Italy’s electronic health record system, intended as a cornerstone of healthcare digitalization, risks becoming a driver of new inequalities. Implementation varies drastically across the country, creating a “digital divide”. A Gimbe Foundation analysis presented at the 9th Mediterranean Health Forum in Bari reveals only four core health documents (hospital discharge letters, lab reports, radiology reports, and ER records) are universally available nationwide. Furthermore, only 42% of citizens have consented to their data being accessed via the system.
“The electronic health record,” stated Gimbe Foundation President Nino Cartabellotta, “remains far from fully operational for millions of citizens today. The digital gap between regions risks turning into a new form of healthcare exclusion.”
The analysis used data from the Health Ministry and Department for Digital Transformation’s Electronic Health Record 2.0 portal, current as of March 31, 2025. While 16 document types should be integrated into the system, currently only the four core types are available everywhere. “A citizen in Sicily does not have the same access to their clinical documentation as one in Veneto. This is unacceptable for a healthcare service claiming to be universal,” Cartabellotta added.
The Gimbe analysis did not incorporate a very recent update to the portal. According to this latest data, documents available nationwide have increased to six, adding pharmaceutical prescriptions and specialist referrals. Vaccine certificate availability has also improved.
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