Telemedicine is increasingly used in the modern health care system because it provides health care services to patients amidst distant locations. However, the prioritisation process for patients with multiple chronic diseases (MCDs) over telemedicine is becoming increasingly complex due to diverse and big data generated from multiple disease conditions. To solve such a problem, massive datasets must be collected, and high velocity must be acquired, specifically in real-time processing. This process requires decision-making (DM) regarding the emergency degree of each chronic disease for every patient. Multi-criteria decisionmaking (MCDM) approaches (i.e. direct aggregation, distance measurement and compromise ranking) are the main solutions for dealing with this complex situation. However, each MCDM approach provides a unique rank from those of other methods. By far, the preferred DM approach that can provide an ideal rank better than other approaches has not been established. This study proposes an extension of the technique for reorganising opinion order to interval levels (TROOIL). Such an extension is called Hybrid DM and Voting Method (HDMVM) which is based on different DM approaches (i.e. direct aggregation, distance measurement and compromise ranking). HDMVM is used to prioritise big data of patients with MCDs in real-time through the remote health-monitoring procedure. In this paper, we propose a methodology that is based on three sequential stages. The first stage illustrates how the big data of patients with MCDs can be recognised in the telemedicine environment and identifies the target telemedicine tier in this study. The second stage describes the steps of the proposed HDMVM sequentially. The third stage applies the proposed method by prioritising the case study of big data of patients with MCDs based on the above DM approaches. Moreover, dataset of remote patients with MCDs (n = 500) is adopted, which contains three diseases, namely, chronic heart diseases and high and low blood pressures. The prioritisation results vary among direct aggregation, distance measurement and compromise approaches. The proposed HDMVM effectively provides a uniform and final ranking result for big data of patients with MCDs. A statistical method (i.e. mean) is performed to objectively validate the ranking results. Significant differences between the scores of the groups are identified in the objective validation, signifying identical ranking results. The evaluation of the proposed work with the benchmark study indicates that this study has tackled issues relevant to big data and diversity of MCDM approaches in the prioritisation of patients with MCDs.