More information
Description
The main objective of the project is to improve the access of 520 people (including a minimum of 260 women) who meet the inclusion criteria, among them at least 52 people (minimum 10%) originating from excluded areas (counties where the mean per capita income is lower than the national average) to health care benefits, mostly via telemedicine, according to the assumptions of model no. 5 “Chronic diseases.”
Summary of project results
MAIN OBJECTIVE:
to increase access to health care services, mainly telemedicine, for 520 persons (including a minimum of 260 women) meeting the inclusion criteria (age => 18 years with a diagnosis of COPD, who have given written informed consent to participate in the project), including at least 52 persons (a minimum of 10%) from excluded areas (counties with an average income per capita below the national average), in accordance with the assumptions of the ‘Chronic Diseases’ model improving prognosis in the treatment of COPD.
The main objective is the levelling of social inequalities in access to health care, by limiting the factor of place of residence and income achieved, thanks to the use of telemedicine, which overcomes geographical limitations in access to outpatient specialist care (in centres far from the supply of specialists, i.e. in villages and small towns far from large agglomerations) and incorporates primary care outpatient clinics (with a nurse) into care close to the patient - using remote contact with a specialist and personal contact with a sub-primary care doctor
The main objective was realised by achieving SPECIFIC OBJECTIVES:
1. increase quality of life, independence and sense of health security and access to outpatient specialist care
2. validation of the effectiveness of the investigational model as a tool to improve the prognosis of patients, in collaboration between PCPs, AOS and the use of assumed telemedicine tools,
3. optimisation of health services for people with COPD, which will allow to increase the emphasis on activities related to secondary prevention and health education, involving in the first place the primary care physician, and only in situations requiring it - a specialist, and more extensive inclusion and involvement of the patient (and/or hypothetically his/her guardian - formal or legal) in taking care of his/her own health and the process of treatment, through the use of telemedicine solutions and health education.
The project had a pilot character in order to introduce (implement) a new method and accompanying organisational and technological solutions (platform, devices) in an area where current models and schemes of therapeutic and diagnostic support were insufficient. The project made it possible to check whether the planned activities are having the desired effect.
Action – Preventive and promotional activities in the area of public health
- The project was supported by preventive and promotional activities, carried out both by the Project Leader and by the Partners, addressed to the group of patients receiving support.
-The Communication and Recruitment Plan included activities aimed at increasing the public’s awareness about the existence of Norwegian and EEA Funds, their goals, bilateral cooperation with entities from Norway, as well as their implementation, results, and the impact of these projects.
-Radio spots were created and broadcasted, with their airing time adjusted to recruitment opportunities to achieve the best possible effect.
- A project website was created, along with a promotional panel.
- A communication system was developed for partners, patients, contractors, and the Leader''s accounting department.
- Throughout the project period, meetings, conferences, and other events were organized to inform and educate about the project’s assumptions.
- During the closing conference, promotional materials about the project’s indicators and results were presented. These materials, created during the project, were translated into English for distribution during the conference trip to Norway, where an exchange of experiences took place with Norwegian telemedicine program participants and technology providers for telemedicine tools.
- The visit to Norway took place from 14th to 17th January 2024, including a visit to the Norwegian Partner’s headquarters, covering the scope of the completed project. Promotional materials, indicators, and results were presented.
Activities carried out in the project:
1. Opening Conference of the Project combined with a Health Picnic, Date: 22.06.2023, Number of participants (on-site and remote via teleconference): 73, o 23 representatives from the medical and scientific communities, 50 patient representatives
2. Telemedicine Workshops for Patients, Date: 19.04.2023, 10 patient representatives,
3. Closing Conference of the Project, Date: 21.12.2023, Number of participants (on-site and remote via teleconference): 50,
4. Field Conference at the University of Drammen, Date: 14-17.01.2024, Number of participants: 18
5. Telemedicine during Polish Armed Forces Day, Date: 15.08.2023, Number of participants: 34
6. White Saturday at Magnolia Shopping Center – Wrocław Health Promotion Days, Date: 09.09.2023, Number of participants: 28
7. White Saturday for Seniors at the “Dobrzyńska” Medical Center, Date: 07.10.2023, Number of participants: 19
8. Telemedicine at the Third Age University, Date: 19.10.2023, Number of participants: 48
9. White Week for the beneficiaries of the Municipal Social Services Center, 100 participants
Action – Testing model solutions in partnership with Primary Health Care entities
1) The applicant, along with the partners, carried out a pilot of telemedicine solutions, in accordance with model "chronic diseases."
