Telemedicine, eHealth, and Digital Transformation in Poland (2014–2024): Trends, Specializations, and Systemic Implications

Abstract

Background: Between 2014 and 2024, Poland underwent a significant digital transformation in its healthcare sector, evolving from isolated initiatives to a cohesive national eHealth ecosystem. This review examines the development, clinical significance, and research trends in telemedicine in Poland, providing comparative insights from 1995 to 2015 and assessing the impact of the COVID-19 pandemic. Methods: A narrative review was conducted using the PubMed, Scopus, EMBASE, and Web of Science databases to identify peer-reviewed articles published between January 2014 and December 2024. A total of 1012 records were identified, and 212 articles were included after applying predefined inclusion criteria. These articles were categorized by medical specialty, study type, COVID-19 relevance, and clinical versus nonclinical focus. Gray literature and policy reports were examined only to provide a context for the findings. Results: Ninety-six publications were included in the clinical studies. The most common specialties are cardiology, psychiatry, geriatrics, general practice, and rehabilitation. In earlier years, survey-based and observational designs were predominant, whereas later years saw an increase in interventional trials and studies enabled by Artificial Intelligence (AI). The COVID-19 pandemic has had a significant impact on research activity, accelerating the adoption of digital technologies in previously underrepresented fields, such as pulmonology and palliative care, as well as in the routine use of modern Internet communication technologies for daily patient–doctor interactions. Discussion: Advancements in digital health (including eHealth and telemedicine) in Poland have been driven by policy reforms, technological advancements, and epidemiological events, such as COVID-19. Various fields have evolved from feasibility studies to clinical trials, and emerging specialties have focused on user experience and implementation. However, the adoption of AI and its interoperability remains underdeveloped, primarily because of regulatory and reimbursement challenges. Conclusions: Poland has made significant strides in institutionalizing digital health; however, ongoing innovation necessitates regulatory alignment, strategic funding, and enhanced collaboration between academia and industry. As the country aligns with the European Union (EU) initiatives, such as the European Health Data Space, it has the potential to lead to regional integration in digital health.

1. Introduction

Digital health encompasses various technologies, including artificial intelligence (AI) in healthcare, telemedicine, eHealth, big data analytics, and connected devices, which are transforming the way care is delivered, making it more efficient, personalized, and accessible [1,2]. It also encompasses AI, wearable devices, and mobile health (mHealth). The digital transformation of healthcare has profoundly altered the delivery, access, and management of services across Europe [3,4]. Telemedicine is defined as the use of communications networks for delivering healthcare services and medical education from one geographic location to another, designed to overcome issues like uneven resource distribution and accessibility barriers [5,6,7]. It typically involves real-time, two-way communication between a patient and a healthcare provider for clinical purposes, such as consultation, diagnosis, and treatment [8]. Telemedicine refers more specifically to the provision of healthcare services at a distance, including diagnosis, treatment, prevention, and health education, through the use of telecommunication technologies [9,10,11]. It involves recent, rather real-time, or rarely asynchronous interactions [12] between healthcare professionals and patients (or between professionals). It is recognized in Poland as a regulated form of medical service.

Both definitions by the European Commission’s eHealth framework and proposed earlier by the Polish Telemedicine Society, which adds medical professional liability to the definition of real telemedicine [13], are followed. eHealth is defined as ‘the use of information and communication technologies locally and at a distance’ to support and enhance healthcare, public health, and health education [14,15]. Digital health transformation reshapes how health services are delivered, public health is protected, and chronic disease is managed and prevented [16,17].

In Poland, telemedicine and eHealth have played a central role in this shift, driving a decade-long evolution toward more accessible, efficient, and patient-centered care [18,19,20]. Between 2014 and 2024, Poland transitioned from fragmented digital health initiatives to a nationally coordinated eHealth (digital health) ecosystem [19,20,21]. This system integrates teleconsultations, remote monitoring, telerehabilitation, Electronic health records (EHRs), electronic prescriptions (e-prescriptions), mobile applications, and artificial intelligence (AI) tools for healthcare delivery [20,22]. This progress was propelled by a combination of policy, technological, and epidemiological factors. Telemedicine refers to the delivery of healthcare services at a distance using information and communication technology (ICT) [8,11,23]. eHealth encompasses broader digital health solutions including EHRs and decision-support systems [15,24,25]. The definitions used align with those of the WHO and European Commission (e.g., eHealth Action Plan 2012–2020). However, the definition of telemedicine proposed by the Polish Telemedicine Society before 2000 also addresses medical professional liability, which primarily distinguishes it from other forms of digital health [26]. This has recently been recognized by the EU [27]. Initially, telemedicine efforts in Poland led by academic centers or innovative clinicians lacked systemic integration [19,22,28]. The digitization of healthcare in Poland has thus far been not only technological but also regulatory. A breakthrough occurred in December 2015, when formal regulations enabling the use of telemedicine services were introduced into Polish law [18]. These changes are crucial for further development and institutionalization of digital health services. A pivotal transformation occurred with the legalization of teleconsultations, followed by the implementation of mandatory e-prescriptions, alongside e-referrals and the Internet Patient Account (IKP) [29,30,31,32]. These developments were facilitated by structural funding from the Ministry of Health (MH), National Health Fund (NFZ), and European Union (EU) structural funding [18,22,33]. Digital health initiatives were initially confined to academic experimentation and institutional solutions. However, by the mid-2010s, the formal legalization of teleconsultations and the establishment of nationwide platforms laid the foundation for a cohesive digital health infrastructure supported by EU funding and domestic policy frameworks [18]. The COVID-19 pandemic has accelerated the adoption of digital tools and telemedicine in primary and specialist care, demonstrating the adaptability of the Polish health system and highlighting challenges in interoperability, access, digital literacy, and regulations [34,35,36,37]. The pandemic spurred widespread adoption of telehealth across various clinical domains, with notable growth in psychiatry [38], cardiology [39], geriatrics [40], and rehabilitation [41], including increased use of mobile health applications [42,43,44,45,46] and AI-assisted diagnostics [47]. Healthcare stakeholders respond to scaling services and establishing standards for remote care.

This study aimed to analyze telemedicine and eHealth research in Poland from 2014 to 2024 by exploring thematic trends, clinical relevance, and digital health initiatives across various medical specialties. By comparing this period with 1995–2015 [28], this study assesses the maturity of Poland’s digital health ecosystem and identifies key challenges and opportunities. It examines thematic trends and clinical relevance, situating the country’s progress within a broader European context. This study seeks to synthesize trends, research areas, and the involvement of specialists across diverse medical fields where telemedicine and eHealth solutions have been implemented in Poland during the specified period. It identifies the enablers, barriers, and opportunities for regional leadership in digital health innovation.

2. Materials and Methods

A comprehensive and structured literature search was conducted using four major databases: PubMed, EMBASE, Scopus, and Web of Science.

2.1. Search Strategy and Data Sources

The search terms included combinations of “telemedicine,” “eHealth,” “digital health,” AND “Poland,” using Boolean operators (AND, OR). The search was limited to English-language publications. The initial query identified 1012 records, of which 852 were published between 2014 and 2024. After restricting the results to this timeframe and conducting deduplication and relevance screening, a final dataset comprising 212 peer-reviewed publications was selected for in-depth review. Duplicates were removed using EndNote’s deduplication function, followed by manual screening to ensure accuracy.

