Every day, in every local health authority across Italy, the same scene plays out: a patient arrives at the Emergency Department and the on-call physician has no access to their clinical history. A general practitioner opens the practice management system after a patient’s discharge and finds nothing. A report exists somewhere, in some system, but it never reaches the person who needs it at the moment it matters. The clinical information is there — it simply does not travel with the patient.

This has a name: lack of interoperability. And it is not an IT problem. It is a patient safety and quality of care problem.

Italy is investing more than ever before to address it. The EHR 2.0 (Fascicolo Sanitario Elettronico 2.0), the National Telemedicine Platform, the international HL7 FHIR standard chosen for the new Health Data Ecosystem, alignment with the European Health Data Space (EHDS): these are all pieces of a structural transformation that aims to make clinical data travel with the citizen, across the entire national territory and, soon, across all of Europe.

But this transformation cannot succeed without clinicians.

Two concrete calls to action are worth putting to every healthcare professional in the Italian National Health Service — physicians, psychologists, nurses.

The first: ask yourself whether the IT systems we use every day speak the same language. When practice management software does not export data in a standard format (HL7 FHIR), when it does not integrate with the Electronic Health Record, when it creates an information silo, that is not merely a technical inconvenience. It is an issue that directly affects the quality of care and patient safety. Even simple feedback from healthcare professionals — flagging a problem, proposing that interoperability requirements be included in procurement specifications — can make a real difference in overcoming entrenched habits that, however understandable, produce discontinuity in care.

The second: take an interest. Interoperability is too important to be left to IT specialists alone. We need clinicians who understand the value of structured data, who participate in defining standards, who bring the patient’s perspective into technology decisions. Today, the technical specifications for the EHR and telemedicine are being written at tables where the clinician’s voice is often absent or marginal. And yet, it is precisely clinicians who know what is needed at the patient’s bedside, in the outpatient clinic, during the home visit.

Italy’s path is ambitious and not without obstacles — twenty different regional systems, semantic gaps, disparities in digital maturity between North and South. It is not a finished journey: it is a transformation in progress. But the direction is clear, the NRRP investment is unprecedented, and the HL7 FHIR standard has been chosen.

What is still missing is widespread awareness among healthcare professionals that this is their fight, personally. Not as spectators of a technological change, but as protagonists of a cultural one.

A report uploaded to the EHR today could save a clinical decision tomorrow. A clinician who raises their hand and asks “why doesn’t this system talk to the others?” is performing an act of patient advocacy.

Interoperability is not an IT affair. It is the affair of those who care for patients.