## 4 Discussion
### Evolution of Digital Health in Poland
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.