver Economy is a lion’s den where EU-funded research and innovation projects sometimes struggle to find a place. Thi...

Population ageing represents one of the major challenges that contemporary society is going to face in the coming years. This phenomenon is putting high pressure on the healthcare system and makes it necessary to identify specific instruments ensuring to live longer in healthy conditions, concept also referred to as healthy ageing. In this view, th...

This study gathers evidence on the interplay between the institutional and individual factors to explain which one may influence the use of a digital solution within hospitals. Data have been collected through a survey administered to nursing coordinators in an Italian Hospital in Italy. A total of 137 responses had been received. The analysis carr...

Background: The healthcare sector is an interesting target for fraudsters. The availability of a great amount of data makes it possible to tackle this issue with the adoption of data mining techniques, making the auditing process more efficient and effective. This research has the objective of developing a novel data mining model devoted to fraud...

Background Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study design, conducted on fluorescence-guided compared with stand...

This study develops a novel theoretical model that clarifies the main determinants of the acceptance of an innovative Assistive Technology by neurological/neuromuscular patients with upper limb motor disability. The model has been developed through a three stage method: Literature Review, Expert Judgement Elicitation and a pilot test of the model i...

Purpose This paper aims to shed novel light to further the ongoing debate about the relationship between traditional sports and eSports by gathering empirical evidence on the role that eSports play on the consumption of traditional sports (i.e. live matches at the Stadium, TV matches spectating, merchandise or sponsor purchase), in the peculiar con...

Background Controlling the quality of care through readmissions and mortality for patients with heart failure (HF) is a national priority for healthcare regulators in developed countries. In this longitudinal cohort study, using administrative data such as hospital discharge forms (HDFs), emergency departments (EDs) accesses, and vital statistics,...

The implementation of hospital-wide Electronic Medical Records (EMRs) is still an unsolved quest for many hospital managers. EMRs have long been considered a key factor for improving healthcare quality and safety, reducing adverse events for patients, decreasing costs, optimizing processes, improving clinical research and obtaining best clinical pe...

Healthcare is moving towards new patterns and models, with an increasing attention paid to prevention. Smart technologies for mobile health care are emerging as new instruments to monitor the state of essential parameters in citizens. A very debated subject in literature is the critical role played by citizens’ acceptance and willingness to pay for...

Virtual Coaches, also known as e-coaches, are a disruptive technology in healthcare. Indeed, among other usages, they might provide cost-effective solutions for increasing human wellbeing in different domains, such as physical, nutritional, cognitive, social, and emotional. This paper presents a systematic review of virtual coaches specifically aim...

Background: This study aims at gathering evidence about the relation between 30-day mortality and 30-day unplanned readmission and patient and hospital factors. By definition, we refer to 30-day mortality and 30-day unplanned readmission as the number of deaths and non-programmed hospitalizations for any cause within 30 days after the incident hea...

Objectives: Hospital wards are required to exploit current knowledge and explore for new knowledge. Ambidexterity (i.e., the capability to combine both exploitation and exploration) is a major issue in healthcare as result of the growing expectations that hospitals wards have the capability to manage the trade-off between high-quality delivery of...

Literature of cleaner production shows that, for improving the environmental performance of the organization, it is important to provide employees with specific green-related competencies and to buy their commitment towards the green cause. Accordingly, studies explored the effects on environmental performance of green human resource management, in...

Despite their potential, the adoption of wearable devices has been relatively slow when compared to other digital technologies. This paper investigates, grounding on the Theory of Planned Behavior, the adoption by end users of digital technologies for lifestyle monitoring. Data on consumers' perception and usage of wearable devices have been collec...

The increasing use of messaging applications such as WhatsApp for both social and personal purposes has determined an increase in the widespread use of these technologies, even in healthcare. A growing number of healthcare professionals have adopted WhatsApp in their daily work in order to share information with peers and patients. Past research ha...

Mode of WhatsApp usage with patients. (DOCX)

Perceived benefits about WhatsApp usage between healthcare professionals. (DOCX)

Perceived benefits related to WhatsApp usage with patients. (DOCX)

Perceived threats about WhatsApp usage between healthcare professionals. (DOCX)

Perceived threats related to WhatsApp usage with patients. (DOCX)

Personal use of WhatsApp. (DOCX)

Mode of WhatsApp usage between healthcare professionals. (DOCX)

Lower-limb prosthetics is rapidly advancing through innovative technologies. Simultaneously, patients in need of prosthetic rehabilitation treatments are expected to double by 2050. Unfortunately, available economic resources are not growing at a comparable pace. The result is the widening gap between what is technologically possible and what is ec...

