{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:06:59Z","timestamp":1790114819300,"version":"4.0.1"},"reference-count":40,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The COVID-19 pandemic transformed telemedicine in Poland from a niche service into a core mode of health care delivery, supported by nationwide eHealth infrastructure such as obligatory e-prescriptions and the central P1 platform. Despite this rapid expansion, concerns persist that the benefits of digital health are not shared equally, and that a digital divide limits equitable access to telemedicine services across sociodemographic and geographic groups.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to describe the patterns of telemedicine and eHealth tool use among Polish adults in the postpandemic era, to identify key sociodemographic, economic, and health-related predictors of their adoption, and to map digital inequalities in access to health care services.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This cross-sectional study used data from the \u201cNational Test for Poles\u2019 Health\u201d (Narodowy Test Zdrowia Polak\u00f3w), a nationwide online survey conducted annually in Poland between 2020 and 2024. The full surveyed sample comprised 1,196,102 adults, of whom 820,000 completed the telemedicine-use module and formed the analytic sample; detailed questions on 12 specific eHealth services were administered to a randomly assigned subsample of 120,000 respondents under a split-questionnaire design. Sociodemographic factors (age, gender, education level, and place of residence), health status, and barriers to accessing care were analyzed as predictors using ordered and binary logistic regression models, with results expressed as odds ratios (ORs) with 95% CIs, and statistical significance set at\n P<\/jats:italic>\n \u2264.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall, 49.7% (407,502\/820,000) of respondents reported using a telemedicine visit at least once in the preceding 12 months. Telephone consultations were the most common form of remote visit (43,598\/120,000, 36.3%), whereas video consultations were rare (8736\/120,000, 7.3%). System-driven tools showed high adoption (e-prescriptions: 87,121\/120,000, 72.6%; e-referrals: 64,083\/120,000, 53.4%), while patient-driven tools, such as mobile health apps (24,341\/120,000, 20.3%), were used less frequently. Education and place of residence were the strongest sociodemographic predictors: participants with a master\u2019s degree were 2.2 times more likely than those with secondary education to use the Internet Patient Account (OR 2.2, 95% CI 2.1\u20102.2), and residents of cities with over 500,000 inhabitants had higher odds of telemedicine use (OR 1.5, 95% CI 1.5\u20101.6). Chronic disease was a strong health-related predictor (OR 1.8, 95% CI 1.7\u20101.9). Gender differences were also observed: women used telephone consultations more often, whereas men more frequently used the Internet Patient Account.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Telemedicine adoption in postpandemic Poland is driven more by pre-existing socioeconomic advantage, particularly higher education and urban residence, than by clinical need alone, indicating a persistent digital divide. Telemedicine functions largely as a tool of convenience for the already connected rather than a tool of necessity for underserved groups. Targeted interventions, including community-based digital literacy programs, investment in rural broadband infrastructure, and guaranteed hybrid in-person alternatives, are needed to ensure that Poland\u2019s eHealth transformation promotes inclusion rather than exacerbating health inequalities.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/88442","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:28:02Z","timestamp":1790112482000},"page":"e88442-e88442","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Telemedicine Use and the Digital Divide Among Adults in Poland\u2019s Postpandemic Era: Nationwide Cross-Sectional Survey"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4555-5400","authenticated-orcid":false,"given":"Aleksander","family":"Biesiada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5566-6278","authenticated-orcid":false,"given":"Anna","family":"Zimny-Zaj\u0105c","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0395-9826","authenticated-orcid":false,"given":"Karolina","family":"K\u0142oda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-6959","authenticated-orcid":false,"given":"Mateusz","family":"Babicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-2760","authenticated-orcid":false,"given":"Agnieszka","family":"Mastalerz-Migas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3132-8044","authenticated-orcid":false,"given":"Beata","family":"Jankowska-Pola\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1118-5090","authenticated-orcid":false,"given":"Siddarth","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","DOI":"10.1007\/s13721-021-00300-y","article-title":"Telehealth and the digital divide as a social determinant of health during the COVID-19 pandemic","volume":"10","author":"Clare","journal-title":"Netw Model Anal Health Inform Bioinform"},{"issue":"8","key":"R2","doi-asserted-by":"publisher","first-page":"e435","DOI":"10.1016\/S2589-7500(20)30142-4","article-title":"Applications of digital technology in COVID-19 pandemic planning and response","volume":"2","author":"Whitelaw","journal-title":"Lancet Digit Health"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20010115","article-title":"Patient\u2019s perspective of telemedicine in Poland-a two-year pandemic picture","volume":"20","author":"So\u0142omacha","journal-title":"Int J Environ Res Public Health"},{"key":"R4","unstructured":"Announcement of the minister of health of april 29, 2022 on the announcement of the uniform text of the regulation of the minister of health on the organizational standard of teleconsultation within the framework of primary health care [Article in Polish]. Electronic Legal Gazette (ELI). 