Telemedicine. Declaration of 21 organizations. “We recognize the key right of the patient to choose the type of service”

21 organizations signed a declaration on the development of standards for the provision of telemedicine services in Poland. They include, among others Federation of Polish Patients, Supreme Medical Council, Polish Cancer Federation, Polish Federation of Hospitals, Polish Diabetes Association and Employers of the Republic of Poland. One of their most important postulates is “the patient’s right to choose the form of health care”.

1. In a dozen or so days, a draft regulation of the Ministry of Health on the provision of telemedicine services in Poland is to enter into force
2. Several of its provisions are being questioned by specialists from medical, patient and work environments
3. The Ministry of Health is considering administrative restrictions aimed at making telemedicine services possible only after the first stationary visit in most cases. Patients understand the reason, but believe that another solution must be found – write the authors of the declaration signed by over 20 entities
4. Not an order, not a prohibition, and the possibility of choosing is crucial from the patient’s perspective – emphasizes the president of the MY Patients Foundation
5. More information can be found on the TvoiLokony home page

21 patient and medical organizations and employers are working on developing an environmental standard for telemedicine care, calling for dialogue and not restricting patients’ access to telemedicine services based on administrative criteria.

The signatories of the declaration emphasize that they care about the constant improvement of the quality of telemedicine and the patient’s right to choose the service and health education of the society.

Good telemedicine – quality, choice and access to services for everyone

«The clinical situation, medical knowledge of the doctor and the choice of the patient should be the basis for choosing a telemedical or inpatient service»- the signatories of the declaration on developing a telemedicine care standard are writing. They remind that although telemedicine has become popular due to the solutions used during a pandemic, it has been operating successfully in many areas for over a dozen years and contributes to wider access to services and patient safety.

The authors of the declaration emphasize that telemedicine is much more than just telepathics.

– That is why we are taking steps to develop a systemic proposal of solutions to improve the quality of telemedicine services and we will strive to create standards supported by all participants of the health care system. – says the President of the Management Board of the Telemedicine Working Group Foundation Jan Pachocki.

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– We believe that the bill on quality in health care and patient safety, being processed by the Minister of Health, can be an excellent contribution to the dialogue on this matter. Solutions used in many countries show that telemedicine can no longer be considered in isolation from the rest of the system. It is an integral part of highly developed health care systems, providing advanced care and increasing the safety and comfort of patients – adds Pachocki.

As emphasized by the authors of the declaration, in Switzerland, Great Britain and the Netherlands, more and more emphasis is placed on the use of telemedicine to properly guide the patient in the system, which reduces the burden on hospital emergency departments and the number of calls to the emergency services, and thus reduces unjustified departures of ambulances.

“In Poland, the Ministry of Health is considering administrative restrictions aimed at making telemedicine services possible only after the first stationary visit in most cases. Patients understand the reason, but believe that a different solution must be found »- we read in the list of signatories of the declaration.

Telemedicine – what does the Ministry of Health want to change?

From October 1, new rules for awarding will apply teleport. The author of the draft regulation is the Ministry of Health. In a few cases, the regulations limit or even exclude the possibility of remote consultation with a doctor, only direct contact during a visit to the facility will be allowed. This will happen, inter alia, in the case of a new disease, a change in symptoms in a chronic disease or a visit by a child up to 6 years of age.

Both the medical and patient communities are protesting against the changes, employers’ unions have expressed negative opinions, and companies that mediate in online consultations also raise objections.

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Many organizations emphasize that the new regulations will make it difficult to access specialists, limit the possibility of contacting a doctor for people from small towns, cause queues at clinics to be longer, and the waiting time for an appointment will increase significantly. We cannot forget about the prevailing pandemic, so the necessity to make a stationary visit may still pose an epidemiological threat.

Telemedicine is developing and the quality of services is growing

“Although the epidemic accelerated certain processes, telemedicine in Poland has been developing dynamically for over a dozen years and many entities ensure that the quality of services provided in this way constantly increases” – write the authors of the declaration.

– The development of new technologies in the treatment of diabetes: continuous glucose monitoring systems, glucometers with applications, insulin pumps, software for automatic data analysis from these devices allow for a wide and effective use of telemedicine in diabetology. Thanks to them, it is possible to monitor the health of patients, thanks to which we are able to react to many events remotely and remotely discuss changes or modifications to the therapy. And often it does not require a patient’s visit to an in-patient facility. – says prof. Agnieszka Szadkowska from the Polish Diabetes Society.