Background: Fascinating developments in big data technologies and unprecedented diffusion of social networking sites (SNSs) generate unseen opportunities for scientific fields, including psychiatry. This study focuses on the use of SNSs by adolescent psychiatric patients and the potential use of SNS-generated data to help medical practitioners dia...

This study investigates the stability of the “hospital effect” on performance over time by administrative health data as a source of evidence. Using 78,907 heart failure adult records from 117 hospitals in the Lombardy Region (Northern Italy) over three years (2010–2012), we analyzed hospital performance in terms of 30-day mortality and 30-day unpl...

Can we—or anyone else—disagree sincerely with this demythologizing exercise carried out by Henry Mintzberg? In conferences, meetings and teaching classes we discuss emblematic cases from all the most developed countries about ambitious, top-down, advised-by-experts plans of action aimed at fixing the health care ecosystem that actually fell very sh...

Purpose This manuscript discusses the main findings gathered through a systematic literature review aimed at crystallizing the state of art about evidence-based management (EBMgt) in healthcare. The purpose of this paper is to narrow the main gaps in current understanding about the linkage between sources of evidence, categories of analysis and ki...

The role of exploration and exploitation, alone or combined with each other (ambidexterity), in the healthcare setting is relevant today, since hospitals are experimenting new organisational designs aimed at improving their capability to manage the tension between high-quality delivery of care and cost-containment. In this view, the present paper f...

The rising use of messaging applications such as WhatsApp for both social and personal purposes, has determined an increasing widespread of the use of these technologies even in healthcare contexts. Previous research has mainly focused on individual variables which determine the use of WhatsApp rather than on the relationship between individual and...

Background: Technological tools such as Web-based social networks, telemedicine, apps, or wearable devices are becoming more widespread in health care like elsewhere. Although patients are the main users, for example, to monitor symptoms and clinical parameters or to communicate with the doctor, their perspective is seldom analyzed, and to the bes...

BACKGROUND Technological tools such as Web-based social networks, telemedicine, apps, or wearable devices are becoming more widespread in health care like elsewhere. Although patients are the main users, for example, to monitor symptoms and clinical parameters or to communicate with the doctor, their perspective is seldom analyzed, and to the best...

Starting from an analysis of the health care levels in Indian scenario, the research project “Healthcare for All” developed a meta-project that considers all the current criticisms and the Indian customs through a flexible layout that responds to the healthcare needs of population of West Bengal. The innovation of the research work is to develop a...

This study investigates the stability of the 'hospital effect' on performance over time by administrative health data as a source of evidence. Using 78,907 heart failure adult records from 117 hospitals in the Lombardy Region (Northern Italy) over three years (2010-2012), we analyzed hospital performance in terms of 30-day mortality and 30-day unpl...

This study investigates the factors that affect the continued use of Electronic Medical Record (EMR) in hospitals. Our model integrates constructs such as perceived usefulness and ease of use (Technology Acceptance Model) along with constructs associated to organizational expectations, change culture and alignment of meaning systems (institutional...

Objectives: To present the European landscape regarding the re-use of health administrative data for research. Methods: We present some collaborative projects and solutions that have been developed by Nordic countries, Italy, Spain, France, Germany, and the UK, to facilitate access to their health data for research purposes. Results: Research in pu...

Objectives: To present the European landscape regarding the re-use of health administrative data for research. Methods: We present some collaborative projects and solutions that have been developed by Nordic countries, Italy, Spain, France, Germany, and the UK, to facilitate access to their health data for research purposes. Results: Research in pu...

This study deals with the identification of the 'hospital effect' on performance by administrative health data. Using 78,907 heart failure adult records from 117 hospitals in the Lombardy Region (Italy) over three years (2010-2012), we analyzed 30-day mortality and readmission as hospital performance indicators through multilevel models that take i...

Objectives: Hospital Based Health Technology Assessment (HBHTA) practices, to inform decision making at the hospital level, emerged as urgent priority for policy makers, hospital managers, and professionals. The present study crystallized the results achieved by the testing of an original framework for HBHTA, developed within Lombardy Region: the I...

This study offers original insights to further the ongoing debate about the stability of ‘hospital effect’ on performance with administrative data as a source of evidence. The overall assumption behind is investigating the debate on organizing the hospitals by learning from their previous performance to transform change. In this way, one available...

This study offers original insights to further the ongoing debate about the stability of ‘hospital effect’ on performance with administrative data as a source of evidence. The overall assumption behind is investigating the debate on organizing the hospitals by learning from their previous performance to transform change. In this way, one available...

