Mapping Echocardiographic Practice in Emilia-Romagna: A Regional Healthcare Census
Year: 2026
Type: article
Abstract: Aims: To assess echocardiographic practice within a regional healthcare system. The Emilia-Romagna region, a high-performing, digitally advanced context, was therefore used as a “stress test” setting in which observed heterogeneity is unlikely to be overestimated. Methods: A region-wide census of echocardiography laboratories collected data on governance, staffing, workflow, digital infrastructure, and imaging capabilities. A 5-item structural–digital readiness index (0–5) included: Picture Archiving and Communication System (PACS) archiving, structured reporting, Electronic Health Record (EHR) integration, availability of advanced echocardiographic tools, and an appointment slot for transthoracic echocardiography (TTE) of ≥20 min. High quality was defined as ≥4. Logistic regression identified independent predictors. Results: Of 148 centers, 122 (82%) responded, reporting 294,156 TTEs in 2023 (range < 500 to >15,000 per center); 46% were accredited private centers. Public institutions showed greater digital maturity than private centers (p < 0.001), with higher PACS availability and structured reporting. Overall, 86% reported ≥ 20 min per examination. Advanced modalities were unevenly distributed: left ventricular strain (50%), 3D imaging (33%), and stress echocardiography (42%). Workforce limitations were common, with 80% of centers lacking sonographers. A high structural–digital readiness index (score ≥ 4) was achieved by 38 laboratories (31%) and was associated with digital infrastructure and advanced imaging (p < 0.001). In multivariable analysis, university affiliation (OR 8.2–9.1) and a designated echocardiography lead (OR 4.1) independently predicted high quality, whereas procedural volume was not independently associated with quality. Conclusions: Marked variability in echocardiographic infrastructure and quality persists despite an advanced organizational and technological context. Leadership and digital infrastructure are the primary determinants of quality.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15103719
Authors: Andrea Barbieri, Francesca Mantovani, Francesca Bursi, Mattia Malaguti, Federico Fortuni, Luca Moderato, Ylenia Bartolacelli, Simone Binno, Alessandro Malagoli, Rita Pavasini, Chiara Pedone, Sergio Suma, Angelo Squeri, Alessandra Albini, Anna Chiara Vermi, Giovanna Di Giannuario, Marianna Laurito, Mauro Li Calzi, Alessandro Navazio, Antonella Moreo, Giovanni Di Salvo, Scipione Carerj
Institutions: University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Azienda Sanitaria Unità Locale di Reggio Emilia, University of Milan, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Perugia, Azienda Socio Sanitaria Territoriale di Cremona, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, University of Parma, Arcispedale Sant'Anna, Ospedale Maggiore Carlo Alberto Pizzardi, Maria Cecilia Hospital, Ospedale “M. Bufalini” di Cesena, Guglielmo da Saliceto Hospital, Ospedale Infermi di Rimini, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, University of Padua, University of Messina, Azienda Ospedaliera Universitaria Policlinico "G. Martino"
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7160942153