In the time of COVID-19 epidemic, Italy was found unprepared to manage lockdown patients with chronic diseases, due to limited availability and diffusion of large-scale telemedicine solutions. The scattered distribution and heterogeneity of available tools, the lack of integration with the electronic health record of the national health system, the poor interconnection between telemedicine services operating at different levels, the lack of a real multidisciplinary approach to the patient's management, the heavy privacy regulations, and lack of clear guidelines, together with the lack of reimbursement, all hinder the implementation of effective telemedicine solutions for long-term patients' management. This COVID-19 epidemic should help promote better use and a larger integration of telemedicine services in the armamentarium of health care services. Telemedicine must no longer be considered as an option or add-on to react to an emergency. © Stefano Omboni 2020; Published by Mary Ann Liebert, Inc. 2020.