RESEARCH PAPER
Telemedicine services in the work of a doctor, dentist, nurse and midwife – analysis of legal regulations in Poland and the possibility of their implementation on the example of selected European countries
 
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1
Department of Civil Procedure, Faculty of Law and Administration, University of Szczecin, Poland
2
Department of Medical Law of the Social Medicine Chair, Pomeranian Medical University in Szczecin, Szczecin, Poland
3
Department of Social Medicine and Public Health of the Social Medicine Chair, Pomeranian Medical University in Szczecin, Szczecin, Poland
4
Department of Clinical Nursing, Pomeranian Medical University in Szczecin, Szczecin, Poland
CORRESPONDING AUTHOR
Marta Kożybska   

Department of Medical Law of the Social Medicine Chair, Pomeranian Medical University in Szczecin
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
The aim of the study is to discuss the legal framework for telemedicine services in Poland, and to present telemedicine solutions used in selected European countries.

Material and Methods:
The analysis of legal cts was chosen as a research method in order to determine legal possibilities for medical professionals to use telemedicine services. A literature review was undertaken to demonstrate the possibilities of telemedicine as used in the United Kingdom, Germany, Norway, The Netherlands and Sweden.

Results:
The Act on the professions of a doctor and a dentist states that the doctor and the dentist can perform their profession via ICT systems or communication systems. The doctor is obliged to practice in accordance with current medical knowledge and available methods. ‘Available methods’ include considering information and communication measures that may allow prevention, recognition or treatment. The Act on the profession of a nurse and a midwife states that the nurse and midwife perform the professions using current medical knowledge and the mediation of ICT systems or communication systems. Thus, the legislator has clearly authorized persons performing these professions to provide services in the field of telemedicine. However, despite the existence of a legal basis for using telemedicine, its development in Poland is not as high as in the United Kingdom, Germany, Norway, The Netherlands or Sweden.

Conclusions:
The legislator gradually introduces legal solutions necessary for the development of telemedicine services, although the pace of these changes, as well as building the technical infrastructure that is the basis for the proper provision of telemedicine services, are too slow.

 
REFERENCES (52)
1.
Lops K. Cross-border telemedicine. Opportunities and barriers from an economical and legal perspective. Rotterdam: Erasmus University – Institute of Health Policy and Management; 2008.
 
2.
Chojecka M, Nowak A. Telemedycyna na tle polskich regulacji prawnych – szansa czy zagrożenie? IKAR 2016; 8: 75–76.
 
3.
American Telemedicine Association. ATA Wiki [Internet]. [cited 2017 Nov 30]. Available from: http://www.americantelemed.org....
 
4.
Glanowski G. Telemedycyna w świetle ustawy o zawodach lekarza i lekarza dentysty, Monitor Prawniczy 2015; 18: 978.
 
5.
Nowak A. Telemedycyna transgraniczna – problematyka prawa właściwego dla przypadków odpowiedzialności cywilnej podmiotów medycznych na gruncie prawodawstwa unijnego. PME 2018; 1: 37.
 
6.
Act of 5 December 1996 on the professions of a doctor and a dentist. Journal of Laws of 2017, item 125, 19 January(consolidated text: Journal of Laws of 2019, item 537, PL: t.j.Dz.U. 2019, poz. 537).
 
7.
Kopeć M (editor). Ustawa o zawodach lekarza i lekarza dentysty. Komentarz. Warsaw: Wolters Kluwer Poland; 2016.
 
8.
Górski A, Grassmann M, Sarnacka E (editor), Standard wykonywania zawodów medycznych. Warszawa 2019. p. 121–133;.
 
9.
Walecki P, Lasoń W. Telemedycyna – wprowadzenie. In: Martyniak J, editor. Podstawy informatyki z elementami telemedycyny Ćwiczenia dla studentów medycyny. Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego; 2005. p. 118.
 
10.
Kubiak R. Prawo medyczne, 3rd edition. Warsaw: C.H. Beck; 2017
 
11.
Stanisław Z. i Andrzej O. v. State Treasury (2011) III KK 29/11, the Supreme Court, 7 October.
 
12.
Act of 6 November 2008 on Patients’ Rights and the Patient’s Rights Ombudsman. Journal of Laws of 2017, item 1318, 4 July(consolidated text: Journal of Laws of 2019, item 1127, PL: t.j.Dz.U. 2019 poz. 1127).
 
