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Purpose This paper aims to provide a helpful tool for those who plan to implement blockchain-based solutions for the governance of the electronic medical record (EMR) in health-care settings. The goals are to identify each type of stakeholders involved in these projects and to clarify the relevance, to achieve success, of their readiness, intended as availability and ability to adopt blockchain. Design/methodology/approach The chosen methodology is a multiple case study on three initiatives that used blockchain to manage EMRs. This study relied on multiple sources of evidence. The primary data consisted of two rounds of semi-structured interviews with different informants. This study followed a grounded theory approach and performed within- and cross-case analyses. Findings This study identified the types of stakeholders – nodes and not-nodes – of the network and how their readiness level affects the implementation of blockchain-based projects applied to EMR. The nodes (e.g. patients and doctors) are pivotal in making the network working once this has been constructed. Out of the four readiness dimensions suggested by literature, motivational readiness, has the higher impact. Not-nodes stakeholders play a pivotal role in the project’s pre-implementation phase. For them, structural readiness is the dimension with the higher relevance. Originality/value To the best of the authors’ knowledge, it is the first time that a paper analyses the differences between nodes and not-nodes stakeholders of the blockchain network, in terms not only of type but also of readiness. Identifying the readiness level to implement successful projects is a fundamental step that has never been analysed in the health field.

PurposeThe study investigates the use of early forms of environmental accounting in the implementation of environmental strategies in the Grand Duchy of Tuscany between the 16th and 17th centuries.Design/methodology/approachThe study adopts the Foucauldian concept of raison d’État to shed light on the ways in which environmental accounting practices were used by Tuscan Grand Dukes to form a detailed knowledge of the territory to be governed and act accordingly.FindingsFinancial and non-financial information relating to environmental issues enabled the Grand Dukes to “visualise” the territory to be managed as an enclosed disciplinary space whereby the conduct of people living therein could be decisively influenced. Accounting practices as a tool for the implementation of environmental strategies did not merely aim to protect the environment but were a means to reinforce the power of the State.Research limitations/implicationsThe paper can inform future works that investigate the ways in which environmental policies and accounting are used to pursue far-reaching governmental goals. It encourages scholars to examine further the origins of environmental accounting and its early forms.Social implicationsThe study documents how environmental strategies and the related use of accounting can have a significant influence on how individuals are allowed to conduct themselves. It also shows that environmental accounting practices can be an important tool in a State’s machinery of power.Originality/valueThe study offers a novel perspective on the use of environmental accounting information as a tool in the exercise of State power. It explores explicitly the interrelations between accounting, sustainability and power. It also adds new evidence to historical research that has engaged with early forms of environmental accounting.

The contribution is based on the emergency situation following the Covid-19 pandemic The dramatic situation that has arisen offers an opportunity to reflect on the characteristics of Italian health care and in particular on the model for the division of responsibilities in health matters between the State and the regions Every emergency requires exceptional interventions and extraordinary decisions In a health emergency such as the current one, it is natural to set up task forces, intervene with emergency decrees or act on the contingency way The basic question is whether the regionalization of health care, as it has been formed since 1992, is the suitable institutional model to respond in a unified and homogeneous way to the health needs of Italians The paper proposes and argues the hypothesis of bringing hospital care back to the central level The Regions would be kept in charge of primary care and low and medium-intensity hospitalization In this way, in front of critical issues the chain of responsibilities and the leadership of the system would be clear Copyright © FrancoAngeli

During the past few years, scholars have investigated accounting practices from different perspectives and in different contexts; however, the topics of accounting and fraud-corruption appear to be underresearched areas in accounting history literature. This article examines the case of Galliera Hospital of Genoa, established as Opera Pia De Ferrari Brignole Sale in 1877 by the Duchess Maria Brignole Sale. Currently, the Galliera Hospital is an important and specialised Italian hospital with 450 beds and almost 2,000 employees. Using the lens of Foucault’s governmentality and discipline power framework, this article explores how unforeseen events and misconduct can deeply change governance and control mechanisms, implying the adoption of empowered accounting practices. Thus, this article shows that accounting practices, when perceived as a real technology of government, allow the exercise of power. The study offers a relevant contribution to the extant accounting history literature by examining how accounting can be used as an instrument of power in the presence of misconduct.

The Directive 2013/34/EU has changed the content of the annual accounts, impacting on many items. The paper presents the consequences of the Directive on Italian legislation, analyzing in detail the values that have been modified. The concluding part contains interesting considerations on the whole reform process.

This paper analyses recent tendencies of managing public real estate and public stake-holdings in a sample of Italian municipalities. The data, retrieved from the Italian Ministry of Interior (Central Department of Local Finances), has been analysed to understand if the local public group, intended in a wider sense and including both subsidiaries and real estate property, is changed over time, in terms of size and composition. The first results show that there has not been adequate divestment to postulate on a general reduction of the boundaries of the “Integrated” Public Groups.

This chapter aims to investigate the role of accounting information system in supporting the adoption of accrual accounting in public universities and its main effects on the organization. The study is focused on Italian public universities, with a specific reference to the accounting management of research projects. The treatment of the research projects is particularly interesting because of their relevance in the university budget and their effects on the whole organization (e.g. on the delegation system). Therefore, the configuration of the new accounting information system of universities is not a mere technical problem but involves organizational changes. The research is based on a comparative case study of two Italian public universities (Universities of Genoa and Pisa) relating to the role of the accounting information system in supporting the research project accounting and in affecting their organization (in terms of competences and responsibilities).

The paper analyzes how the accounting information system supports the transition from the traditional public accounting to the accrual accounting and the new budgeting and reporting system in public universities, with a specific reference to the bookkeeping of research projects. The accounting treatment of the research projects is particularly interesting because of the relevance of this item in the university budget, the options indicated by the lawmaker for its valuation criteria and the effects the valuation criteria have on the economic and investment budget of the university. Therefore the configuration of the accounting information system is not a mere technical problem, but involves the whole management. The research is based on the case study method applied to the University of Genoa. The research method is based on in-depth description of the role of the accounting information system in supporting the various phases of the research project accounting.

The objective of this paper is to offer a significant contribution to the debate on how to implement performance measurement systems in the Public Administration by proposing a model based on an integrated information system where planning (strategic and operational) and measurement systems are supported by a single application that drives the whole process. The research is based on the case study method [1] and analyses the characteristics of ICT systems in supporting the management control systems developed by the Italian regulatory authority for the energy sector (AEEG). The results of our work suggest that a single measurement metric may be identified for the assessment of the output produced by both core and accessory structures, in complete integration with the planning and control process.

Cardiovascular diseases represent a relevant problem worldwide. Data from World Health Organization (W.H.O.) demonstrate that they are one of the principle causes of death: 30% of all losses of human life throughout the world are due to heart diseases. Such data buries a substantial economic cost considering both the direct component, first of all the national health expense, and the indirect part, such as absenteeism rate, productivity loss, quality of life and, more generally, social costs. The future scenario pictured by the W.H.O. reveals a negative trend due to an increasing in the rate of morbidity and mortality especially in Emerging Countries. One of the solution to stem the costs - economic and not - connected to cardiovascular diseases is to empower the prevention activities overall the actions of primary prevention. This require a change in the traditional patient-physician relationship management model to get to an organizational model centred on patient and based on a proactive approach. In this perspective in the paper will be analysed the principal changes that occurred in the Italian national healthcare system and in particular the strategic plans and actions in theme of cardiovascular prevention.