Based on the number of articles on specific specializations and fields, the most frequently represented ones (four or more articles from a given specialization) were selected, and field-specific comments were added. For comparison, the remaining articles (three or fewer articles) were analyzed and described collectively with references to Supplementary Table S1. To enrich the dataset and provide a policy context, the national context was considered based on gray literature, national reports, and strategic policy documents using targeted searches in the Semantic Scholar database, digital archives of the MH, NFZ, and Center of eHealth (formerly Central Center for Information and Health Systems (CSIOZ), and selected European health repositories. However, these studies were excluded from analysis.

2.2. Inclusion and Exclusion Criteria

Studies were eligible for inclusion if they met the following criteria:

• Centered in Poland, with a focus on telemedicine, eHealth, and digital health.
• The peer-reviewed articles focused on the implementation, evaluation, and development of the field.
• Reported on empirical data, pilot project results, implementation outcomes, and health policy evaluations.
• Provided insights into clinical outcomes, patient satisfaction, technological development, or institutional adoption.
• Clinical studies, pilot programs, policy evaluations, and health technology assessments.

The exclusion criteria were as follows:

• The studies were conducted entirely outside of Poland.
• Technical or engineering reports with no clinical or policy relevance.
• Editorials, conference-only publications, opinion pieces, or articles lacking empirical or methodological content.
• Studies unrelated to the Polish healthcare system.
• Purely technical articles lacking clinical or health system relevance.

2.3. Data Extraction and Classification

Two independent reviewers screened titles and abstracts to ensure their relevance. Disagreements were resolved through discussions or third-party arbitration. Full-text articles were assessed for study type, clinical focus, and relevance to the national health transformation. The extracted metadata are as follows:

• Journal and publication year.
• Study type (e.g., trial, review, survey, cross-sectional).
• Medical specialty (e.g., psychiatry, cardiology, and geriatrics).
• Intervention type (e.g., teleconsultation, AI diagnostics, mHealth).
• Clinical versus non-clinical categories.
• COVID-19 relationship (if applicable).

Conflicts in the data extraction were resolved by consensus or adjudication by a third reviewer. Descriptive statistics and thematic coding were used to identify specific trends, temporal shifts, and the impact of significant policy changes or events such as the COVID-19 pandemic. Visualizations were created to depict trends in publication frequency, specialty engagement, and evolution of study types.

Regardless of the structure of the narrative review studies, the PRISMA flowchart (Figure 1) was developed to emphasize compliance with the rigorous research methodology.

3. Results

Of the 1012 records identified, 256 met all eligibility criteria. Of these, 212 studies were classified as either clinical (n = 96) or nonclinical (n = 116). The number of telemedicine and eHealth publications has grown steadily over the past decade, with significant increases observed during the COVID-19 pandemic (2020–2022). The analysis of temporal trends and themes (captured by thematic codes) examined the evolution of telemedicine and eHealth in Poland across three phases: (1) the Pre-Pandemic Foundations Phase (2014–2019), (2) the Pandemic Catalyst Phase (2020–2022), and (3) the Post-Pandemic Maturation Phase (2023–2024).

In the first phase (2014–2019), Polish law formally recognized and accepted telemedicine in December 2015, and e-prescriptions, e-referrals, and online patient accounts (IKP) were gradually implemented [23,24]. The initial clinical focus during this period was on psychiatry, cardiology, and dermatology. In the second phase (2020–2022), teleconsultations will be mandatorily implemented, accounting for up to 80% of primary care visits and 79% of specialist visits. In this phase, e-prescriptions became mandatory, with 67% of users accessing them independently. The scope of the national pilot programs for remote monitoring, including heart failure and geriatrics, has expanded. The third phase (2023–2024) witnessed the implementation of AI-based diagnostics in cardiology [48] and mental health as well as the emergence of cross-sector partnerships, including collaborations with the space industry and EU agencies. A strategic focus is placed on digital skills, interoperability, and sustainability.

3.1. Distribution by Medical Specialties

The most frequently studied medical specialties were psychiatry (n = 35), cardiology (n = 25), geriatrics (n = 22), general practice (n = 21), and rehabilitation (n = 18). The emerging fields were assumed to have the lowest number of studies that had not been scientifically explored in the previous period. These fields include oncology, neurology, dermatology, and diabetes. Psychiatry and geriatrics had the highest proportion of nonclinical research, whereas cardiology and rehabilitation were more heavily represented in clinical investigations.

3.2. Study Types

Surveys and questionnaire-based research (n = 78) dominated the dataset, particularly for the newly engaged specialties. Reviews accounted for 64 studies, which are often used to map the early to moderately advanced stages of adoption. Clinical trials and interventional studies (n = 37) were focused on cardiology, geriatrics, and rehabilitation. The standards for mental health and chronic diseases were based on cross-sectional and observational designs (n = 49).

3.3. Impact of COVID-19

Approximately 25% of the included studies were related to COVID-19, either in design or context. In certain specialties, including infectious diseases, pulmonology, and geriatrics, COVID-19 has catalyzed the implementation of telemedicine and the initiation of studies. Notably, in fields such as palliative care and rehabilitation, the only research output identified during that decade was related to COVID-19.

3.4. Clinical vs. Non-Clinical Studies by Specialty

Clinical studies were predominantly conducted in the cardiology (80%), rehabilitation (78%), and general practice (67%) settings. Nonclinical dominance was observed in the domains of psychiatry, geriatrics, and public health.

3.5. Research Aims and Maturity Assessment

Studies in telemedically advanced specialties such as cardiology and rehabilitation have emphasized outcome measurement, integration into care pathways, and the implementation of AI. In contrast, studies on less mature specialties have focused on feasibility, user perception, and platform usability. These differences reflect the varying stages of telemedicine and eHealth maturity across different specialties.

3.6. Trends over Time

Between 2014 and 2016, the publication volume was limited and predominantly nonclinical. From 2017 onward, thematic diversification increased, with growing contributions from geriatrics, psychiatry, and cardiology. The COVID-19 pandemic marked a sharp inflection point, after which implementation-focused research gained prominence. Post-pandemic years have witnessed a gradual return to strategic evaluation and interoperability studies. Figure 2 presents the trend analysis of telemedicine and eHealth publications in Poland from 2014 to 2024.

There has been a steady increase in the number of publications since 2015, which is aligned with the formal legal implementation of telemedicine. COVID-19-related publications experienced a notable surge starting in 2020 and peaking in 2021 and 2022, reflecting the pandemic’s catalytic effect on research.

The comparison of two periods: 1995–2015 and 2014–2024 shows changes in the number of publications on telemedicine and eHealth by specialization (Figure 3).

An analysis of progress in telemedicine and eHealth has shown that, between 2014 and 2024, these solutions have evolved from niche innovations to integral parts of national healthcare systems. The COVID-19 pandemic has significantly accelerated these changes, highlighting the shortcomings of traditional healthcare delivery methods, and accelerating the implementation of remote services. Such interdisciplinary bridges connect and integrate the expanding digital infrastructure in healthcare in Poland, ensuring the flow of data, funding, and innovation between sectors, while protecting patients’ needs, rights, coverage, and accountability.

3.7. Detailed Analysis of Developments in Selected Specialties

In accordance with the described methodology, the most prevalent disciplines were thoroughly analyzed and discussed, with field-specific comments included. The remaining specialties, which had three or fewer articles, were collectively analyzed and described, with references provided in Supplementary Table S1.