13.
the Constitutional Court’s judgment of 5 March 2013, Act 2/11, OTK-A 2013, no. 3, item 24, Journal of Laws, item 375.
 
14.
Karkowska D (editor). Ustawa o prawach pacjenta i Rzeczniku Praw Pacjenta. Komentarz.Warsaw: Wolters Kluwer Poland; 2016.
 
15.
Act of 25 June 1999 on cash benefits from social insurance in case of illness and maternity. Journal of Laws of 2017, item 1368, 12 July. (consolidated text: Journal of Laws of 2019, item 645, PL: t.j.Dz.U. 2019 poz. 645).
 
16.
Act of 19 August 1994 on Mental Health Protection. Journal of Laws of 2017, item 882, 5 May. (consolidated text: Journal of Laws of 2018, item 1878, PL: t.j.Dz.U. 2018 poz. 1878).
 
17.
Act of 28 April 2011 on the Information System in Health Care. Journal of Laws of 2017, item 1845, 5 October. (consolidated text: Journal of Laws of 2019, item 408, PL: t.j.Dz.U. 2019 poz. 408).
 
18.
Wąsik D. Ustawa o systemie informacji w ochronie zdrowia. Komentarz. Warsaw: Lex; 2015.
 
19.
M. Sp. z o.o. w Z. v. Minister of Finance (2015) I SA/Kr 721/15, Voivodeship Administrative Court in Krakow, 23 June.
 
20.
Act of 15 July 2011 on the professions of a nurse and a midwife. Journal of Laws of 2016, item 1251, 16 August. (consolidated text: Journal of Laws of 2019, item 576, PL: t.j. Dz.U. 2019 poz. 576).
 
21.
Lis W, Sadowska M (editor). Ustawa o zawodach pielęgniarki i położnej. Komentarz. Warsaw: Wolters Kluwer Poland; 2019.
 
22.
American Hospital Association. Trendwatch, The Promise of Telehealth For Hospitals, Health Systems and Their Communities. Washington; 2015.
 
23.
Drew H, Vass M. Overcoming the hurdles to the adoption of telemedicine [Internet]. 2016 [cited 2017 Nov 22]. Available from: http://www.osborneclarke.com/i....
 
24.
PwC Health Research Institute. Medical Cost Trend 2016 [Internet]. 2016 [cited 2017 Nov 27]. Available from: https://www.achp.org/wp-conten....
 
25.
Market study on telemedecine 2018, KomisjaEuropejska, s.32.
 
26.
Debnath D. Activity analysis of telemedicine in the UK. Postgrad Med J 2004; 80:335–338.
 
27.
Asadi H, Akhlaghi H. Ethical and legal aspects of telemedicine and telecare. BMJ Clin Res. 2002; 324(7345).
 
28.
Industry Report on Telemedicine Legal and Regulatory Framework. United4Health 2015, s. 20.
 
29.
Top Markets Report Health IT, Country Case Study, GERMANY, Department of Commerce, USA, 2016.
 
30.
(Model) Professional Code for Physicians in Germany-MBO-Ä 1997. The Resolutions of the114th German Medical Assembly, Kiel 2011.
 
31.
Zanaboni P, Wooton R. Adoption of routine telemedicine in Norwegian hospitals: progress over 5 years. BMC Health Services Res. 16(1).
 
32.
Hartvigsen G, Pedersen S. Lessons learned from 25 years with telemedicine in Northern Norway, 2015 Tromso.
 
33.
Knarvik U, Zanaboni P, Wooton R. Adoption of Routine Telemedicine in Norway: An overview of activities from 2009 to 2011, 2014 Tromso.
 
34.
Grol R, Giesen P, van Uden C. After-hours care in the United Kingdom, Denmark, and the Netherlands: new models. Health affairs. 2006; 25(6): 1733–1737.
 
