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Description
The main objective of the project is to show how information and communication technologies can support the process of diagnosis and treatment of patients with COPD. The project aims to facilitate access to specialist consultations and to facilitate the flow of information between patients, PHC physicians and specialists. The proposed patient-centric telecare model will utilise a web-based platform for patient coordination and as an educational tool for patients. The proposed solution will reduce social inequalities in health by also enabling patients in localities far from specialist centres to receive specialist consultations. Video consultations with specialists and assistant support provided to patients after severe exacerbations of COPD (or at risk of frequent exacerbations) are aimed at preventing further exacerbations (including rehospitalisation) and improving chronic disease self-management.
Summary of project results
In Poland, the number of chronic lung disease patients ranges from 2 to 2.5 million. The disease is diagnosed in the early stages in about 20% of patients. Most patients learn about it in the advanced stage of the disease. The older the population, the higher the incidence. In Poland, about 500 thousand patients are treated. Risk factors for the disease include smoking cigarettes, using IQOS, exposure to dust and atmospheric pollution, the occurrence of asthma, recurrent respiratory infections in childhood. The treatment is a process consisting of many elements, a significant part of which can take place in primary health care (PHC) conditions. Currently, the Polish health care system does not have a tool that would allow for education of patients in the field of lifestyle and therapy, as well as facilitation of cooperation between primary health care facilities and respiratory disease specialists.
The telemedicine solution proposed in the project assumes easier access to specialist consultation and after stabilization of the patient''s condition, transfer of the patient to the care of a primary care physician. Supporting activities for the patient after discharge from hospital due to severe exacerbation of disease have also been planned. An important element of the proposed solution is to facilitate access of patients to knowledge about the disease, its prevention and therapy. Cooperation between primary care physicians and specialists using the telemedicine system allows for the preparation of an individual therapy plan for the patient containing recommendations regarding pharmacotherapy, lifestyle, rehabilitation, preventive vaccinations, oxygen therapy, recommendations for consultations with other specialists.
The main objective of the project was to show how information and communication technologies can support the diagnostics and therapy process for patients. The project aimed to facilitate access to specialist consultations and to facilitate the flow of information between patients, primary care physicians and specialists. The proposed patient-centric telecare model used an Internet platform that served to coordinate activities for the patient and as an educational tool for patients.
The project involved the Project promoter and 7 Partners, together with a Norwegian partnership.
During the project work was initiated on establishing communication requirements for the advertising spot and the content of leaflets and posters, in cooperation with project partners. An information campaign was launched on the project promoter''s and partners'' websites, remote meetings were held to prioritize promotional activities, and steps were taken to select the implementer of promotional activities, which took place until December 31, 2023.
Informational materials such as educational posters and flyers were prepared, designed and produced and distributed to partners. An information and promotional video was produced and published on hospotal''s social media, on the project website and on information screens at the hostpital in Gansk. An open educational webinar was also conducted and participated in a conference summarizing an analogous telemedicine project in Glucholazy.
A closing conference was held, attended by partners, organizations involved in the project, and patients. At the conference, the results of the project were discussed, lessons were learned, and assumptions were made for the continuation of activities in the standard treatment activities. In parallel, a “Patient Debate on Telemedicine” was held, organized jointly with the Lung Cancer Association. Activities were widely promoted in the media and on the project website. The results of surveys on patients'' knowledge of COPD and the usefulness of telemedicine technologies were summarized, with more than 500 responses. Promotional activities contributed to increased health awareness and recognition of the project among patients and partners.
The project aimed to test the feasibility of supporting the diagnosis and treatment of chronic lung disease patients using telemedicine technologies. 700 video consultations were carried out, including 368 with a pulmonologist, during which individualized therapeutic recommendations and consultations were developed. A diagnosis of the disease was confirmed in 180 patients.
The interdisciplinary diagnostic and therapeutic care was provided to 39 patients, 32 of whom completed the process as outlined in the project, receiving comprehensive support and individualized recommendations.
The project team developed assumptions about the functionality of the telemedicine platform. During numerous meetings, the functional scope of the platform was defined, taking into account the roles of doctors, nurses, coordinators, educators, assistants and patients. A specialist consultation referral module, patient and medical staff satisfaction surveys were implemented on the platform. At the University Clinical Center in Gdansk, the information system was updated, adding patterns of specialized visits and recommendations for patients after consultations. A method for exchanging data between the telemedicine platform and the system was established. Eight Spirolab spirometers with pulse oximeters and computer equipment for the project promoter and partners were purchased. Tests were conducted to integrate the spirometers with the platform, and training on the use of the equipment and treatment algorithms was organized for the staff.