3.7.1. Telecardiology

Over the past decade, telecardiology in Poland has evolved significantly, transitioning from feasibility studies to clinical trials, particularly for the management of heart failure. During the early phase from 2014 to 2016, prospective studies established the safety of home-based cardiac telerehabilitation [49,50,51,52,53,54]. This initial focus on telemedicine laid the groundwork for structured programs [52]. Between 2019 and 2021, studies validated portable electrocardiogram (ECG) devices against standard 12-lead ECG [39,55]. The COVID-19 pandemic accelerated the adoption of telecardiology [56], while also highlighting its limitations [57]. An app was introduced to manage atrial fibrillation [43], and trials assessed the impact of hybrid telerehabilitation on heart failure patients [58,59,60,61,62,63]. Selected trials developed interventions aimed at reducing hospitalizations [64], whereas studies examined teleconsultations [39,65,66]. A cost-effectiveness analysis evaluated hybrid telerehabilitation [67]. Reviews have analyzed telemedicine in cardiology and the impact of digital technologies [68,69,70,71,72], and AI applications have also been reviewed [73]. Natural language processing (NLP) algorithms have been developed to extract data from EHRs [74], and remote heart monitoring via VPG from drones has been explored [75]. Patient perspectives on telemedicine have also been evaluated [76,77]. Trials have assessed post-myocardial interventions [78,79,80], and studies have supported the safety of telerehabilitation after acute myocardial infarction [81], demonstrating benefits for heart failure etiology [82]. Telemonitoring in cardiac resynchronization therapy has also been evaluated [83]. Overall, during the study period, Polish telecardiology advanced from telerehabilitation studies to comprehensive remote monitoring systems bolstered by clinical evidence and technological advancements.

3.7.2. Teledermatology

The evolution of teledermatology demonstrates the integration of virtual tools accelerated by COVID-19, encompassing diagnosis, management, and patient care. Initially, Reflectance confocal microscopy with cloud-based telemedicine was assessed for dermatological consultations [84]. During COVID-19 (2020–2022), the pandemic has accelerated the adoption of teledermatology through virtual conferences [85]. Research has explored COVID-19’s impact on atopic dermatitiss [86] and its efficacy in skin cancer screening [87]. Reviews have evaluated melanoma management through teledermatology [88], while the role of mobile teledermoscopy in skin cancer management has been analyzed [89]. Surveys have shown a growing acceptance of AI and telemedicine among dermatologists [90], and studies have reported positive patient experiences during COVID-19 restrictions [91]. The role of teledermatology in managing sexually transmitted infections was examined during the pandemic [92]. Early teledermatology used advanced diagnostics for remote consultation [87,92,93]. COVID-19 has expanded teledermatology into clinical care and education, particularly in skin cancer screening. Mobile teledermoscopy [89] and virtual conferences [85] have become essential remote tools. Healthcare professionals are increasingly accepting of AI and telemedicine. Teledermatology has proven to be effective for chronic conditions and patient access during social distancing. Its expansion to sexually transmitted infections has broadened in scope. The reviews have highlighted the benefits and limitations of these approaches.

3.7.3. eHealth Development

The evolution of eHealth in Poland encompasses user acceptance, digital literacy, telemedicine solutions, and inequities, reflecting the pandemic and demographic challenges. Studies have examined internet usage and eHealth literacy among elderly populations [94,95]. An 8-item eHealth literacy scale validation enabled reliable measurements [96]. Research has explored eHealth acceptance among patients with chronic diseases [97] and machine translation of telemedicine data [98]. Studies have assessed user satisfaction during COVID-19 [99,100], while surveys have examined demographic factors affecting older adults’ engagement [101]. Geographic disparities were analyzed using the Theil Index [102]. Research has examined telemedicine for individuals with intellectual disabilities [103] and eHealth service use factors in Central and Eastern Europe [104]. The Polish eHEALS validation supported literacy measurement [105]. A virtual patient collection blueprint enhances clinical reasoning [106]. Studies have analyzed pandemic-driven eHealth usage [107,108] and digital health definitions [109]. Advanced analytics has been evaluated in omics research [110]. Studies have established adoption hurdles and validated literacy assessment tools. COVID-19 has accelerated adoption, while research has addressed inequities and vulnerable groups through inclusive design.

3.7.4. Emergency Medicine Telemedicine Development

Research on telemedicine in Poland has focused on collaborative efforts, technology-enhanced training, telemonitoring, and pandemic reviews to enhance emergency care delivery. Early initiatives have improved cross-border cooperation in emergency medical services (EMS) through regional coordination [111]. Telemedicine interventions have been piloted to improve the quality of cardiopulmonary resuscitation (CPR) among healthcare providers. A randomized trial showed promising results in augmenting resuscitation skills [112], whereas a pilot study evaluated telemedicine tools in simulated cardiac arrest scenarios [113]. Research on prehospital electrocardiogram (ECG) teletransmission has improved transport logistics and hospital admissions [114]. The COVID-19 pandemic prompted a review of telemedicine in emergency medicine, covering prehospital, in-hospital, and remote consultations [115]. Emergency medicine telemedicine initially focused on harmonizing cross-border EMS systems. Telemedicine platforms enhance emergency skill training and clinical competencies. ECG teletransmission expedited patient triage and cardiac care. This pandemic has accelerated the adoption of telemedicine in emergency medicine. Polish emergency telemedicine research emphasizes clinical applications rather than large trials or technological development.

3.7.5. Telemedicine and Digital Health Development in Laryngology (ENT)

Telemedicine in ENT is gaining traction in Poland, focusing on remote screening, mobile applications, and adaptation to the pandemic. A telemedicine model for hearing screening in children developed in Poland was adopted in Tajikistan, demonstrating the feasibility of remote auditory testing [116]. The COVID-19 pandemic prompted clinical recommendations for otolaryngologists regarding high-risk procedures [117] and guidelines for managing patients while preventing infections [118]. Surveys assessed the impact of the pandemic on the Newborn Hearing Screening Program in Poland [119]. Research has evaluated a mobile application for tinnitus sound therapy, showing therapeutic potential through telehealth platforms [120]. A multicenter study investigated COVID-19’s impact on head and neck cancer progression, addressing emergency airway management and telemedicine in acute care [121]. Trends in ENT telemedicine indicate that remote pediatric screening is among the earliest applications. This pandemic has influenced ENT practices and requires infection control guidelines. Service disruptions affect newborn hearing screening, highlighting the need for remote solutions. Digital therapeutics through mobile apps shows promise for patient support. Telemedicine remains vital in acute and oncological ENT care, with data showing delayed cancer diagnosis due to the pandemic. The integration of telemedicine reflects technological adoption and pandemic adaptation, while maintaining the quality of care.

3.7.6. Telemedicine in Gerontology

Advancements in this field highlight Poland’s efforts to promote telehealth adoption among older adults and healthcare transformations during COVID-19. The study “Patient Perspectives and Telemedicine Accessibility” (2017) examined Polish patients’ views on telemedicine, uncovering insights into senior barriers [122]. “The Impact of the COVID-19 Pandemic on Older Adults” assessed healthcare service utilization among the elderly during the pandemic [40]. The 2022 study “Clinical Telerehabilitation in Specific Geriatric Conditions” showcased telerehabilitation for managing pelvic girdle pain in geriatric contexts [123]. “Pilot Telemedicine Projects for Frailty and Malnutrition” described an initiative for geriatric patients with frailty syndrome [124]. Research on Polish telemedicine in gerontology is in its early stages with a focus on patient acceptance. Although telerehabilitation addresses specific geriatric issues, further clinical studies are needed.