2) In the pilot, the technology partner purchased and adapted a telemedicine platform for the purposes of the project, enabling patients—participants in the project—to remotely complete surveys.
3) The internet platform used in the project allowed the collection and management of medical data as well as the provision of services (including scheduling appointments, consultations, and remote monitoring, remote data acquisition from the integrated spirometer).
4) The platform meets the following conditions:
a. It is available at the specified web address.
b. It operates as a website that can be accessed on a PC (or MacOS) and mobile devices (smartphones/tablets with Android/iOS operating systems).
5) The platform had the function of downloading data from interconnected spirometers.
Patient recruitment was carried out through:
• Phone contact – information about the project;
• Scheduling an initial "zero" visit upon the recommendation of the primary healthcare doctor, also during organized events;
• Making an appointment during hospitalization – after exacerbation of COPD symptoms
The patient/caregiver was recruited within the primary care setting. It was not required for the patient to be registered at a given Primary Health Care Facility, people from outside a given Facility were also admitted who, as a result of information and promotional activities, received information about the possibility of joining the project.
Under the Program, the patient received access to education in which he was provided with:
- in electronic form and in the form of printed materials
- information and recommendations regarding his health condition, compliance with medical recommendations and lifestyle recommended for patients at risk of COPD exacerbation,
- Application installed on your own phone with Internet access or an electronic device (tablet) borrowed free of charge during the visit initiating participation in the project, if the patient did not have access to the Internet, an easy-to-use spirometer that allowed you to independently measure your respiratory parameters at home and provide information directly to the project staff via a telemedicine platform . Summary of participation in the project in the form of a document that could be submitted to the attending physician after completion of participation in the project, additionally containing the results of spirometry performed during the project. In order to develop the best standards of medical care for patients diagnosed with COPD, at each visit planned as part of the program, we obtained the patient''s opinions and comments on whether the solutions used were understandable, purposeful and whether they brought satisfactory results, using standardized ex ante and ex post surveys, the patient and the doctor had the opportunity to assess their participation in the project, the Project Staff observed and described the patient''s health condition on the telemedicine platform and notified him of any exacerbation of disease symptoms, which required consultation with a specialist. As part of the project, the primary care physician received an interview template on the telemedicine platform, which allowed for efficient analysis of the patient''s condition remotely during consultations between the primary care physician and the pulmonologist.
Action – Purchase of equipment for testing Model Solutions
As part of the task, equipment and devices were purchased, which will enable the implementation of the project and subsequent testing of model solutions. The following equipment was purchased to facilitate the execution of the project, including:
15 sets of computers were purchased for doctors and physiotherapists (nurses).
50 tablets for patients who do not have equipment enabling Internet access.
and 30 spirometers.
Thanks to the implementation of the action, patients were provided with equipment that allowed them to gain benefits in the form of: increased awareness and access to reliable knowledge about the possibilities of therapy and rehabilitation in the case of COPD, through adequate care and health education, focused on lifestyle changes, in particular smoking cessation, the ability to monitor the disease in people who until now had been deprived of - adequate to their needs - care from a specialist pulmonologist, reinforced by the involvement of a primary care physician. Access to reliable information increased independence and a sense of health security in the population of COPD patients. The equipment improved communication on the telemedicine platform for both patients and doctors. Thanks to the purchased equipment, primary care physicians had access to ongoing consultations on the condition of patients with a pulmonologist. During each visit, they could support themselves with digital tools, such as a template for assessing the patient''s health condition.
