How has telemedicine developed in Poland?

– I have been dealing with telemedicine for over 10 years. I was fascinated by the ease and speed of contact with patients, the possibility of immediate help – says Tomasz Grzelewski, MD, PhD. The doctor also recalls the beginnings of telemedicine in Poland – chat with patients and phone calls. Faulty networks, broken connections and stress, because on the other side there is a patient with a heart attack or a child with a fever …

Lost connection. A minute is an hour

Tomasz Grzelewski, MD, PhD: I have been dealing with telemedicine for over 10 years. I was fascinated by the ease and speed of contact with patients and the possibility of immediate help. I have worked for several companies that provided such services, with many taking their first steps in it. What I can say in retrospect is that you should remember that telemedicine is created by people. And for people. With a load of emotions and worries. This is often forgotten. In my opinion, this is a new, good measure to the goal of human health.

In Poland, the development of companies dealing with this subject was slow. I remember my work in systems based largely on Skype contacts, or on regular chats. Sometimes connections were broken, which additionally stressed the doctor, because on the other side there was a sick child with a fever or an adult patient with a suspicion of a heart attack. With a broken connection, a minute meant an hour …

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I believed in the development of telemedicine

Luxmed was the first to use the benefits of telemedicine, in the form of a chat with patients, which I remember perfectly well. At that time, I was working in Łódź and it was a great convenience for me to remotely assess the results of patient examinations. For several months I worked for an insurance company, where in the summer I consulted Polish tourists around the world by phone. However, it was too much of a challenge. Both the patients and the employer had too high expectations of a doctor who is only a doctor and only a human.

A fantastic thing that revolutionized my approach to contact with patients was the portal on pediatrics, where parents could ask the doctor questions about the diagnosis and treatment of their children 24 hours a day. It was a testing ground for my further work, because I had to answer many thousands of questions myself. I quickly realized that this is what I want to do with my life. That challenge made me a new physician – a physician dedicated to this job.

After some time, I realized that telemedicine would develop. It was inevitable. Slow but it did come! All the time, however, I was looking for someone who would have an idea for total telemedicine, without borders. Such that the prescription could be sent to the patient all over the world. So as not to neglect anything. Reach out to everyone. Everywhere. Always. Quick.

Connection breaks and freezes

Another project is the pioneers of true telemedicine in Poland. The service was in the form of a chat for patients, so it was the first one hundred percent telemedicine service. It is worth remembering that 6-7 years ago, smartphones or tablets were not as good as they are now. Once chat worked, other times it did not, connections crashed and broke, but we all tried to be as good as possible, and we gradually succeeded in doing that.

At that time, the so-called courier prescriptions which, even before the advent of e-prescriptions, helped our patients. The doctor initially diagnosed the disease via the VoIP system or video chat and sent the prescriptions by courier to the patient’s home. It was a pioneering test, with flaws, but also a great breakthrough.

At times the system did not work, which made me very nervous, but I knew I had to wait, be patient. I come from the academic community, from a large children’s clinic, university. I wanted to heal, help, write prescriptions. I wanted to help this system especially for large-scale allergy patients! But then the system was not working as efficiently yet.

At the moment, I am co-creating the first fully patient-oriented sublingual immunotherapy program in Poland for patients with any type of allergy. Telemedicine and its development are sometimes decided by chance and it was the case – the method of sublingual desensitization came to my mind because I did not find the drug in the company’s e-prescriptions that patients asked about! I was surprised, but this was the beginning of e-prescription, to this day not all medications are on the e-prescription list! And I missed an oral desensitisation drug that any allergist could prescribe, but we didn’t have one because we used the official list of drugs from the Ministry of Health and found it was not on it! We all fixed this bug together with the drug manufacturer and the Ministry.

Such a program is a huge progress, we serve thousands of patients all over Poland. Sublingual vaccines are safe and effective almost as well as subcutaneous vaccines. It is enough to send the patient an e-prescription for the preparation several times a year and help him so that his allergy practically disappears in 3-5 years.

From my adventures related to telemedicine, I will also mention that I was one of the consultants for the development of the modern telemedicine device Higo Sense, which is entering the market this year. It is a portable telemedicine device: a stethoscope for auscultation of the lungs, heart and abdomen, a thermometer, a dermatoscope for viewing the skin, a spatula for viewing the throat, an otoscope for viewing the ears. This is the first such device in the world, thanks to it, patients can initially examine themselves or initially examine their children.

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