3.7.7. Telemedicine and Digital Health Development in Medical Practice

In this field, telemedicine and digital health have grown significantly owing to COVID-19, focusing on teleconsultations, digital skills, and legal frameworks. Early studies from 2017 to 2020 explored the potential of teleconsultation in Polish healthcare [125]. Legal analyses have reviewed telemedicine according to European standards [18]. National surveys have examined public interest in electronic health records (EHRs) [126]. Trials have evaluated remote monitoring of cardiac patients [127]. Studies have assessed the impact of teleconsultation on GP-patient communication [31,32] and healthcare professionals’ acceptance [29,128]. Research has examined physicians’ digital skills [129] and analyzed hospitals’ telemedicine monitoring [93,130]. Reviews evaluated patient satisfaction and digital health frameworks [131,132,133]. Studies have assessed legal barriers [22] and analyzed reimbursement models [134]. Research has examined GP telehealth adoption [29] and telemedicine uptake factors [135]. Projects have tested telemedicine for chronic diseases [136] and long-COVID [130]. Studies have compared rural telemedicine across Europe [137] and Generation Z’s teleconsultation satisfaction [138]. COVID-19 has accelerated telemedicine adoption, with studies showing positive attitudes and a need for digital literacy. Research has emphasized digital skills and regulatory clarity as enablers. Telemonitoring for chronic conditions has become part of routine care, and cross-border projects inform Polish telemedicine through European benchmarking.

3.7.8. mHealth Development and Research in Poland

In Poland, mHealth focuses on patient-centered mobile apps, wearables, informatics, and behavioral engagement. This study included clinical research, algorithm development, and mobile health technology surveys. Early and Clinical Usability Studies (2019–2021) explored Polish citizens’ attitudes toward mHealth and evaluated app usability for venous thromboembolic diseases [139,140]. Research has examined cardiovascular and pre-frailty risks using wearable data during the COVID-19 lockdown [141]. Attitudinal assessments (2020–2021) have investigated telemedical features for older adults, physicians’ views on rhythm-monitoring devices, and integration challenges [142,143]. Innovative Informatics (2022–2024) explored personalizing mHealth and developing algorithms for behavioral incentivization through rewards [144,145]. Studies have explored the impact of gamification and developed machine-learning models for estimating cognitive load using smartwatch data [146]. Early research established public attitudes and needs, whereas clinical studies validated apps and wearables for remote monitoring. Despite integration challenges, professional acceptance of wearables is increasing. Recent focus on personalization and engagement shows the field’s maturation through adaptive algorithms and gamification. The field remains exploratory, emphasizing development and feasibility, and further clinical validation is needed.

3.7.9. Telerehabilitation

In Poland, rehabilitation has seen significant growth in telerehabilitation technologies for neurological and musculoskeletal conditions accelerated by COVID-19. During Early Development (2016–2018), efforts focused on hand telerehabilitation systems for post-stroke patients using computer vision [147] and mobile applications for monitoring activities [148]. During the pandemic (2021–2023), telerehabilitation programs for Duchenne muscular dystrophy (DMD) proved feasible [149,150], with surveys exploring respiratory telerehabilitation for DMD patients [149,150]. Reviews of multiple sclerosis rehabilitation have highlighted the role of telemedicine while emphasizing clinical validation needs [151]. Studies have compared patient satisfaction between telerehabilitation and traditional therapies [152]. Recent Advances (2022–2024) include meta-analyses of cognitive telerehabilitation effectiveness [153] and evidence-based guidelines for Physical and Rehabilitation Medicine [154]. This field has progressed from feasibility studies to clinical evaluations, particularly in neurological rehabilitation. Research shows telerehabilitation’s effectiveness for stroke, DMD, MS, and cognitive impairment. The pandemic has accelerated its implementation when in-person care is limited. Studies indicate that telerehabilitation matches traditional methods in terms of patient acceptance. Despite these positive findings, additional large-scale trials are needed to refine the protocols and verify long-term outcomes.

3.7.10. Telemedicine and eHealth in Nursing

The research explores eHealth literacy among nursing students and has outlined the requirements for telemedical systems in home monitoring, particularly in rural areas with limited care access [155]. Surveys have examined nurses’ views on eHealth and patient empowerment through digital solutions, noting the value of eHealth despite implementation barriers [156]. Research has studied nursing students’ clinical education during COVID-19, advocating tele-education integration into curricula [157]. Cross-sectional studies have evaluated eHealth literacy among nursing students in Poland and Sweden, showing varying yet positive literacy trends in digital healthcare [158]. Nursing research has evolved from a system design to workforce needs and education. The COVID-19 pandemic has accelerated the use of remote learning in nursing education. eHealth literacy among students remains vital for telemedicine in patient care, highlighting the need to prepare nurses for digital healthcare.

3.7.11. Teleophthalmology

Teleophthalmology indicates a growing interest in remote eye care, particularly for diabetic retinopathy, with AI and telemedicine enhancing access to and diagnostics. Studies have evaluated diabetic retinopathy patients’ attitudes towards telemedicine, showing positive reception of remote management [159]. Surveys of visually impaired patients demonstrated acceptance of telemedicine, highlighting the need for disability-specific adaptations [160]. An algorithm for detecting hard exudates in retinal images demonstrated the feasibility of automated screening [161]. Reviews examining AI’s role of AI in diabetic retinopathy screening indicate its potential to improve accuracy and reduce specialist workload [162]. The analyses confirmed that home/remote optical coherence tomography (OCT) devices provide accurate retinal imaging outside clinics. Literature reviews have shown teleophthalmology’s potential to expand eye care access in underserved populations through remote monitoring [163]. In Poland, teleophthalmology combines AI algorithms with home-based OCT to enhance the diagnostics. While customization remains crucial, patients show positive attitudes towards telemedicine. AI and teleophthalmology improve screening while reducing the specialist burden. Although some studies were clinical, others were survey-based, indicating a need for validation in Poland.

3.7.12. Telemedicine and Digital Health Development in Locomotor System

The evolution of telemedicine in Orthopedics and trauma in Poland has driven the evaluation of pandemic-induced teleconsultation adoption and post-surgical care, particularly after total hip arthroplasty (THA) [164]. Research has focused on 3D telediagnostic screening for scoliosis and postural disorders [165]. A web survey examined “red flags” for serious low back pain among Internet users, highlighting the need for tele-triage [166]. During COVID-19 (2021–2023), studies have focused on orthopedic teleconsultations, documenting diagnoses, and effectiveness [167,168]. Surveys have explored surgeons’ methods for assessing fracture healing [169]. Literature reviews have proposed telemedicine-based postsurgical care models for THA recovery [170]. Systematic reviews have identified technologies for postsagittal THA care [171]. Early telemedicine focused on diagnostic screening and patient self-reporting. The pandemic has accelerated the adoption of teleconsultation, proving its effectiveness. Research has emphasized post-hospital telemedicine care, including rehabilitation monitoring, for THA patients. Future efforts should enhance organizational frameworks and patient outcomes through telemedicine.

3.7.13. Telemedicine in Pediatrics

The evolution of telemedicine in pediatrics has accelerated owing to COVID-19, focusing on the remote management of complex diseases, impact assessments, and cross-border collaborations. Clinical Case Reports and Treatment Advances (2024) have highlighted the treatment of infantile hemangioma with β-blockers via telemedicine, demonstrating the feasibility of managing complex conditions remotely [172]. The pandemic’s impact on pediatric healthcare and service adaptation (2020–2022) examined COVID-19’s effects on pediatric hospital activities, emphasizing disruptions and strategies for resuming services [173]. The focus was on pediatric epilepsy and asthma, assessing clinical changes and satisfaction with telemedicine [174,175]. Reviews have addressed pediatric hepatitis C management during pandemics [176]. Surveys have documented telemedicine use among pediatric providers, offering insights into acceptance and barriers [177]. Telemedicine Network Development (2023–2024) reported a cross-border network for pediatric hematology and oncology, emphasizing specialist access [178]. Studies have evaluated healthcare providers’ and patients’ perspectives on teleconsultations in Poland [179]. COVID-19 has accelerated the adoption of telemedicine in pediatric care, particularly in chronic conditions. Telemedicine has proven effective for managing complicated pediatric cases. Surveys have shown a growing acceptance among providers and patients while identifying challenges. Cross-border collaborations demonstrate the expanding scope of specialized care. The field has evolved from pandemic-driven adoption to sustainable models supported by evidence and feedback.

