Telemedicine as a socio-medical process. Experiences from remote monitoring of long-COVID patients in Poland
Keywords:telemedicine, m-health, e-health, COVID-19, long-COVID
Aim. Long-COVID syndrome is still under broad investigation. It is known, however, that the consequences of COVID-19 disease can permanently affect the health and quality of life of patients in many respects. For this reason, monitoring parameters in patients who are still experiencing symptoms is an extremely serious task for medicine. It is possible with the use of telehealth paradigm, which helps to provide long-term care. The use of wearable medical devices that record certain vital parameters (e.g., Aidmed) can ensure that the patient is under constant surveillance after an infection. For this reason, the development and introduction of nationwide telemonitoring and telerehabilitation programs for the long-COVID patients seems to be a key solution.
Methods. The main goal of this analysis, which involved 373 patients, is to present practical experiences and discuss the strengths and weaknesses of the use of remote diagnostic tools in patients with long-COVID syndrome. The analysis based on a multicentre study in Poland focuses on the technological and social aspects of Aidmed telehealth system. The results were obtained on the basis of the deliberative reflection method, conducted by a multidisciplinary team: 2 medical sociologists, 1 epidemiologist, 2 biomedical students (secretary roles in the projects), 2 computer scientists and 2 medical doctors.
Results. The analysis showed that the use of telemedicine tools is quicker and allows to obtain more accurate diagnostic data (strengths). It is also inclusive and educational in relation to the excluded groups of patients (opportunities). However, it may lead to limitation of contacts between the doctor and the patient (threats) and limited access due to high costs and time investments (weaknesses).
Conclusions. Remote home monitoring and telerehabilitation of patients with long-COVID syndrome has the potential to reduce the burden of disease and prevent overloading of the healthcare system. Therefore, it should be widely used. However, we need to learn how to implement it correctly. Our recommendations are: 1) technology should be inclusive in both e-literacy and health literacy; 2) solutions must be as simple as possible for an end user; 3) the entire process requires efficient logistics facilities.
Bailo, L., Guiddi, P., Vergani, L., Marton, G., & Pravettoni, G. (2019). The patient perspective: investigating patient empowerment enablers and barriers within the oncological care process. Ecancermedicalscience, 13(912). https://doi.org/10.3332/ecancer.2019.912
Binder-Olibrowska, K. W., Wrzesińska, M. A., & Godycki-Ćwirko, M. (2022). Is Telemedicine in Primary Care a Good Option for Polish Patients with Visual Impairments Outside of a Pandemic? International Journal of Environmental Research and Public Health, 19 (11), 6357. https://doi.org/10.3390/ijerph19116357
Chudzik, M., Babicki, M., Kapusta, J., Kołat, D., Kałuzińska, Ż., Mastalerz-Migas, A., & Jankowski, P. (2022). Do the Successive Waves of SARS-CoV-2, Vaccination Status and Place of Infection Influence the Clinical Picture and COVID-19 Severity among Patients with Persistent Clinical Symptoms? The Retrospective Study of Patients from the STOP-COVID Registry of the PoLoCOV-Study. Journal of Personalized Medicine, 12(5), 706. https://doi.org/10.3390/jpm12050706
Cory, M. J., Colman, N., McCracken, C. E., & Hebbar, K. B. (2019). Rapid Cycle Deliberate Practice Versus Reflective Debriefing for Pediatric Septic Shock Training*: Pediatric Critical Care Medicine, 20(5), 481–489. https://doi.org/10.1097/PCC.0000000000001891
Ćwiklicki, M., Duplaga, M., & Klich, J. (Eds.). (2022). The digital transformation of healthcare: Health 4.0. Routledge.
Diesel, J., Sterrett, N., Dasgupta, S., Kriss, J. L., Barry, V., Vanden Esschert, K., Whiteman, A., Cadwell, B. L., Weller, D., Qualters, J. R., Harris, L., Bhatt, A., Williams, C., Fox, L. M., Meaney Delman, D., Black, C. L., & Barbour, K. E. (2021). COVID-19 Vaccination Coverage Among Adults—United States, December 14, 2020–May 22, 2021.
