As part of the healthcare transformation initiated by the NRRP (National Recovery and Resilience Plan), the DARE – Digital Lifelong Prevention Foundation is taking a leading role in repositioning prevention at the heart of public health policies. Established in 2022, the Foundation brings together universities, INFN, IRCCS, healthcare companies and leading technology companies – including Exprivia and Engineering, key players in Italian digital innovation – with the aim of building a national infrastructure for continuous, personalised and data-driven prevention.
The scale of the initiative is unprecedented: over 80 trials underway, from the north to the south of the country, more than 2.5 million citizens involved, 450 researchers and technologists engaged in the development of predictive algorithms, digital prevention solutions and interoperable platforms for public health. The aim is to strengthen the National Health System's ability to anticipate needs, prevent disease and make pathways more sustainable.
Prevention as a strategic focus During the ‘Health 5.0 and Research’ event, held on 11 November at La Sapienza University in the presence of Minister Schillaci, the four foundations of the National Complementary Plan – D34Health, ANTHEM, Fit4MedRob and DARE – showed how the country is building an innovation ecosystem capable of integrating omic sciences, wearables, artificial intelligence, digital twins and large research infrastructures. In this context, DARE illustrated a model that combines clinical, behavioural, genetic and environmental data in a single architecture, providing predictive tools that are useful for anticipating health needs and making preventive interventions more effective.
The strategic importance of this model was also reiterated at the General Assembly of Medical and Scientific Research organised by the Senate, where Lorenzo Chiari, professor of biomedical engineering at the University of Bologna and president of the Foundation, emphasised how “prevention represents a structural investment for the country” and how interoperability and innovation can strengthen the National Health Service by addressing chronic conditions, frailty and disability more effectively. 'The political and cultural challenge,“ he explained, 'is to move from Health in all policies to Prevention in all health policies. We need continuity in health research and innovation policies, and impact finance tools that promote forward-looking investments in prevention”.
The three Spokes
The project is divided into three main areas. Spoke 1 enables the entire ecosystem by providing technologies, ethical-legal and economic expertise, infrastructure and organisational models. Filippo Lanubile describes the contribution of the University of Bari team as follows: "We have developed an MLOps pipeline for building predictive models in the healthcare sector. In addition to full traceability of experiments, we automate quality control and support developers in preparing the documents necessary for the certification of AI systems as medical devices."
Spoke 2, led by Walter Mazzucco of the University of Palermo, works on primary prevention and interoperability between health and non-health data. ‘Integrated data exploitation,’ he says, ‘will make it possible to predict health scenarios and guide widespread promotional actions. A 5.0 approach that combines clinical data, environmental conditions and exposure to pollutants will enable more effective community-based interventions.’ .
Spoke 3, coordinated by Massimo Federici of Roma Tor Vergata, addresses secondary and tertiary prevention in a rapidly ageing population. ‘Digital solutions,’ he explains, ‘can facilitate the collection of clinical data, remote monitoring, mobility in the elderly, and the personalised administration of therapies.’ There are 39 projects active here on cardiometabolic, oncological, and neurodegenerative diseases.
A national unicum
Alongside these activities, DARE is carrying out a unique work in Italy, on aspects such as regulatory science and interoperability governance: three integrated Solution Frameworks – wearables and apps, the Salus Ratio platform as a Secure Processing Environment compliant with the European Health Data Space, and an advanced MLOps environment – constitute an architecture that currently integrates eight high-impact projects dedicated to data standardisation (HL7-FHIR, HealthDCAT-AP), the complete simulation of the HealthData@EU infrastructure and the development of a true regulatory ML-Ops, paving the way for a possible Regulatory Sandbox for artificial intelligence in healthcare.
Impact on innovation
From an economic point of view, prevention is a multiplier: as Mazzucco points out, “every euro invested in prevention can generate savings of up to €14-15 in treatment not provided”. It is therefore not surprising that DARE has also chosen to invest in entrepreneurship, with programmes such as ReActorPro, promoted by Bi-Rex and G-Factor and designed to support researchers in creating high-potential start-ups and bringing research and industry closer together, which has already trained 25 teams. ‘Digital transformation,’ explains Chiari, ‘offers us tools that can improve not only health but also the sustainability of the system.’ This direction is echoed in Europe's positioning: from the EHDS to the AI Act, Italy can play a leading role thanks to initiatives such as DARE.
Towards an Italian model
DARE is contributing in the field to defining a national prevention model based on interoperability, scientific evidence and public-private collaboration that could interact with actors such as the National Prevention Hub established by the Ministry of Health. A model that, by anticipating needs and reducing costs, accelerates innovation and enhances the Italian industrial supply chain.