3.7.14. Telepsychiatry

Psychiatry has been instrumental in introducing telemedicine in Poland, with research encompassing telepsychiatric compliance studies, clinical trials, mental health interventions during COVID-19, mobile app support for addictions, and studies on cyberchondria related to health literacy. Foundational studies on Early Telepsychiatry Adoption and Compliance (2015–2019) concentrated on enhancing compliance in patients with paranoid schizophrenia through telemedicine systems [180]. A trial involving the MONEO platform with paranoid schizophrenia patients demonstrated the feasibility of remote monitoring [181]. Surveys have evaluated patient and psychiatrist attitudes towards telepsychiatry and identified levels of acceptance [182]. Commentaries have underscored the role of psychiatry in telemedicine, highlighting opportunities in mental healthcare [183]. The Expansion to Broader Mental Health Interventions and Tools (2017–2022) reviewed telemedicine interventions during COVID-19, summarizing the challenges of telepsychiatry delivery [184]. A pictogram-based tool was developed for individuals with communication impairments [185]. Mobile health applications have been evaluated to aid recovery from alcohol use disorders [186]. Reviews have identified strategies for occupational e-mental health interventions [187]. Studies have examined the mental health effects of COVID-19 on pregnant women [188]. Recent Cross-Sectional and Interventional Studies (2024) have explored cyberchondria and its connection with health literacy and eHealth literacy [189]. Sociodemographic factors have been linked to eHealth tool usage patterns among psychiatric populations [190]. A study comparing the Geriatric Depression Scale-30 assessments conducted face-to-face and telephone interviews [191]. Interviews analyzed user experiences with mobile apps for alcohol-use disorders [186]. Overall, psychiatry has become one of the leading specializations in Poland in terms of telemedicine integration, especially for serious mental illnesses. Clinical trials have demonstrated the efficacy of telepsychiatric platforms, alongside innovations in digital therapeutics. The scope of research has expanded owing to COVID-19, with studies focusing on digital behaviors and mental health. Tools have been developed to address communication impairments, and telepsychiatry has been extended to geriatric and occupational health.

3.7.15. Telemedicine in Pulmonology

In Poland, telemedicine research and practice in pulmonology have concentrated on chronic respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and sleep-related breathing disorders, such as obstructive sleep apnea (OSA). This field encompasses telehealth projects, telemonitoring for exacerbations, and evaluation of innovative technologies, including virtual reality (VR). A pilot study assessed daily telemonitoring to predict acute exacerbations (ECOPD) and demonstrated the feasibility of providing early warning signs to prevent hospitalization [192]. A recent pilot project (2022–2023) implemented telemedical solutions for managing COPD in senior populations in Wrocław and the Lower Silesian Voivodeship, offering insights into telehealth strategies for older adults with COPD [193]. A narrative review explored telehealth and VR applications in COPD management during COVID-19, highlighting VR’s role of VR in pulmonary rehabilitation alongside telemedicine approaches [194]. A questionnaire-based study assessed OSA management across Europe, revealing an increased adoption of telemedicine approaches including remote diagnostics and therapy monitoring [195]. COPD management remains central to pulmonology telemedicine research in Poland, with telemonitoring showing promise for early detection of exacerbations. The integration of telehealth with innovative technologies has enhanced pulmonary rehabilitation. Regional pilot projects provide evidence for scaling telemedical care models for older adults with respiratory disease. European studies on OSA management have demonstrated that the increasing adoption of telemedicine is applicable in Polish practice. The field combines practical pilots and reviews, indicating growth while highlighting opportunities for larger implementations.

3.7.16. Telemedicine in Urology

The advancement of telemedicine in urology, accelerated by COVID-19, has integrated remote solutions with a focus on clinical guidelines, practical impact, and future directions. Guidelines for online consultations in uro-oncology have been established to optimize remote care delivery while maintaining quality [196]. A review assessed the impact of the pandemic on urological practices and offered recommendations for adapting to new healthcare realities [197]. Research has identified key barriers to telemedicine implementation, such as technological limitations and reimbursement issues [198,199], while examining patient perceptions revealed positive attitudes towards convenience but concerns about care quality. A recent review evaluated the evolution of telemedicine in urology and proposed enhancing teleurology through AI, remote monitoring, and personalized care models [200]. The pandemic has catalyzed telemedicine adoption in urology, prompting guideline development and practice changes. Research highlights implementation challenges while showing positive patient attitudes towards teleurology accessibility. Recent analyses have suggested incorporating digital technologies to improve outcomes, although more empirical studies are needed to evaluate the impact of telemedicine on urological outcomes in Poland and beyond.

3.7.17. Telemedicine in Other Specialties

Telemedicine is being increasingly adopted across various medical specialties in Poland. However, fields such as artificial intelligence, allergology, bariatrics, dentistry, diabetes, hematology, laboratory medicine, maritime and tropical medicine, medical education, nephrology, neurosurgery, obesity, obstetrics/gynecology, oncology, pharmacy, prenatal care, preventive medicine, radiology, rheumatology, surgery, telemedicine/eHealth, and digital twins remain underrepresented in academic literature. Initial investigations, often in the form of surveys, reviews, or pilot studies, have indicated the development of telemedicine applications. The COVID-19 pandemic has heightened interest, prompting research on its impact on service delivery and patient perceptions, particularly in bariatrics, diabetes, obesity, and prenatal care. Patient satisfaction surveys are common in nephrology, hematology, and dentistry. Clinical studies are exploring technologies, such as artificial intelligence in voice technology, mobile nutrition applications, and virtual patients in medical education. Specialized services include telemedical assistance in maritime and tropical medicine for mass casualties. Some specialties such as orthopedics, urology, and rheumatology integrate telemedicine with traditional care. In summary, telemedicine in Poland is expanding, with cardiology, emergency medicine, and psychiatry exhibiting mature research, whereas other fields remain in the pilot phase. The pandemic has stimulated interest in telemedical solutions for the continuity of care, with satisfaction surveys indicating a need for acceptance. Technological studies suggest ongoing innovation, although implementation lags behind that of more established fields.

4. Discussion

4.1. Evolution of Digital Health in Poland

Based on the analyses conducted, we can conclude that, over the last decade, a mature digital health ecosystem (eHealth and telemedicine) has been established in Poland (Figure 4). Compared to the previous decade, it has undergone a significant transformation influenced by political reforms, technological innovations, the digitization of healthcare, and the growing involvement of stakeholders. This ecosystem comprises five main areas: (1) clinical care and telemedicine; (2) public health and health policy; (3) technological infrastructure; (4) patient and community engagement; and (5) research and innovation (

Table 1. Domains and key players in the eHealth ecosystem in Poland (2014–2024).

Domain	Description	Key Actors
1. Clinical Care and Telemedicine	Includes teleconsultations, remote monitoring, telerehabilitation, teleradiology, and teledermatology.	Hospitals, specialist clinics, NFZ, family physicians, rehab centers.
2. Public Health and Policy	Covers legal frameworks and regulatory structures (e.g., e-prescriptions, e-sick leave, digital medical records).	Polish Ministry of Health, Parliament, CSIOZ, WHO Europe, EU Commission.
3. Technological Infrastructure	Encompasses national eHealth platforms, mobile health apps, wearable devices, and AI tools.	Health IT companies, startups, software developers, AI consortia.
4. Patient and Community Engagement	Involves digital literacy campaigns, telecare for vulnerable groups, and user engagement strategies.	Patients, caregivers, NGOs, universities, advocacy groups.
5. Research and Innovation	Represents over 250 studies and trials on telemonitoring, AI diagnostics, virtual education, etc.	Academic institutions, research consortia, journals, EU Horizon, Polish R&D agencies.