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– Thanks to telemedicine, we can constantly monitor patients with particular cardiological risk, we have better contact with patients who are excluded from communication or people with disabilities. They gain greater comfort and a sense of security, and we monitor their health on an ongoing basis. – adds the spokesman of the Polish Cardiac Society, prof. Marcin Grabowski.

Declaration on telemedicine – what is it about?

Twenty-one organizations signed the “declaration for the development of solutions to improve the quality of telemedicine services”. The signatories believe that the constantly emerging new telemedicine solutions require constant updating of the standards of these services, monitoring their quality, but also enabling patients to choose a stationary visit at every stage.

The signatories of the declaration inform:

1. we consider telemedicine as a tool, the proper application of which can significantly improve the health situation of patients and the effectiveness of medical care;
2. we want to make the most of the growing potential of telemedicine resulting from technological progress and digital transformation of the healthcare system;
3. we believe that the appropriate use of telemedicine solutions, like any innovation, requires systemic actions aimed at increasing the quality;
4. we underline the necessity to implement a coherent, effective policy based on standardization and education of medical professionals and patients;
5. we recognize the key right of the patient to choose the type of service while retaining the right to demand a stationary visit at any time.

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The authors of the declaration declare that:

Telemedicine should aim to improve:

1. the state of health of patients;
2. access to medical care;
3. satisfaction with the health service.

The basic condition for the provision of telemedicine services are medical indications allowing for the application of this solution in relation to a specific health problem.

In addition, a doctor / nurse or other medical professional should be competent to provide telemedicine services.

A necessary condition should also be the patient’s conscious decision that he / she wants to receive such a service remotely. No type of care – including telemedicine services – can be provided against the patient’s will.

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Medicine is a complex area with over seventy specializations. As part of standardization, it is necessary to take into account the specificity of individual therapeutic areas.

The organization of telemedicine services should guarantee high quality of the service as well as its affordability and patient-friendliness.

An important area is the use of modern IT solutions, including the potential of medical devices.

Telemedicine provides the opportunity to effectively educate patients. Proper use of telemedicine allows taking preventive measures on a large scale.

Effective standardization requires simultaneous proper monitoring of undertaken activities and education of patients and medical professionals.

Key aspects related to the provision of telemedicine services should be anchored in systemically consistent legal provisions.

Telemedicine – develop satisfactory and optimal solutions

One of the signatories of the declaration is Dorota Korycińska, president of the National Cancer Federation. – Telemedicine solutions have been introduced to the Polish public health care system relatively urgently, due to the duration of the SARS-CoV-2 epidemic. We had the opportunity to see the numerous advantages of this solution, which the patients were happy to accept, as well as the disadvantages they experienced, writes Korycińska.

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– Taking into account the clinical needs of nearly half of the population of our country, requiring constant health checks due to chronic diseases, as well as the crisis in the health care system related to the COVID-19 epidemic and staff shortages, satisfactory and optimal solutions should be developed for all stakeholders of the system – points out the president of the National Cancer Federation.

The patient must have the right to decide

Magdalena Kołodziej, the president of the MY Patients Foundation, emphasizes that it is important to respect the patients’ right to be able to decide in what form they want to fulfill their need to contact medical staff.

– We are at the stage where it is necessary to standardize telemedicine services and provide system support for their implementation. We expect support for the development of telemedicine towards more advanced solutions, supporting the patient in controlling the course of his treatment or chronic disease. Just like traditional services, television visits should be subject to quality control and develop in order to constantly improve their quality – Kołodziej writes.

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– We appeal to the Minister of Health not to introduce legal regulations that would make this process impossible due to the inability to offer patients a TV visit. We emphasize once again that not an order, not a prohibition, and the possibility of choosing is crucial from the patient’s perspective – emphasizes the president of the MY Patients Foundation.

Declaration – who signed it?

The list of signatories of the Declaration includes:

1. Federation of Polish Patients
2. MY Patients Foundation
3. Children’s Heart Foundation
4. Telemedicine Foundation Working Group
5. IT and Telemedicine Commission of the Polish Society of Cardiology
6. Supreme Medical Council
7. National Cancer Federation
8. National Association of Patients with Heart and Vascular Diseases “EcoSerce”
9. Polish Federation of Education in Diabetology
10. Polish Federation of Hospitals
11. Polish Diabetes Association
12. Polish Association of People with Heart Failure
13. Polish Diabetes Society
14. Polish Society for the Advancement of Medicine, Medicine XXI
15. Private Medicine Employers
16. Employers of the Republic of Poland
17. Marfan Polska Association
18. Association of Metal Hearts
19. Association of People After Heart Transplant New Heart
20. Association of Heart Operators
21. Heart Transplant Association

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