Beyond distance: the San Raffaele Hospital telemedicine portal experience

Background

Telemedicine has evolved from an emergency response during the COVID-19 pandemic into a strategic component of healthcare delivery. However, evidence is needed on how hospital-based platforms can be embedded in routine clinical practice. IRCCS San Raffaele Hospital (HSR), Milan, implemented a telemedicine portal to structure remote patient-specialist interactions within secure, traceable and clinically governed care processes.

Methods

We conducted a retrospective observational analysis of aggregated, anonymised data from the HSR telemedicine portal between 2020 and September 2025. Outcomes included registered users and specialists, numbers and types of telemedicine services, annual trends and distribution by medical specialty.

Results

Overall, 142,177 users and 940 specialists were registered. The largest user age group was ≥65 years (39,205; 27.6%), followed by 55-64 years (29,492; 20.7%) and 45-54 years (27,730; 19.5%); women accounted for 52.5%. The portal delivered 62,134 services: 18,700 first televisits (30.1%), 18,712 follow-up televisits (30.1%), 14,628 follow-up teleconsultations (23.5%) and 10,094 first teleconsultations (16.2%). Follow-up televisits increased from 1,014 in 2020 to 4,635 by September 2025, while first televisits rose from 1,605 to 3,989. Among 59,640 services classified by specialty, psychology/psychotherapy accounted for 11,030 (18.5%), followed by endocrinology (5,640; 9.5%), neurology (4,332; 7.3%), general surgery (4,192; 7.0%) and psychiatry (4,165; 7.0%).

Conclusions

The HSR experience shows that a secure, integrated telemedicine platform can become part of ordinary hospital practice when supported by clinical governance and multidisciplinary engagement. Its use in chronic disease management, follow-up care and mental health services highlights the role of telemedicine in strengthening patient management and complementing in-person clinical pathways.

Key messages

• The HSR portal delivered 62,134 services, mainly televisits and follow-up care, showing integration into routine outpatient pathways.

• Use in chronic disease management, follow-up and mental health care supports telemedicine as a complement to in-person pathways.