).

Table 1 presents descriptions of the domains and key players in the Polish eHealth ecosystem (2014–2024).

In Poland, telemedicine and eHealth transitioned from niche innovations to integral components of the national healthcare system between 2014 and 2024 [18,19]. The COVID-19 pandemic has significantly accelerated these transformations by highlighting the deficiencies in traditional healthcare delivery and expediting the adoption of remote services [35,100,107,131,137,201,202].

Poland is actively engaged in the development of telemedicine and eHealth. Since the early 21st century, substantial investments have been made and executed in line with the global dynamics of the telemedicine market, leading to the development and implementation of innovative telemedicine technologies. Notably, these investments were partially funded by the Polish public sector, specifically the MFZ and Mandatory Health Care Fund [18,19]. The potential benefits of telemedicine technologies are widely acknowledged and particularly evident in healthcare systems, society, and individual patients [203].

Telemedicine and eHealth represent robust and rapidly evolving medical sectors with the shared objective of enhancing healthcare and supporting the management and control of infectious and non-communicable diseases [7,8]. The global interest in these sectors is evident among governments and stakeholders. According to a recent report on eHealth status in the World Health Organization (WHO) European Region (from 2012), 41 of 53 countries had an eHealth strategy or policy in place by 2012 [104,204,205].

Numerous Polish projects and initiatives have explored various methodologies in telemedicine and eHealth and introduced classifications that incorporate diverse perspectives on commitment and environmental considerations [35,43,74,124,136,193,206,207,208]. Solutions in this field must encompass a wide range, including individual noninvasive telemonitoring, elements of space technology, comprehensive software for managing medical entities, and the development of virtual patients representing thousands of different diseases, thereby enhancing the educational process for students and medical personnel. Furthermore, systems facilitating real-time consultations, teleconferencing tools, advanced specialized equipment, robots, and other specialists are being developed. These systems utilize artificial intelligence in high-ranking simulation modes such as laboratories, telesurgery in high-precision operating modes, remote rehabilitation through computer games, and other intellectual and entertainment activities controlled by feedback from telemonitoring [19,22,108,209].

The evolution of telemedicine and eHealth in Poland is characterized by diverse projects and initiatives, highlighting key areas of commitment to systemic transformation through the enhancement of online and broadband health services. Notably, attention is directed towards further development and planned European Union financing for 2020–2026, alongside the requirements for comprehensive strategic investment plans utilizing funds from the National eHealth/Telemedicine Program [19,20,22].

Telemedicine and eHealth have emerged as transformative forces in global healthcare delivery for countries in Central and Eastern Europe, such as Poland [16,22,31]. The past decade has been marked by digital acceleration driven by evolving ICT technologies and urgent demands posed by the COVID-19 pandemic [22,35,203]. Before this period, digital health in Poland was in its infancy, characterized by sporadic implementation and limited legal support [28]. However, since 2015, strategic investments and regulatory reforms have spurred growth [22,35], positioning Poland as a regional innovator.

The scope and trajectory of telemedicine and eHealth development in Poland from 2014 to 2024 demonstrate the integration of national health platforms, telemonitoring systems, artificial intelligence-based tools, and mobile applications while assessing barriers and enabling factors in policy, practice, and public perception. The analyzed material contributes to understanding how a medium-sized European healthcare system can transition towards nationwide adoption and digital maturity.

Poland’s eHealth ecosystem encompasses formal and informal legal, strategic, and institutional mechanisms that facilitate cooperation and data exchange among key stakeholders, including government administration, healthcare providers, technology developers, patients, and research institutions. Based on the analyzed studies (2014–2024), several aspects of links with digital health strategies can be identified, including the national eHealth strategy and the P1 project, which involves a central platform enabling the provision of services such as e-prescriptions, e-referrals, and online patient accounts (IKP). Legislation on telemedicine enacted in 2015 provides a legal basis for remote consultation, digital documentation, and reimbursement. Regulations from the MH and NFZ define the scope of reimbursable telehealth services, including coding and eligibility criteria for service providers. An essential element is the regulation of data management and privacy, including standards compliant with the GDPR, which affects how personal and health data are collected, processed, and shared; a national interoperability framework aimed at standardizing data exchange between hospitals, clinics, and IT providers; consent protocols for data access via IKP and mobile apps; reimbursement and financing mechanisms; systems for the reimbursement of telehealth services by the NFZ, introduced or expanded during the COVID-19 pandemic; public–private financing programs, including support for AI tools, mHealth, and pilot implementations; and EU structural funds used for infrastructure and innovation.

Before COVID-19, telemedicine reimbursement by Poland’s NFZ was inconsistent. Though teleconsultations were legally recognized after the 2015 Act on Medical Activity amendment, the reimbursement framework remained limited, with services mostly restricted to pilot projects or regional initiatives [19,35]. The lack of standardized tariffs discouraged widespread adoption. COVID-19 has led to rapid institutionalization of telemedicine reimbursement. In March 2020, full reimbursement for teleconsultations in primary care and selected specialties was authorized with fees equivalent to those for in-person visits. E-prescriptions and e-referrals became mandatory, facilitating remote care workflows, while new codes were introduced for COVID-related telemedicine [35]. Regulatory changes granted telemedicine visits equal legal status. Post-COVID, while emergency measures were reduced, telemedicine reimbursement remained integral to routine care, particularly in primary care (POZ), specialist services, and chronic care management. However, a comprehensive long-term reimbursement policy has not yet been adopted, depending on local interpretations. Unlike Germany and France, Poland lacks quality-based payments for telemedicine metrics and reimbursements for AI-based diagnostics or mHealth tools. In the EU context, Poland followed similar trends, where Germany implemented Digitale-Versorgung-Gesetz (DVG) for digital app reimbursement [210,211], France maintained teleconsultation reimbursement post-COVID [212], and Nordic countries incorporated telehealth in chronic disease management [213,214].

Digital spaces also include cross-sector cooperation agreements, such as public–private partnerships (PPPs) between tech startups, academic centers, and hospitals; research grants carried out in collaboration between academia and industry, contributing to the promotion of innovation in artificial intelligence, wearable technology, and remote monitoring tools; space sector alliances covering, among other things, the use of telemetry in extreme conditions; and marine medicine. The professional standards and guidelines established by specialist medical and scientific associations that provide ethical and procedural frameworks must play a key role in implementing telemedicine services. Training and certification policies for healthcare professionals using telemedicine tools are crucial.

Over the last decade, Poland’s digital health evolution has demonstrated how a mid-income European country can harness legal reforms, policy momentum, and innovation to modernize its healthcare system [20]. Before 2014, telemedicine in Poland was primarily confined to conceptual or small-scale pilot projects, with minimal national coordination [28,215]. The period from 1995 to 2015 was characterized by specialties such as cardiology, pathology, orthopedics, and medical imaging, with research primarily focusing on technological feasibility rather than clinical outcomes.

