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Description
The aim of the project is to carry out and test under real conditions an implementation project in the field of telemedicine in cardiology: “Telemonitoring of patients with heart failure”, as well as carrying out prevention activities in this area. Implementation of the pilot project will contribute to the achievement of the Health Programme result, which is reducing social inequalities in health, including improved access to health care services in the field of telemedicine and e-health, and Result 1.1 of the Programme: Improved access to health care services (telemedicine and e-health).
The aim of implementing this telemedicine-based care model is to prevent heart failure exacerbations and cardiovascular deaths. With thorough care and an educational panel, emphasis will be put on prevention.
Summary of project results
Heart failure is a very big problem not only in Poland but also in the world. It is called the epidemic of the 21st century. It is a very serious disease that affects a large percentage of the population. Previous data indicated that there are about 750,000 people with heart failure in Poland. Realities, costs, suggestions for improving the situation from December 2020 indicates over 1.2 million patients. Moreover, it is predicted that over the next 10 years the number of patients with heart failure will increase by about 25%. Another problem is the high rates of hospitalizations due to heart failure in Poland compared to member states of the Organization for Economic Cooperation and Development (OECD). Annually, the number of hospitalizations due to heart failure in Poland exceeds 300,000. Additionally, it is estimated that it will increase and in 2025 it may increase by as much as 25%. The average age of a person with heart failure in 2018 was 75 years, but this does not mean that heart failure is only a disease of the elderly. Every tenth patient is under 60 years old. Heart failure is the leading single cause of death in Poland. In one third of cases, heart failure is the direct cause of death, in the remaining cases - a significant syndrome accompanying other diseases.
The aim of the project was to conduct and test in real conditions an implementation project in the field of telemedicine in the field of Cardiology. The aim of implementing the described model of care based on telemedicine is to prevent exacerbations of heart failure and cardiovascular deaths. Through thorough care and an educational panel, emphasis was placed on prevention.
The pilot program used a dedicated internet platform, which served to coordinate activities around the patient and as an educational tool for patients.
The platform was intended to enable doctors and nurses to obtain and manage medical data, and also was a tool for providing services, such as teleconsultations and remote monitoring. Such a care model assumes comprehensive patient care with effective use of medical resources. It was patient-oriented, and a group of specialists worked around the patient to improve their prognosis and quality of life through the integration of hospital care, outpatient specialist care and primary health care.
The project management team (Project Manager together with project coordinators) cooperated on an ongoing basis with the other groups: cardiologists, partners in the project - Healthcare Services and Norwegian Partner - University of Stavanger (Norway) to develop the best possible solutions for the proper implementation of the project and to solve current problems related to project implementation. For the implementation of the project, tenders were initiated for the equipment necessary for the implementation of the pilot (tenders for the purchase of scales, blood pressure monitors, computers, tablets and platform).
A flyer was created to promote the project, informing the public about the project, the partners and the benefits of participating in the project. A poster promoting the project was also designed. The flyers and posters were placed at the project partners, as well as at the Institute in the Department of Cardiology. An instructional video necessary for patients as well as medical staff was produced. The patient handbook was replaced by the instructional video mentioned above. A website dedicated to the project was created. 550 flash drives were purchased for patients participating in the project, on which test data from the platform was provided, as well as an instructional video:
- (https://drive.google.com/file/d/1RcMInWmmDC8GK1pFcdz9LyGuJdm9P9cB/view?usp=sharing).
The project was also promoted on the regional TV channel, in the program "The Power of Health" :
- https://tvtoya.pl/program/potega_zdrowia?vid=29387.
The project was also promoted through an organized press conference at the Beneficiary''s headquarters - a lot of information about the project was published in the regional press and television, on the Institute''s social media, and on the following websites:
- https://lodz.tvp.pl/72879556/pacjenci-z-niewydolnoscia-serca-moga-skorzystac-ze-wsparcia-telemedycyny,
- https://radiolodz.pl/telemedycyna-w-matce-polce-projekt-skierowany-do-pacjentow-z-chorobami-serca-zdjecia,293220/,
- https://www.eska.pl/lodz/nowy-program-w-centrum-zdrowia-matki-polki-pomoze-w-monitorowaniu-stanu-zdrowia-aa-6kHL-nTCs-zoU2.html,
- https://lodz.wyborcza.pl/lodz/7,35136,30209483,w-iczmp-rozdaja-cisnieniomierze-telemedycyna-ma-pomoc-pacjentom.html.
