From 'digital hospitals' to telemedicine: NRP targets met but what benefits for citizens

"As of 31 December 2025, three European deadlines for the Health Mission of the NRP were set for the digitisation of the National Health Service: all of them were formally met, but without any certainty as to the real benefits for citizens and public health. Moreover, meeting the deadlines cannot justify non-transparent reporting: the absence of public data and the criteria used to certify the achievement of the targets raise a number of perplexities and must be supplemented by detailed reporting on the results. Transparency is an essential requirement of accountability and public data are 'common good'. This was stated by Nino Cartabellotta, president of the Gimbe Foundation, which is engaged in independent monitoring of the implementation of the Health Mission of the National Recovery and Resilience Plan.

With EUR 1.45 billion," the Foundation observes, "only a basic level of digitalisation has been achieved, instead of 280 computerised hospitals, while the Health File is used by 95 per cent of family doctors, but the summary health profile 'is still a mirage' and only 44 per cent of citizens have given their consent to consultation. As for the Eu target of at least 300,000 patients assisted in telemedicine, it has been largely exceeded with 467,479 patients, as certified by the Seventh Report to Parliament on the state of implementation of the NRP. "However," Cartabellotta emphasises, "the monitoring carried out through the National Telemedicine Platform managed by Agenas is not publicly accessible: all the Regions and Autonomous Provinces have activated at least one telemedicine project, but no public data are available on the number of patients assisted by individual Region. If the target has been reached,' he comments, 'it is essential to make the numbers public. Without knowing the number of patients assisted in each Region and for which telemedicine services, it is impossible to verify whether there are digital gaps to be bridged. Because the NRP is not just about reaching the national targets, it must reduce regional and territorial inequalities'.

Precisely because public data represent a 'common good', the Gimbe Foundation is asking the Ministry of Health for a detailed and accessible report on: the number of patients assisted in telemedicine for each Region, the level of digitalisation achieved by each of the 280 hospitals, and the definition of clear and consistent indicators on the actual feeding of the ESF by family doctors and paediatricians. But above all, whether and how soon the complete digitisation of the 280 hospitals envisaged in the original NRP plan will be achieved.

The original European target envisaged - as still reported on the Ministry of Health website - the computerisation of all departments in 280 hospitals with level I and II Emergency and Acceptance Departments (Dea). In other words, the complete digitisation of the 280 hospital facilities, the list of which has never been made public," the Gimbe Foundation points out: 210 by the first quarter of 2024 and a further 70 facilities by the end of 2025. With the sixth request to amend the NRP, made by the government on 26 September 2025 and approved by the Council of the European Union on 27 November 2025, the target was scaled down. The target is considered achieved if all 280 hospitals increase by at least one level on the Emram (Electronic Medical Record Adoption Model) maturity scale, based on an independent certification by the Healthcare Information and Management Systems Society, and if at least 50 hospitals reach at least Emram level 2.

The Emram scale measures the degree of digitisation of a hospital in eight levels (from 0 to 7): level 0 indicates no digitisation and level 7 identifies a totally digitised hospital, almost completely 'paperless'. "We are talking about an investment of over 1,450 million," Cartabellotta notes, "for the complete computerisation of 280 hospitals. But today 'we are content' to raise at least one Emram level in all hospitals and certify at least 50 of them to level 2: a still embryonic stage of the digitisation process. That is, if the bar has been lowered to reach the target by the deadline, we are light years away from the initial goal of computerising all departments of 280 hospitals. Moreover, even here there is a lack of public data to assess regional and local differences and the status of the digital transformation of Italian hospitals. Which 280 hospitals are to be digitised? Which ones have been certified with what level of digital maturity?".