In contrast, the 2014–2024 decade brought about a profound shift. The legalization of teleconsultations in 2015, implementation of mandatory e-prescriptions in 2020, and introduction of electronic referrals in 2018 established a functional policy framework. These regulatory milestones coincided with the development of the core infrastructure, including the P1 platform and IKP, which enabled the delivery of scalable digital services. The COVID-19 pandemic has further accelerated digital adoption, resulting in a significant increase in publication volumes, particularly between 2020 and 2022 [35]. Over the past decade, Poland has transitioned from fragmented and experimental telemedicine efforts to establishing coordinated, legally sanctioned, and partially interoperable eHealth ecosystems. Key drivers include top-down legal reforms, EU-supported infrastructure development, increased professional acceptance, and disruptive but catalytic influence of the COVID-19 pandemic.

Legislative decisions mandating e-prescriptions, e-referrals, and the rollout of the IKP were the most visible accelerators of systemic change. These milestones have enabled large-scale adoption by integrating digital tools into clinical workflows, reimbursement frameworks, and patient engagement strategies. While centralizing key services, the national digitization strategy laid the groundwork for expanded data sharing, user authentication, and remote service delivery, which became critical during the pandemic.

Notably, COVID-19 has accelerated the digitization of healthcare delivery and significantly reshaped the specialty landscape. Fields with minimal or no prior engagement in telemedicine, such as geriatrics, pulmonology, infectious diseases, and palliative care, saw rapid adoption of digital tools. In some cases, such as palliative medicine and respiratory care, COVID-related studies constituted the only publications on digital health, suggesting that the pandemic served as a trigger for digital innovation in those domains.

Simultaneously, mature specialties such as cardiology and rehabilitation have transitioned from feasibility studies to rigorous clinical trials and outcome-based evaluations. Notably, over 50% of cardiology-related articles involve patient-level data, with several evaluating the use of remote monitoring and telerehabilitation in chronic disease management. The digital footprints of mental health, psychiatry, and neurology have expanded their digital footprints through mHealth applications, AI-supported diagnostics, and video consultations, reflecting both clinical necessity and increased societal demand.

Conversely, traditional strongholds in digital health research from the pre-2015 period, such as pathology, orthopedics, and technical imaging, showed a relative regression in research activity. Despite advances in teleradiology infrastructure, the number of specialty-specific publications has decreased, possibly due to integration into broader health IT systems or shifting research funding priorities.

Artificial intelligence (AI) is an area of significant development. Although still emerging, AI applications in Poland’s healthcare system, particularly in cardiology, oncology, and geriatrics, include natural language processing (NLP) for electronic health records (EHRs), image recognition in radiology, and AI-assisted cognitive assessments [216]. However, its integration into the clinical workflow remains limited. Regulatory ambiguity, lack of reimbursement models, and insufficient clinician training/impeding their widespread implementation.

This regulatory lag is particularly evident compared to countries such as Germany, which has legislated digital therapeutics (DiGAs) [217], or Estonia [218], which operates under a fully digitalized, blockchain-secured health infrastructure [219,220]. Poland’s strength lies in its centralized platforms and capacity for rapid policy execution. However, its weakness is the slow translation of innovation into everyday clinical practice and limited long-term evaluation of digital interventions.

Furthermore, the distribution of study types underscores the advanced maturity of digital health research. Survey-based studies were predominant in emerging specialties and during the initial phases of the pandemic, whereas trials and longitudinal studies were more common in established fields, such as cardiology, psychiatry, and rehabilitation. This trend reflects both the readiness of infrastructure and the presence of established academic-industry collaborations, which have been instrumental in broadening the scope of research. Poland’s alignment with the European Health Data Space (EHDS) presents a critical opportunity to address the remaining challenges in interoperability, ethical governance, and cross-border data sharing [221,222]. Achieving success in this subsequent phase will necessitate technological advancements, enhanced regulatory clarity, inclusion of AI in strategic planning, and proactive engagement with patients and professionals to ensure trust and adoption. The period from 2014 to 2024 marked an accelerated transition from experimentation to institutionalization within the Polish digital health sector. The capacity to scale digital infrastructure and mobilize various sectors during a crisis has become evident from a national perspective. However, sustaining this trajectory in the coming decade will require greater emphasis on the interoperability, regulation of new technologies, strategic financing, and synergies between academia and industry. Identifying and supporting specializations that remain underrepresented, but could significantly benefit from tailored digital interventions, is crucial. Drawing on insights from previous research, a thirty-year outlook for the development of telemedicine and eHealth in Poland was delineated. The results of this study reflect both the historical progress and significant shifts in priorities, opportunities, and system integration over the past decade. Recent years have witnessed significant thematic diversification, demonstrating the expansion of the scope and increased maturity of telemedicine and eHealth in Poland. Psychiatry, pulmonology, rehabilitation, and neurology have emerged as key areas of development, reflecting the adaptation of Polish medicine to promote solutions to address the burden of chronic diseases and undertaking strategic public health initiatives. The importance of previously developed areas, such as orthopedics and pathology, has declined, not due to a loss of significance, but rather due to a shift from opportunistic applications to strategically driven development. Instead, their representation has decreased because of their heightened interest in other specialties.

There has been a notable increase in clinical research encompassing projects, trials, and implementations, with over 60% of studies incorporating patient data and structured clinical protocols. This trend underscores the advancement and specialization of clinical research. The number and sophistication of research projects is particularly evident in the fields of cardiology, geriatrics, and mental health. The application of artificial intelligence and telemonitoring tools in cardiology, along with video consultations in psychiatry and dermatology, highlights the progression from general tools to solutions tailored to specific specialties. The COVID-19 pandemic has served a pivotal moment by acting as a systemic catalyst. The volume of publications on telemedicine and eHealth surged between 2020 and 2022, aligning with the national guidelines on teleconsultation and e-prescriptions. The swift deployment of digital infrastructure bolstered by EU funds and changes in national policy has facilitated the integration of telemedicine into routine healthcare. However, this transformation has exposed structural deficiencies such as disparities in access to digital technologies, varying levels of health literacy, and inconsistent implementation of technologies across regions and professional groups. Compared to the pre-2014 scenario, characterized by localized pilot projects and minimal institutional coordination, the Polish digital health system has undergone substantial transformation, allowing for an assessment of regional maturity. The establishment of national platforms (e.g., e-prescriptions, e-referrals, IKP), innovative projects executed under public–private partnerships, and a formalized legal framework have enabled Poland to attain a medium level of eHealth maturity in Europe. Estonia remains a regional leader because of its fully integrated electronic medical records and blockchain-secured systems [220,223]. Germany has pioneered regulations for artificial intelligence and digital therapies [224,225], and Poland has surpassed countries such as Hungary, Romania, and Bulgaria in terms of telemedicine infrastructure and utilization.

Poland’s eHealth integration and governance ecosystem encompasses interdisciplinary and interconnected domains, public administration, healthcare providers, patients, technology developers, and research institutions linked by digital platforms and policy bridges. These bridges include a national eHealth strategy, GDPR-based regulatory updates, and a P1 health information infrastructure. Key areas of convergence include reimbursement reforms, digital skill initiatives, and cross-sector research collaborations. A visual model of the ecosystem reflects the interdependencies and direction of influence between these actors.

The path towards sustainable innovation requires the institutionalization of telemedicine in reimbursement systems, prioritizing digital integration, and introducing mandatory interoperability between platforms. Developing training programs for healthcare professionals, particularly those aimed at bridging the digital skill gap among older doctors, is essential. Training in this area must be included in the curriculum of medical universities in the clinical sciences section, as students are familiar with clinical examination methods and have a basic understanding of disease diagnosis and treatment. Ethical oversight mechanisms should be strengthened to address concerns about AI implementation of artificial intelligence, clinical data safety, and data management.

Poland’s participation in EU initiatives such as the European Health Data Space (EHDS) should be used to increase interoperability and support joint innovation. Furthermore, integrating space technologies, wearable devices, and NLP tools into national projects demonstrates Poland’s potential to become a regional leader in applied digital health innovations.