Introduction: Country- and region-specific health technology assessment (HTA) organisations for priority-setting and resource allocation have emerged around the world. Decision-making in healthcare is a continuum from evidence generation to deliberation and communication of the decision made, and HTA is only a part of this process whereby the avail...

Radical innovation in professional settings faces an institutional challenge. Professionals enjoy autonomy predicated on jurisdictional knowledge and can resist radical innovation if their interests are threatened. Our study examines if and how managers mediate professional resistance and ensure that radical innovation can take hold. A comparative...

In the context of professional service organizations, user engagement with knowledge search might generate significant risks of inappropriateness to innovation processes. Previous research suggests that professionals would then keep users at arms' length, controlling the design and implementation of innovations internally. This study overcomes this...

INTRODUCTION While “how to perform” a rigorous Health Technology Assessment (HTA) at the institutional level is well established (1), very little has been experienced for empirically approaching an HTA in hospitals: no scientific evidence is available concerning the correct organizational model, to maximise and to improve the functioning, the perfo...

Seminal contributions show that Big Data, if coherently collected and analysed, hold potential to innovate approaches and models for care delivery. However, the quest for evidence on how to collect and handle data from different sources and how to translate it into innovative solutions for health care organizations is still open; moreover, debate s...

Structured Abstract Purpose – This study discusses the main findings from a systematic literature review about Big Data and analytics in the healthcare field. Although the use of Big Data in healthcare is emerging as fashionable research topic, policy-makers and healthcare professionals still struggle on how to unfold the potential value locked in...

Purpose The purpose of this paper is to provide arguments and empirical evidence that different knowledge sharing behaviours – i.e. sharing best practices, sharing mistakes, seeking feedbacks – are promoted and enabled by different types of knowledge assets, and differently affect employees’ innovative work behaviours. Design/methodology/approach...

Background: The fitting rate of the C-Leg electronic knee (Otto-Bock, D) has increased steadily over the last 15 years. Current cost-utility studies, however, have not considered the patients' characteristics. Objectives: To complete a cost-utility analysis involving C-Leg and mechanical knee users; "age at the time of enrollment," "age at the t...

This study is the first that theorises and empirically tests, at the organisational level, the role that ‘Green’ Human Resource Management (HRM) practices play in facilitating employees’ collective engagement in environment protection by taking voluntary actions that ‘go the extra mile’. In this regard, we take an original perspective on Environmen...

Introduction: India is one of the five countries with the lowest public health spending levels: the private medical services are one of the most developed fields, meanwhile public health ones are totally inadequate with the most number of health facilities concentrated in cities, where only the 25% of the population lives. Public facilities are mai...

This study sheds new light on why healthcare organisations are having difficulty responding to the growing pressure from stakeholders to proactively address their responsibility to deliver high-quality services without harming the environment. Basing our work on past research on stakeholder pressure and environmental barriers, we conceptualise and...

In Europe, health and medical administrative data is increasingly accumulating on a national level. Looking further than re-use of this data on a national level, sharing health and medical administrative data would enable large-scale analyses and European-level public health projects. There is currently no research infrastructure for this type of s...

Background: This paper crystallises the experience developed by the pan-European PALANTE Consortium in dealing with the generation of relevant evidence from heterogeneous eHealth services for patient empowerment in nine European Regions. The European Commission (EC) recently funded a number of pan-European eHealth projects aimed at empowering Euro...

Purpose – The present study investigates the factors that directly affect the use of Electronic Medical Records (EMRs) among healthcare professionals. Findings will contribute to our understanding of which explanation (deterministic vs. institutional) might be the most relevant to directly predict adopters' behaviour, and whether institutional and...

Healthcare structures are supposed to protect and improve Public Health, but in the meanwhile they are highly energy-demanding and socially impactful structures, which cause negative side effects on the people’s health and on the environment. Building hospitals able to cope with the definition of Health as complete well-being and which can fit to t...

Physicians’ willingness to share knowledge is a central antecedent of effective knowledge sharing within hospitals. This paper aims at supporting the micro-foundation of knowledge sharing with the identification of the factors that affect willingness to share and their classification according to a behavioural model grounded in the Theory of Planne...

This book describes the Sustainable High Quality Healthcare (SustHealth) project, which had the goal of developing an original multidisciplinary evaluation tool that can be applied to assess and improve hospitals’ overall sustainability. The comprehensive nature of the appraisal offered by this tool exceeds the scope of most current rating systems,...

Patients are increasingly encouraged to become active players in self-care and shared decision-making. Such attention has led to an explosion of terms - empowerment, engagement, enablement, participation, involvement, activation - each having multiple and overlapping meanings. The resulting ambiguity inhibits an effective use of existing evidence....