MMWR. Morbidity and Mortality Weekly Report, 70(25), 922–927. https://doi.org/10.15585/mmwr.mm7025e1
Duplaga, M. (2020). Determinants and Consequences of Limited Health Literacy in Polish Society. International Journal of Environmental Research and Public Health, 17(2), 642. https://doi.org/10.3390/ijerph17020642
Grabowski, M., Balsam, P., Zajdel, J., Opolski, G. (2022). Telemedicine Model in Chronic Diseases: Chronic Obstructive Pulmonary Disease. Ministry of Health. accessed on 18 June 2022, https://zdrowie.gov.pl/portal/download/file_id/33924/pid/1007.html
Jarynowski, A., & Belik, V. (2022). Access to healthcare as an important moderating variable for understanding geography of COVID-19 outcomes - preliminary insights from Poland. European Journal of Translational and Clinical Medicine (accepted). https://doi.org/10.1101/2021.12.08.21267167
Jarynowski, A., Stochmal, M., & Maciejewski, J. (2020). Przegląd i charakterystyka prowadzonych w Polsce badań na temat społecznych uwarunkowań epidemii COVID-19 w jej początkowej fazie [A review of studies of social background during the first phase of the COVID-19 epidemic in Poland]. Bezpieczeństwo Obronność Socjologia, 13, 38–87. http://cejsh.icm.edu.pl/cejsh/element/bwmeta1.element.desklight-a8f411a3-64a8-4d36-a7d6-c02e1acb8489
Koonin, L. M., Hoots, B., Tsang, C. A., Leroy, Z., Farris, K., Jolly, B., Antall, P., McCabe, B., Zelis, C. B. R., Tong, I., & Harris, A. M. (2020). Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic—United States, January–March 2020. MMWR. Morbidity and Mortality Weekly Report, 69(43), 1595–1599. https://doi.org/10.15585/mmwr.mm6943a3
Kornowska, K., Witczak, J., Kornowska, L., Szybowicz, U. (2022). Top Disruptors in Healthcare. Przegląd Innowacyjnych Startupów Medycznych w Polsce [Top Disruptors in Healthcare. Review of innovative start-ups in Poland]. Medmetrix. accessed on 18 June 2022, https://icm.edu.pl/wp-content/uploads/2021/06/Top-Disruptors-in-Healthcare-min.pdf
Lavado, B. (2017). Telerehabilitation Compared to Conventional Physical Therapy in Improving Physical Functioning in Community-Dwelling Adults: A Systematic Review. accessed on 18 June 2022, https://www.scranton.edu/academics/pcps/physicaltherapy/ptresearch/DPT-3-PowerPoints-2017/group-6-research-presentation-2017.pdf
Lin, Q., Paykin, S., Halpern, D., Martinez-Cardoso, A., & Kolak, M. (2022). Assessment of Structural Barriers and Racial Group Disparities of COVID-19 Mortality With Spatial Analysis. JAMA Network Open, 5(3), e220984. https://doi.org/10.1001/jamanetworkopen.2022.0984
McNaughton, C. D., Austin, P. C., Sivaswamy, A., Fang, J., Abdel-Qadir, H., Daneman, N., Udell, J. A., Wodchis, W., Mostarac, I., & Atzema, C. L. (2022). Post-acute health care burden after SARS-CoV-2 infection: A retrospective cohort study of long COVID among 530,892 adults [Preprint]. MedRxiv. https://doi.org/10.1101/2022.05.06.22274782
Niewada, M., Tabor, B., Piotrowicz, E., Piotrowicz, R., Opolski, G., Banach, M., & Jakubczyk, M. (2021). Cost-effectiveness of telerehabilitation in patients with heart failure in Poland: An analysis based on the results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) randomized clinical trial. Kardiologia Polska, 79(5), 510–516. https://doi.org/10.33963/KP.15885
Okoniewska, M. (2021). Nowe technologie rewolucjonizują opiekę zdrowotną. https://medycynaprywatna.pl/nowe-technologie-rewolucjonizuja-opieke-zdrowotna/
Romaszko-Wojtowicz, A., & Konrad, M. (2021). COVID-19 And Chronic Respiratory Diseases: Basic Information. Almanach, 16(2), 64–69.
Romaszko-Wojtowicz, A. & Doboszyńska, A. (2021). Pulmonary complications due to COVID-19 – a literature review. Polish Annals of Medicine, 8(2), 244–249. https://doi.org/10.29089/2021.21.00181
Romaszko-Wojtowicz, A., Maksymowicz, S., Jarynowski, A., Jaśkiewicz, Ł., Czekaj, Ł., & Doboszyńska, A. (2022). Telemonitoring in Long-COVID Patients - Preliminary Findings. International Journal of Environmental Research and Public Health, 19(9), 5268. https://doi.org/10.3390/ijerph19095268
Soriano, J. B., Murthy, S., Marshall, J. C., Relan, P., & Diaz, J. V. (2022). A clinical case definition of post-COVID-19 condition by a Delphi consensus. The Lancet Infectious Diseases, 22(4), e102–e107. https://doi.org/10.1016/S1473-3099(21)00703-9
Szczegielniak, J., Bogacz, K., Majorczyk, E., Szczegielniak, A., & Łuniewski, J. (2021). Post-COVID-19 rehabilitation – a Polish pilot program. Medycyna Pracy, 72(5), 611–616. https://doi.org/10.13075/mp.5893.01122
Vidal-Alaball, J., Acosta-Roja, R., Pastor Hernández, N., Sanchez Luque, U., Morrison, D., Narejos Pérez, S., Perez-Llano, J., Salvador Vèrges, A., & López Seguí, F. (2020). Telemedicine in the face of the COVID-19 pandemic. Atención Primaria, 52(6), 418–422. https://doi.org/10.1016/j.aprim.2020.04.003
Wiedermann, M., Rose, A. H., Maier, B. F., Kolb, J. J., Hinrichs, D., & Brockmann, D. (2022). Evidence for positive long- and short-term effects of vaccinations against COVID-19 in wearable sensor metrics—Insights from the German Corona Data Donation Project [Preprint]. ARxiv. https://doi.org/10.48550/ARXIV.2204.02846
Witeska-Młynarczyk, A. (2015). Critical Medical Anthropology – A voice for just and equitable healthcare. Annals of Agricultural and Environmental Medicine: AAEM, 22(2), 385–389. https://doi.org/10.5604/12321966.1152099
How to Cite
Copyright (c) 2022 Stanisław Maksymowicz, Andrzej Jarynowski, Łukasz Czekaj, Szymon Gęsicki, Anna Romaszko–Wojtowicz, Monika Wójta-Kempa, Doboszyńska Anna
This work is licensed under a Creative Commons Attribution 4.0 International License.