Big data: is clinical practice changing?

The widespread diffusion of the digital culture and technology, involving both individual and population, together with the fast pacing digital globalization process (far surpassing ‘political’ globalization), is radically changing the world social landscape, including medicine and clinical research. The most significant change in clinical research is the ever more frequent acceptance of observational data, both through the use of registry of rare or common conditions and the implementation of capillary networks recording the daily clinical practice (Electronic Health Recording system). By becoming ‘observational’ clinical practice should change significantly: (i) record of different data (epidemiological, clinical, and administrative) in inter-operational database, producing a dynamic map of the health demands, either met or not, that allows a reconfiguration of the health systems capable to adapt to the shifting clinical needs. Implicate the larger group possible of patients and healthy individuals, who, through smartphone technology, could participate in primary and secondary prevention projects and epidemiological analyses. (ii) Support scientific research by integrating it with the clinical practice as instrument of good government that is scientific evidence-based Public Health System: the Learning Health System. The road will be long and gruelling. A first negative by-product is the proliferation of cybercrime throughout digital medicine.