35.
Giesen P, van Charante EM, Mokkink H, Bindels P, van den Bosch W, &Grol R. Patients evaluate accessibility and nurse telephone consultations in out-of-hours GP care: determinants of a negative evaluation. Patient education and counseling. 2007; 65(1): 131–136.
 
36.
Van Uden CJT, Ament AJHA, Hobma SO, Zwietering PJ, Crebolder HFJM. Patient satisfaction with out-of-hours primary care in the Netherlands. BMC health services research. 2005; 5(1): 6.
 
37.
Giesen PHJ, Haandrikman LGR, Broens S, Schreuder JLM, Mokkink HGA. GP cooperatives: Does it benefit the GP? [Centrale huisartsenposten: wordt de huisartserbeter van?] Huisarts Wet. 2000; 43: 508–510.
 
38.
van Uden CJT. Studies on general practice out-of-hours care (Doctoral dissertation, Maastricht University). 2005 [cited 2019 May 29]. Available from: https://cris.maastrichtunivers....
 
39.
Patient Federations ofNetherlands [cited 2019 May 29]. Available from: https://www.patientenfederatie....
 
40.
Alpay LL, Henkemans OB, Otten W, Rövekamp TA & Dumay AC. E-health applications and services for patient empowerment: directions for best practices in The Netherlands. Telemedicine and e-Health. 2010; 16(7): 787–791.
 
41.
Petersson J. Medicine at a distance in Sweden: Spatiotemporal matters in accomplishing working telemedicine. Sci Stud (St Bonaventure) [Internet]. 2011; 24(2): 43–63. Available from: http://www.scopus.com/inward/r....
 
42.
Blix M, Jeansson J. Telemedicine and the Welfare State: The Swedish Experience. Work Pap Ser [Internet]. 2018;(1238). Available from: https://ideas.repec.org/p/hhs/....
 
43.
Blomdahl S, Calissendorff B, Jacobsson U. Patient-Focused Urban Tele-Ophthalmology Services. J Telemed Telecare [Internet]. 2002 Jan [cited 2019 May 10]; 8(2_suppl): 43–4. Available from: http://www.ncbi.nlm.nih.gov/pu....
 
44.
Spri. UtvarderingavTelemedicinskaKonsultationerinomKardiologi. Stockholm; 1999.
 
45.
Carle L, Hellström C, Made S. ’Telemedicini Glesbygdger Nöjda Patienteroch Högre Kompetens’. Lakartidningen. 2001; 98(38): 40.
 
46.
Pettersson H, Holmer NG. Teleradiology in southern Sweden-a tool for reorganization of health care and for education. Comput Methods Programs Biomed [Internet]. [cited 2019 May 13]; 57(1–2): 13–9. Available from: http://www.ncbi.nlm.nih.gov/pu....
 
47.
Mohr NM, Young T, Harland KK, Skow B, Wittrock A, Bell A, et al. Emergency Department Telemedicine Shortens Rural Time-To-Provider and Emergency Department Transfer Times. Telemed e-Health [Internet]. 2018 Aug [cited 2019 May 13]; 24(8): 582–93. Available from: http://www.ncbi.nlm.nih.gov/pu....
 
48.
Andersson O, Sjögren J, Åsberg H. Nätläkarbolagendränerarenunder finansieradprimärvård [Telemedicine doctors drain resources from an underfunded primary care]. Dagens Nyheter, March 2. 2017.
 
49.
Ahlzén R, Berggren L, Metsini A, Olsson L, Tegelberg Å. Vetenskapligtstödsaknasfördigitaladiagnoser [Scientific evidence missing for diagnosis with video call] [Internet]. DagensNyheter. 2018. Available from: https://www.dn.se/debatt/veten....
 
50.
Perspektywy rozwoju polskiej branży ICT do roku 2025., Polska Agencja Rozwoju Przedsiębiorczości, Warszawa; 2017.
 
51.
Ludność. Stan i struktura w przekroju terytorialnym. Główny Urząd Statystyczny, Warszawa; 2017.
 
52.
Społeczeństwo informacyjne w Polsce w 2018r. Główny Urząd Statystyczny, Warszawa; 2018.
 
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