Abstract Objective Telemedicine can improve access and continuity of care for people with epilepsy (PwE), but its adoption across Italian epilepsy centers remains inadequately characterized. We conducted a nationwide cross‐sectional survey of all 75 epilepsy centers certified by the Italian Chapter of the International League Against Epilepsy (Lega Italiana Contro l'Epilessia, LICE) as of July 1, 2025. Methods The survey assessed center characteristics, telemedicine implementation, services provided, digital tool use, institutional recognition, satisfaction, barriers, advantages, and changes since COVID‐19. Associations with adoption were analyzed using chi‐squared or Fisher's exact tests. Results Telemedicine was currently used in 34 centers (45%), more frequently in higher‐level centers ( p = 0.009), with no association to patient volume ( p = 0.229) or geographic macroarea ( p = 0.319). Adoption rates varied regionally: North (54.3%), Central (34.8%), South/Islands (41.2%). Follow‐up visits were the most common (91.2%), while first consultations (26.5%) and teleneurophysiology (23.5%) were less frequent. Messaging apps were widely used (median 4, IQR 3–5 on a 0–5 scale), whereas certified email and medical apps were less common (median 1). Nearly half of centers reported the absence of reimbursement. Satisfaction scores among professionals (five‐point Likert scale) were moderate to high (3.5 ± 0.9). Barriers included technical limitations, insufficient equipment, and inability to perform exams; perceived advantages included improved continuity of care, reduced outpatient visits, and enhanced patient's quality of life. Since the COVID‐19 pandemic, 38.2% reported reduced telemedicine use, 35.3% increased use, and 26.5% no change. Significance Less than half of LICE‐certified Italian epilepsy centers currently use telemedicine. Adoption remains uneven, with benefits recognized but important technical, organizational, and reimbursement‐related barriers limiting widespread and sustainable integration. Plain Language Summary Telemedicine could help people with epilepsy get more consistent care, but fewer than half of Italian epilepsy centers currently use it. A national survey found that use varies by region and is more common in higher‐level centers. Most telemedicine activity involves follow‐up visits, while first appointments and remote testing are rare. Many centers rely on simple messaging apps, and reimbursement is often missing. Staff generally view telemedicine positively, but technical problems, lack of equipment, and the inability to perform exams limit its usefulness. Since COVID‐19, some centers have reduced telemedicine use, while others have increased or maintained it. Overall, adoption remains uneven and is held back by practical and organizational barriers.
Brigo et al. (Sat,) studied this question.