The journey of the 116 117 number in Italy began almost a decade ago with an initiative by the Lombardy’s agency for emergency medical services (AREU). AREU and the Italian Ministry of Health began planning, developing, and promoting the new Harmonized Single Number model for non-urgent care, to unify all call centers and cover the non-urgent medical care service, similarly to what was done for the 112 European emergency number.
116 117 would cover consultancy, information, educational, and support services for all those needs that were not urgent, but still vital for the national welfare, ensuring social support through a single number, easy to dial and to remember. It would reorganize and rationalize a system that saw many different and disjointed numbers often difficult to remember or to reach due to uneven hours and models.
The Pilot Project in Crema
AREU strongly promoted the 116 117 number, advocating at the national and European level to establish guidelines and implementation protocols with clarity and transparency. It was also the first agency in Italy to test the system with a pilot project in the provinces of Mantua, Cremona and Crema.
The local emergency PSAP was reorganized by adding a few workstations dedicated to 116 117. These were manned by newly trained non-medical call takers and featured a new structured filter designed for the service. The call takers did not include doctors or nurses, to prevent any diagnostic evaluation, which nurses and doctors tend to perform by default.
The 2014 pilot was initially greeted with reservations by some who could not see the advantage of a harmonized system. However, after an initial period of mistrust, the 116 117 service was re-evaluated and welcomed even by skeptics because there was a clear improvement in the management and rationalization of the many resources.
From the citizen's point of view, the number simplifies the information process and management, from the PSAP’s point of view it lightens the medical professional’s workload as they are no longer involved in the call process, but only when a diagnosis is needed. Once the service was officialized, it was extended to the entire region and currently covers ten million citizens.
The State-Region agreement is approved: 116 117 is a national reality
On November 24, 2016, at the National-Regional conference the "document with the criteria and methodology guidelines for activating the harmonized european number of social value 116117" was approved. The key principles at the heart of the service are:
The 116 117 service replaces all non-emergency medical services and toll-free assistance numbers in the area, including all social and health care assistance numbers. Some incorporated services include: the medical guard, the tourist guard, some health registry services, such as the choice or revocation of the general practitioner, hospital and planned patient transport.
Building the first national PSAP
The harmonized 116 117 PSAP was inaugurated in 2019 and covers the entire region with 10 million people. It has 38 workstations, with a greater presence of call takers in peak hours (8-10). It can also easily add another 14 workstations if needed. It receives an average of 2,500 calls per day, 75% of which are resolved within two minutes of the pickup. The average answer time is about twenty seconds.
The PSAP is connected to the sister 112 PSAP to redirect any emergency call. It is important to underline that the two services are not separate and ensconced, but they are two connected parts of an ecosystem, which guarantees assistance in any time of need. Unlike 112, the 116 117 PSAP focuses more on the information retrieval process and not on the caller location, as the dispatch service is not expected.
All calls are recorded, and an interpreting service is available to assist people who do not speak Italian. 116 117 is not a simple contact hub to simply sorts calls, it serves to assist the person and guide them to the right solution to their problem; it accompanies, advocates, and helps to retrieve the necessary information or service.
116 117 and Covid19
The 116 117 had a very important role in 2020, as the entire emergency response system had to shift to deal with the unexpected crisis caused by the COVID19 pandemic. The PSAP was an essential reference point for integrating emergency response and general medicine activities.
A special COVID filter was activated in PSAP to manage traffic through 116 117. Furthermore, a special new appendix number (800894545) was activated specifically to deal with citizens’ request. A rearrangement of the medical stations and the call redirection to a greater number of non-medical call takers helped withstand this sudden increase of about two million calls.
The 116 117 system, reorganized to manage the calls, was vital to guarantee citizens a non-urgent medical service.