Three publications were created based on the project’s results:
Polish Medical Journal:
THE FRAMEWORK OF THE PILOT PROJECT FOR TESTING A TELEMEDICINE MODEL IN THE FIELD OF CHRONIC DISEASES – HEALTH CHALLENGES AND JUSTIFICATION OF THE PROJECT IMPLEMENTATION
Medical Science Pulse:
IMPLEMENTATION OF TELEMEDICINE SOLUTIONS IN THE FILD OF CHRONIC OBSTRUCTIVE POLMONARY DISEASE: RISK MANAGEMENT AND REMEDIAL ACTIONS
Medical Advances:
CHALLENGES AND OPPORTUNITIES IN IMPLEMENTING TELEMEDICAL SOLUTIONS FOR COPD MANAGEMENT IN THE POLISH HEALTHCARE SECTOR: A PRSENTING OWN EXPERIENCE
Achievements:
- Increased access to health services, especially telemedicine
- Improvement of the patient’s quality of life, increase of the sense of security regardless of the place of residence
- Possibility of early medical intervention through a telemedicine platform
- Predicting worsening of COPD through telemonitoring of symptoms in the patient’s home
- Detection of worsening of COPD symptoms, reducing the adverse effect on patient’s health
The indicator was achieved as part of the result of the Program, which allowed the achievement of the project objective for almost half of the assumed indicator concerning the number of patients, increasing access (reducing inequalities in access), also for patients from excluded areas to health services, including telemedicine, in accordance with the assumptions of the "Chronic diseases" model, through the applied improvements using diagnosis/treatment using telemedicine. Thanks to the implementation of the action, patients were provided with benefits in the form of: increased awareness and access to reliable knowledge about the possibilities of therapy and rehabilitation in the case of COPD, through adequate care and health education, focused on lifestyle changes, in particular smoking cessation, the ability to observe the disease in people who until now had been deprived of - adequate to their needs - care from a specialist pulmonologist, reinforced by the involvement of a primary care physician. Access to reliable information increased independence and a sense of health security in the population of COPD patients, but also increased access to knowledge about this disease for all people interested in learning about it.
Achievement of indicators:
1. number of beneficiaries (women) to whom services are provided or improved (using diagnosis/treatment with the help of telemedicine) - 143
2. number of beneficiaries (men) to whom services are provided or improved (using the diagnosis/treatment with the assistance of telemedicine) - 110
3. number of persons declaring satisfaction with the services received with the help of new e-health methods according to the implemented model - 253
4. number of people declaring satisfaction with services received with the help of new e-health methods according to the implemented model (women) - 143
5. number of persons covered by the telemedicine service - 253
6. number of health care services provided using the purchased modern equipment - 271
7. number of PCUs covered by telemedicine services - 9
8 Number of organisations (POZ, foreign partners, patient organisations, national partners) which cooperate with the Leader in conducting and validating the project - 12
9. territorial scope of the project: number of counties from which residents participate in the project - 4
10. experience of the applicant and partners: Number of entities which have experience in implementation of at least one project in the field of e-health or telemedicine - 5
11 Information and promotion Number of information and education campaigns carried out among patients - 1
12. bilateral cooperation: Number of partnerships established with a Norwegian entity (bilateral cooperation) - 1
13. number of patients for whom waiting time for an appointment with a specialist was shortened as a result of provision of the telemedicine service - 253
14. increase in the level of knowledge on the use of on-line medical services among project participants - 253
15. increase in the level of knowledge about COPD according to the model, in the way of its diagnosis, principles of prevention and treatment with the involvement of telemedicine, among the participants of the project - 253
Summary of bilateral results
Conference meetings held by the project team in Norway allowed the use of a professional comparative survey, with the help of which telemedicine project implementers from Poland and Norway could analyze the differences in the way they work on these projects and plan possible cooperation in the exchange of experiences. The project team familiarized itself with the methods used in telemedicine by Norwegian technology companies, which have been gathering experience in this area longer than their Polish counterparts. The information obtained was used to create a database of possible technological requirements, which will be used in the descriptions of the subject matter of the order when planning subsequent telemedicine projects. Cooperation with the Norwegian Partner was carried out through consulting on project activities during meetings of the Steering Committee. This provided support in the substantive aspects of the project. The experience of the Norwegian Partner was utilized in preparing the platform, documents, and project procedures, as outlined in the Project''s Regulations.2) The Norwegian Partner presented telemedicine solutions operating in Norway and shared their experience during the project’s opening conference and closing conference.3) In collaboration with the Norwegian Partner, the project team participated in conference meetings with Norwegian telemedicine project implementers and representatives from companies developing telemedicine solutions.19 meetings with the Norwegian Partner were a result of the course of the project and its participation in the Project Steering Committee. The Norwegian Partner participated remotely in the Opening and Closing Conferences of the Project.