In the governance of contemporary healthcare systems, the Diagnostic Therapeutic Care Pathway (DTP) can no longer be considered a simple clinical-organizational tool.In a context marked by strong healthcare regionalism , growing pressure on economic sustainability and rapid evolution of therapeutic and technological innovation, the Pdta is increasingly emerging as a true policy lever, capable of guiding public decisions, investments and service models.
PDTAs are clinical management tools that define, based on the best available scientific evidence and local resources, the most appropriate care pathway for a specific pathology.
They coordinate the work of doctors, nurses, and healthcare professionals in a structured, multidisciplinary manner, integrating the hospital and the community and ensuring patient continuity of care, safety, appropriateness, and consistency of interventions.
From diagnosis to treatment, from rehabilitation to follow-up , the Pdta accompany the person through all phases of health needs, particularly in chronic and complex pathologies.
The operational place where health policies become concrete
The key point is that the Pdta represent the operational place where health policies become concrete.It is along these paths that the effectiveness of reforms, the value of drugs, the impact of technologies and, ultimately, the quality of care provided are measured .
Talking about Pdta therefore means talking about essential levels of care, the pharmaceutical industry, scientific societies and health and patient associations , all called upon to deal with systems increasingly oriented towards transparency, measurability and the evaluation of outcomes.
In a highly regionalized National Health Service, the proliferation of local Pdtas has undoubtedly favored experimentation and adaptation to territorial contexts.
However, this wealth of experiences has also produced marked heterogeneity, with formally similar paths generating different outcomes, making comparisons between territories difficult and weakening planning capacity at the national level.
In this scenario, the standardization of Pdta should not be seen as a form of centralization, but as the definition of minimum common standards that make the pathways comparable, evaluable, and integrable within national health policies.
The role of certification
This is where certification plays a strategic role.The certification of management systems in healthcare facilities and local services, as well as the certification of the PDTAs themselves, represents a powerful institutional tool.
It allows you to anchor paths to shared requirements, make roles and responsibilities explicit, define measurable indicators and outcomes, and activate structured continuous improvement mechanisms.
A Pdta inserted into a certified system is not only “declared”, but becomes verifiable and therefore truly governable.
This is increasingly accompanied by the certification of clinical and healthcare skills.
The quality of training programs cannot depend on the individual variability of professionals, but on the organization's ability to ensure defined, assessed, and maintained skills over time.
From an institutional perspective, certifying skills means strengthening equitable access to care, reducing clinical risk, and increasing the overall resilience of the healthcare system.
For the pharmaceutical industry and scientific societies, this framework represents an enabling condition.
Only in the presence of standardized and certified Pdta and clearly defined and monitored skills , is it possible to develop credible value-based healthcare models and establish a structured and transparent dialogue with public decision-makers.
For healthcare and patient associations, this means being able to claim reliable, consistent, and comparable pathways across the country.
The challenge is therefore clear: to make certified Pdtas, certified systems and certified skills into true institutional infrastructures of the health service .
Not formal requirements, but governance tools capable of combining regional autonomy, national coherence in addressing healthcare needs, and long-term sustainability. (Source: Massimo Dutto, https://formiche.net/ )