A scientific conference on the project was held on 12.12.2023 with the participation of guests from the University of Stavanger (project partner from Norway) and the Mati and Child Institute in Chisinau (Moldova). The conference summarized the assumptions and activities carried out in the project, as well as in a panel discussion the advantages and disadvantages of telemedicine, its assumptions and implementation.
At the end of the project, a publication on the summary of activities in the project was realized. The period of recruitment and subsequent patients'' stay in the project was shortened optimally. In the end, 402 patients were recruited to the project.
Implementation meetings were held with the partners every two weeks. The Healthcare Center''s educator informed about the project''s documentation, patient recruitment opportunities and the progress of the project. Institute cardiologists and nurses held a series of meetings and phone calls to recruit patients to the project, as well as monitored patients participating in the study. There were 2,000 consultations on the platform. All patients were also pre-screened inpatient by cardiologists from the Institute.
Tender proceedings for the purchase of blood pressure monitors, IT equipment (computers and tablets), as well as platforms and scales have been resolved. Blood pressure monitors (550 units), scales 9550 units), 12 computers and 51 tablets have been delivered to the Project Promoter. Problems with the use of the developed telemedicine system were corrected on an ongoing basis, taking into account all comments from cardiologists and nurses, as well as the project administration and interviewers.
On 30.08-03.09.2023, the project manager, 2 coordinators and 2 cardiologists participated in a study visit to the Norwegian partner in Stavanger at the University. Meetings were held with academics involved in R&D projects, as well as with cardiologists. Preliminary discussions were also held regarding another study visit in January to the Norwegian partner in Oslo. In January 2024, another study visit of the Polish team to Norway, in Oslo. Meetings were then held with academics involved in research and development projects, as well as with cardiologists at the university hospital. Preliminary discussions were also held regarding further cooperation on future projects. There were no problems in the implementation of the task, only the date of the study visit was postponed from June to the end of August 2023.
Cardiologists from the Pilot Management and Evaluation Group, after analyzing the activities and data from the platform, shared their experience in a publication on the project.
The implementation of the pilot project contributed to achieving the result of the Health Program, which is to reduce social inequalities in health, including improving access to healthcare services in the field of telemedicine and e-health and Result of the Program: Improved access to healthcare services (telemedicine and e-health).
Due to the project, the organizational know-how and medical experience of doctors reached hihg level and it will be used in the future.
402 idividuals were examined . Cooperation with Partners, including the Norwegian Partner, brought many benefits and the exchange of practices in the healthcare and telemedicine sectors."
To conduct the pilot, a telemedicine platform was leased and adapted for the purposes of implementing the ""Geriatrics"" model. This allowed for increased access (reducing inequalities in access) for people over 60 years old, including those from excluded areas, to healthcare services, including telemedicine, in accordance with the assumptions of the ""Geriatrics"" model. It also involved providing them with screening tests to improve prognosis by detecting malnutrition, sarcopenia, and frailty syndrome.
As a result of the project implementation, patients gained access to doctors, which gave them a sense of greater care. Patients from remote villages could participate in the project through remote monitoring of vital signs, and if necessary, stationary visits to a cardiologist were possible.
The awareness and access to reliable knowledge about medical care was increased through adequate care and health education focused on lifestyle changes, especially for individuals with overlapping health conditions. Access to reliable information enhanced independence and the sense of health security in the 60+ population.
Summary of bilateral results
The Norwegian partner, the University of Stavanger, provided substantive and opinion support in the project. Topics of further cooperation on further international projects related to the development of telemedicine were also discussed. The Norwegian partner participated in online meetings, which were held regularly every 2-3 months (5 meetings were held) and 2 meetings during study visits in Stavanger and Oslo. At the meetings, the most important assumptions and problems of the project were discussed and possible solutions were developed. The Norwegian partner participated, during a study visit to the Project Promoter, in a scientific conference summarizing the project. Bilateral cooperation enabled mutual understanding of issues concerning telemedicine and its comparison between the two countries. Good practices were exchanged and numerous presentations were listened to during study visits and conferences. The participation of the Norwegian partner is an added value of the project.