Policy recommendations per il futuro della telemedicina in Italia. Report di ricerca Delphi Survey progetto ETHICS- ElecTronic Health In ContextS

The working paper discusses the results of a Delphi survey conducted with Italian telemedicine experts to identify the main regulatory, organisational, and professional challenges affecting the uptake of telemedicine within the Italian National Health Service (NHS). Through iterative consultation rounds involving clinicians, managers, legal scholars, engineers, and representatives of national and regional bodies, the study identifies several interrelated priority areas. These include: overcoming data fragmentation through full interoperability and effective implementation of the Electronic Health Record; addressing misalignment between technology providers and frontline clinical needs, including the risks of non-interoperable systems and information overload; balancing bottom-up innovation with coordinated national standards to avoid further system fragmentation; integrating telemedicine into territorial and primary care models while preventing excessive centralisation; strengthening the involvement of general practitioners through organisational support, incentives, and contractual reform; defining clearer eligibility criteria and professional accountability frameworks; and investing in human capital, multiprofessional collaboration, and new organisational infrastructures. The study underscore that telemedicine is not merely a technological innovation, but a systemic reform requiring coordinated multi-level governance, regulatory alignment, and organisational transformation.