Telemedicine in Italy, the starting point

The COVID-19 pandemic was undoubtedly the most critical event that the Italian National Health Service (NHS) had to face in its history. To cope with the emergency, the Italian NHS had to stop most elective care, at least during the first phase of the outbreak. However, such state of crisis had also a positive side: it accelerated the spread of telemedicine, particularly for cancer and chronic patients. The recent WHO Global Safety Action Plan highlights the importance to develop and implement digital solutions, such as telemedicine to improve quality and safety of care (1) The EU has taken major initiatives to strengthen public health sectors in member states and mitigate the socioeconomic impact of the pandemic. One of the first actions was Next Generation EU (NGEU), through which €750 billions were allocated to stimulate growth, investment, and reform (2). Much of this funding is targeted at the health sector for digitization and deployment of telemedicine systems in healthcare. For Italy in particular, resources of up to 20 billion euros are planned for these purposes. Today the market offers a variety of applications for telemedicine services. The main applications of telehealth are tele visiting, tele-assistance, tele monitoring, and tele consultation (3). Their success is often due to the ability of healthcare operators to implement them in operational contexts with different technological quality and various levels of personnel training about the digitization (4). In view of these large investments, we decided to take a snapshot of telemedicine diffusion at the national level to define a baseline and identify actions to be taken for the real development of a new model of digital healthcare in Italy. From February 1 to March 31, 2022, information regarding the use of telemedicine was collected by an anonymous questionnaire disseminated to Italian healthcare operators through the risk management network