Despite this progress, the integration of telemedicine remains uneven across different specialties and geographical regions. Disparities in access to digital technologies persist between urban and rural areas, and many digital tools remain in the pilot phase or are used only to a limited extent. Therefore, overcoming the remaining barriers and research gaps is necessary to ensure sustainable scaling, implementation of a scientific framework, and long-term research of the results.

Specializations, such as orthopedics and pathology, despite their historical contribution to early pilot telemedicine studies in Poland, did not show significant progress in the use of digital technologies in Polish healthcare between 2014 and 2024. This stagnation may be due to infrastructure limitations, limited reimbursement frameworks, and lower perception of the feasibility of remote diagnostics in these specialties. In the current period of the global expansion of AI-assisted image analysis and tele-imaging platforms, targeted national initiatives could accelerate their integration into routine orthopedic examinations and pathological processes. AI-based radiological interpretation tools could enhance musculoskeletal diagnostics and digital pathology systems could facilitate centralized expert consultations, which would be particularly beneficial for regions with limited access to services in these specialized fields. While cardiology, psychiatry, and neurology have maintained high levels of telemedicine use, their future maturity will depend on the structured integration of artificial intelligence, particularly in a changing regulatory environment shaped by the EU’s Artificial Intelligence Act and the future European Health Data Space (EHDS) [226]. Ensuring the ethical implementation of artificial intelligence requires transparent validation of algorithms, physician training, and integration with existing clinical pathways while minimizing the widening of the digital divide. The limited use of artificial intelligence observed in the dataset highlights the current stage of digital transformation in healthcare in Poland. While national eHealth strategies focus on teleconsultations and electronic prescriptions, the integration of advanced digital therapies, real-time clinical decision support, and AI-based diagnostic systems remains in its infancy. Cross-sector collaboration involving academic institutions, technology start-ups, and health policymakers could fill this gap by supporting innovation sandboxes and pilot programs aligned with EU digital health priorities. Finally, as specializations such as rehabilitation, geriatrics, and pulmonology have gained popularity in telehealth applications, a systematic framework is needed to assess their clinical effectiveness, cost-effectiveness, and patient satisfaction.

As emphasized in recent frameworks [227], evaluating telemedicine effectiveness should address patient safety, diagnostic precision, equity, and patient-reported outcomes. Incorporating such multidimensional evaluation frameworks into national monitoring strategies may enhance accountability and service quality

The assessments obtained should ensure that telemedicine not only increases access, but also improves health outcomes, which is a key objective for Poland’s pursuit of digital maturity in health, comparable to leaders such as Estonia and Germany.

4.2. Limitations

This review had several limitations that warrant consideration. The search was confined to English language publications, excluding significant research published in Polish, particularly in national journals, conference proceedings, and institutional reports. Given that local pilot projects and regional innovations have played a role in the implementation of telemedicine and eHealth in Poland, this language restriction may have overlooked critical contributions. Only peer-reviewed and structured literature indexed in major international databases (PubMed, Scopus, EMBASE, and Web of Science) were included. This approach may underestimate the extent of telemedicine and eHealth development in Poland, especially considering the dynamic contributions of gray literature, unindexed national initiatives, and real-world implementation reports that have not been formally published. It is also important to acknowledge that authors often submit articles to high-impact journals when they believe their work has achieved a significant level of scientific maturity, prompting them to undergo a peer-review process. Although efforts were made to ensure accuracy, some records contained limited metadata or ambiguous methodological descriptors, which may have introduced minor classification errors, particularly in distinguishing between clinical and nonclinical studies or assigning studies to specific medical fields when interdisciplinary overlaps occur. This review encompassed various study designs, populations, and digital tools. Although a narrative synthesis approach accounts for this variability, it limits the ability to conduct meta-analyses or to generate summary effect estimates for outcomes, effectiveness, and adoption rates. Studies were classified as “COVID-19-related” based on the presence of keywords and a review of the full article. This may have led to an underestimation of indirect pandemic-related effects, such as changes in healthcare delivery models or accelerated digitization due to crisis-induced changes in healthcare system behavior. Although this study attempted to assess the maturity of telemedicine adoption across specialties, based on trends in research objectives, types of technologies, and integration, a more formalized maturity framework is required to verify these impressions and enable comparisons with international standards for digital healthcare. Future research should focus on methodologies and real-world outcome measures to complement and deepen our understanding of the digital health transformation in Poland.

Another limitation of this study was the potential bias in the misclassification of medical specialties assigned to individual publications. Given that many telemedicine and eHealth interventions are multidisciplinary and often overlap (e.g., rehabilitation studies in neurology or geriatrics and cardiology studies involving respiratory assessment), assigning them to a single specialty may oversimplify their scope. While necessary for quantitative trend analysis, this classification approach may not reflect the actual extent of telemedicine integration in related medical fields.

The lessons learned from the study of peer-reviewed articles on telemedicine and eHealth in Poland, published between 2014 and 2024, highlight the most significant achievements in the field of telemedicine and eHealth in Poland during that period. Telemedicine has been successfully used to treat patients with many chronic diseases including Duchenne muscular dystrophy, intellectual disability, and chronic heart failure. The technology implemented ensured continuity of care for elderly patients during the COVID-19 pandemic despite limited social contact and access to in-person services for improving psychosocial and mental health. Numerous studies have reported enhanced psychosocial outcomes in patients using telepsychiatry, mobile apps, and digital monitoring tools. Virtual reality (VR) and telemedicine have emerged as promising methods for rehabilitation and treatment of neurodevelopmental disorders. Visual tools and wearable devices have been shown to improve post-hospital care, particularly in orthopedic and cardiac rehabilitation, and offer potential for technology-enabled care coordination. The effective use of telemedicine depends on the appropriateness of the technology and the quality of the digital communication infrastructure. Health literacy, user experience, demographic data, and trust in digital technologies significantly impacted patient satisfaction and continued use of telemedicine. Particular attention should be paid to the increasing popularity of telemedicine among older adults and digitally excluded individuals. Some studies have focused on computational tools for analyzing large health datasets, highlighting the growing role of data science in eHealth, which has contributed significantly to scientific and technical advancements in Polish medicine. Although less common, methodological advances have highlighted the interdisciplinary nature of digital health research.

5. Conclusions

An analysis of peer-reviewed material allowed us to present the course of digital transformation and the development of telemedicine and eHealth in Poland, where healthcare has evolved from isolated telemedicine initiatives to a national eHealth ecosystem driven by regulatory, technological, and public health changes. This evolution has been facilitated by legislative reforms, infrastructure investments, and the pandemic, all of which have increased teleconsultations, e-prescriptions, and digital tools in clinical practice. Research on digitization, telemedicine, and eHealth has matured in cardiology, psychiatry, geriatrics, and rehabilitation, with new applications emerging in pulmonology and pediatrics. However, fields that were active ten years ago, such as orthopedics and pathology, have not seen similar development and remain underrepresented in publications. Investments in artificial intelligence (AI), digital infrastructure, and political support are essential for the integration of digital health in all areas of medicine. Studies have demonstrated increased acceptance among patients and providers while highlighting challenges such as regulatory uncertainty, limited reimbursement frameworks, and interoperability gaps, particularly for AI technologies. Despite progress, development depends on regulatory harmonization, sustainable financing, professional training, and collaboration among the government, academia, industry, and patient communities. By aligning with European initiatives such as the European Health Data Space, Poland can become a leader in regional digital healthcare integration, providing reforms that support interoperability, data security, and equitable access.