## 4 Discussion  
### 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). 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]. Table 1 presents descriptions of the domains and key players in the Polish eHealth ecosystem (2014-2024). Poland is actively engaged in the development of telemedicine and eHealth. Since the early 21 st 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; 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