Additional diagnostic equipment, including pulse oximeters with hubs for telemonitoring, was purchased until 31.12.2023. Technology partner Medily Sp. z o.o. launched a telemedicine platform that supported various user roles and modules, such as patient data collection, scheduling, surveys, and medical record templates. Tests of spirometers showed the ability to download results directly to the database, but due to the dynamics of the project, results were saved as files on the platform. The Patient Portal was made available, configuring it according to project requirements, and mechanisms for reporting visit data.
The project website pacjentwcentrum.ptpz.pl was lounched where information about the project was posted. The project team developed and selected a project logo and prepared content for promotional flyers and posters. The assumptions for the production of a promotional spot were also prepared and the scope of information to be presented during the opening meeting and webinars was planned. Speakers were selected in accordance with the topics of the established issues. Later on activities focused on the organization of training sessions and production of promotional materials. Technology partner provided training for various roles in the project, including doctors, specialists, nurses, coordinators and assistants, on how to use the telemedicine platform. A webinar to summarize the halfway point of patient recruitment was held in October 2023, with discussions including the exchange of medical data between systems, coordination of patient care, and the Norwegian telecare experience. The webinar was broadcast online.
The production of an advertising spot, as well as flyers and posters, which were delivered. A study visit to Norway (January 15-17, 2024) and a project summary conference (January 20, 2024) were organized. During the press conference, the results of the project were presented to the media, including Radio Gdansk and TVP3. Assumptions were prepared for scientific publications describing the developed medical and non-medical management algorithms for both groups of patients. Assumptions were also developed for a model of cooperation between specialists (hospital) and Healthcare Facilities in the care of patients with chronic lung disease.
The implementation of the project reduced social inequalities in health by enabling patients from towns distant from specialist centres to receive specialist consultations. Video consultations with specialists and support from assistants provided to patients after severe sickness exacerbations (or from the risk group of frequent exacerbations) were aimed at preventing further exacerbations (including rehospitalisation) and improving self-coping with chronic disease.
Patients benefited from consultations with a team of specialists, including a physiotherapist, psychologist and nutritionist, and received regular support from a patient assistant.
The implementation of the project contributed to the implementation of effective management algorithms, facilitated the flow of information between patients, Healthcare Facilities and specialists, and improved patient education on how to manage the disease. The results of the project confirm the effectiveness of telemedicine as a tool to support the treatment of patients with chronic lung disease and its potential to optimize the health care system.
Survey results and acceptance of telecare are as follows:
- In total, more than 900 surveys were conducted: 411 via the platform and 500 on paper;
- High acceptance of telecare: 90% of respondents (252 out of 278 patients) rated telecare as equivalent or better than standard care;
- Better than standard care: 52% (147 people) rated telecare as more effective than existing standard care;
- Satisfaction with the project: 85% of patients were satisfied with their participation in the project, most of whom would recommend it to friends.
It is also worth mentioning that information and promotional activities carried out in a systematic and multi-channel manner contributed to the successful implementation of telemedicine solutions and increased awareness of their potential in the care of patients with chronic lung disease.
The measures taken enabled the effective implementation and use of the telemedicine platform and diagnostic equipment, contributing to improving the quality and efficiency of patient care under the project.
Summary of bilateral results
Cooperation with the Norwegian partner was scored very high. The partner participated in project team meetings on a permanent basis. Knowing exactly how the project is progressing, the Norwegian partner shared information about its experiences and referred to the progress of the project in a webinar (October 2023) entitled ‘Summary after the halfway point of patient recruitment’, held for all project participants and invited guests from parallel projects. During the webinar, the issues of exchange of medical data between different IT systems, interoperability from the perspective Project Promoter, patient care coordination issues - lessons learned, Norwegian experience in telecare, a report on the visit to the E-Health Centre in Tromso (Norway), and a discussion of current issues in project implementation were discussed. The Norwegian partner organised a visit to Norway (in Drammen and Oslo) from 15-17 January 2024, which was attended by representatives of the partners and the beneficiary. During the visit, a number of meetings were held with representatives of the university, teaching hospital, local administration with information and education on the Norwegian model of care, and a visit to the medical innovation centre in Oslo took place. Communication with the Norwegian partner continues to be maintained by the Project Promoter with the aim of seeking new areas of cooperation and opportunities to obtain funding for innovative implementation projects. The sustainability of the project will be ensured through the implementation of an internal project for the improvement of UCK''s activities, in terms of cooperation with primary care units