The project

Digital health still for the few: how to accelerate equity and access

Without a change of course, there is a risk of exclusion of the most fragile groups and an increase in regional inequalities with a multi-speed National Health Service: proposal to speed up the deployment of the tools provided by the NPrP

by Health Review

13 May 2026

4' min read

Translated by AI

Versione italiana

4' min read

Translated by AI

Versione italiana

The digitisation of the National Health Service is one of the strategic challenges for Italian healthcare. The investments of the National Recovery and Resilience Plan (NRP) have accelerated the adoption of digital technologies, but the path towards innovative, equitable and patient-centred healthcare is still long.

The basic objective of using digital health is to produce more equity by reducing geographical barriers; ensuring early diagnosis and timely treatment; decreasing costs and increasing efficiency; improving empowerment and the capacity for self-care (adherence, informed choices, etc.) as the EU emphasises. These are targets that, if achieved, would give great added value to the healthcare of our country, which is working to change and be more resilient and in step with the times.

Pnrr's bet

In recent years, especially thanks to the funds of the NRP, the National Health Service has bet on Digital Health in 4 strategic assets: Strengthening the system of data collection and analysis necessary for the governance of the NHS; telemedicine; electronic health record (EHF); artificial intelligence pilot project. This is flanked by the innovation opportunities of Digital Therapeutics and Digital Medicine.

For this reason, Salutequità in collaboration with UCB Pharma has promoted a moment of analysis and discussion to take stock of experts, institutions, patients and operators on digital health in Italia, highlighting criticalities, risks, and opportunities to contribute to the achievement of equity and health objectives. And they launched DHEL, a laboratory that puts equity at the centre of Digital Health. The need for a laboratory starts from the observation of the state of the art today, of the efforts that are being made and of the adjustments that will gradually become necessary to ensure a regulatory, economic and evaluation framework of the use of Digital Health and Digital Medicine capable of ensuring equity and respect for people's rights.

"Digital health," says Tonino Aceti, president of Salutequità, "represents an extraordinary opportunity to reduce regional, geographical, cultural and economic inequalities, bringing the National Health Service into the homes of all, especially the most vulnerable. But on equity, the WHO issues a warning: there is a risk of increasing accessibility for those who are already able to access it, leaving unchanged, or worsening, the situation of those who struggle the most. This is why we have decided to launch a workshop on equity in digital health, which will involve the main stakeholders precisely to reduce inequalities and help keep the focus on this asset also post Pnrr'.

The waiting list node

Difficulties in accessing timely treatment pose a challenge both in terms of timely diagnosis (e.g. for endometriosis the estimated diagnostic delay is 7-10 years from the first symptom) and in terms of impacting on the withdrawal of treatment. In 2024, one in 10 people gave up treatment, mainly because of long waiting times (6.8% of the population). Data that are reflected in the ability of the SSN to meet the priorities placed on the prescription. In December 2025, 75 per cent of people who needed an urgent neurological examination (within 3 days) waited up to twice as long (6 days); for priority within 10 days, 75 per cent waited up to 23 days (more than twice as long); for priority at 30 days, 75 per cent waited up to 82 days; only 15 days difference for priority at 120 days: 75 per cent waited up to 135 days.

In the three-year period 2022-2024, 5 per cent of households experienced many difficulties in reaching three or more essential services, such as pharmacies and emergency rooms, with marked differences depending on the size of the municipality (the difficulty more than doubled in municipalities with up to 2,000 inhabitants 11.1 per cent) and north-south: it ranged from a minimum of 2.6 per cent of households in the Autonomous Province of Bolzano/Bozen to more than three times as many in Campania (8.9 per cent) and Calabria (8.4 per cent).

And we still suffer the lowest levels of confidence in our ability to self-manage our health, as reported by patients themselves: 24.3%, compared to the OECD average 58.9% and over 90% in France; also at the bottom of the league table for confidence in our ability to use internet information (4.9% Italia vs. 19.3% OECD average and over 30% in France) - Surveys (PaRIS) data, OECD.

More telemedicine

We are moving forward with the use of telemedicine, which has enabled 204,865 patients to access health services, with 356,358 services provided in 12 months (2024-2025), but it is not known whether there is an effective distribution according to territorial distress (e.g. inland areas or poor public transport connections) and patient situations. The NRP envisaged the digitisation of 280 hospital facilities and the extension of telemedicine to at least 300,000 people.

Digital therapeutics (DTX) still have no clear regulation in Italia, but in 2024 there were already 93 DTXs globally (37% psychiatry, 14% endocrinology, 10% rheumatology and oncology).

The electronic health record (Fascicolo sanitario elettronico - FSE), a tool that meets multiple objectives concerning the freedom to access all relevant and important information on and for health wherever the person is, as well as for the planning of health services, has been activated, but only 45% of the population has given consent to consult their clinical documents and one out of 10 specialist doctors is still not enabled to consult them; even for the 'Patient Summary', the Pnrr deadline has been postponed to overcome some difficulties in compiling it.

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