2022. URL: https:\/\/eli.gov.pl\/api\/acts\/DU\/2022\/1194\/text.html [Accessed 26-08-2026]"},{"key":"R5","unstructured":"Teleporady w Podstawowej Opiece Zdrowotnej [Article in Polish]. Dane.gov.pl. URL: https:\/\/dane.gov.pl\/pl\/dataset\/4313,teleporady-w-podstawowej-opiece-zdrowotnej [Accessed 18-08-2025]"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Weresa MA Ciecierski C Filus L , editors. Digitalization and Innovation in Health: European and US Perspectives. 1st ed. Routledge; 2024. [doi: 10.4324\/9781032726557]","DOI":"10.4324\/9781032726557-1"},{"key":"R7","unstructured":"Digital society statistics at regional level. Eurostat, European Commission; 2026. URL: https:\/\/ec.europa.eu\/eurostat\/statistics-explained\/SEPDF\/cache\/2549.pdf [Accessed 26-08-2026]"},{"key":"R8","unstructured":"Individuals using the internet for seeking health-related information. Eurostat. 2025. URL: https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/tin00101\/default\/table?lang=en [Accessed 18-08-2025]"},{"key":"R9","unstructured":"Global strategy on digital health 2020-2025. World Health Organization; 2021. URL: https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/1f4d4a08-b20d-4c36-9148-a59429ac3477\/content [Accessed 26-08-2026]"},{"issue":"8","key":"R10","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1016\/j.tele.2017.07.007","article-title":"Determinants of Internet skills, uses and outcomes. A systematic review of the second- and third-level digital divide","volume":"34","author":"Scheerder","journal-title":"Telemat Inform"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-022-00663-0","article-title":"A framework for digital health equity","volume":"5","author":"Richardson","journal-title":"NPJ Digit Med"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s43045-022-00272-3","article-title":"Awareness, knowledge, attitude, and skills of telemedicine among mental healthcare providers","volume":"30","author":"Fouad","journal-title":"Middle East Curr Psychiatry"},{"issue":"2","key":"R13","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1177\/1357633X211049206","article-title":"Telemedicine experiences and perspectives of healthcare providers in long-term care: a scoping review","volume":"30","author":"Tan","journal-title":"J Telemed Telecare"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1080\/07853890.2021.2019826","article-title":"Transition to telemedicine and its impact on missed appointments in community-based clinics","volume":"54","author":"Adepoju","journal-title":"Ann Med"},{"issue":"7","key":"R15","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19074173","article-title":"A meta-analysis of the effectiveness of telemedicine in glycemic management among patients with type 2 diabetes in primary care","volume":"19","author":"Zhang","journal-title":"Int J Environ Res Public Health"},{"issue":"7","key":"R16","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.3117","article-title":"Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012","volume":"16","author":"Kontos","journal-title":"J Med Internet Res"},{"issue":"4","key":"R17","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1055\/s-0041-1733848","article-title":"Telemedicine Adoption during the COVID-19 pandemic: gaps and inequalities","volume":"12","author":"Luo","journal-title":"Appl Clin Inform"},{"issue":"10","key":"R18","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1001\/jamainternmed.2020.2671","article-title":"Assessing telemedicine unreadiness among older adults in the United States during the COVID-19 pandemic","volume":"180","author":"Lam","journal-title":"JAMA Intern Med"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s11524-020-00508-9","article-title":"The expanding digital divide: Digital health access inequities during the COVID-19 pandemic in New York City","volume":"98","author":"Eruchalu","journal-title":"J Urban Health"},{"issue":"6","key":"R20","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1016\/j.japh.2022.05.020","article-title":"The patterns and determinants of telemedicine use during the COVID-19 crisis: a nationwide study","volume":"62","author":"Al Meslamani","journal-title":"J Am Pharm Assoc (2003)"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16040645","article-title":"Sociodemographic factors influencing the use of eHealth in people with chronic diseases","volume":"16","author":"Reiners","journal-title":"Int J Environ Res Public Health"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.2174\/0117450179279732231211110248","article-title":"Telemedicine, e-health, and digital health equity: a scoping review","volume":"20","author":"Petretto","journal-title":"Clin Pract Epidemiol Ment Health"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1473-3","article-title":"Trends in the use of the Internet for health purposes in Poland","volume":"15","author":"Bujnowska-Fedak","journal-title":"BMC Public Health"},{"issue":"14","key":"R24","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19148338","article-title":"A nationwide natural experiment of e-health implementation during the COVID-19 pandemic in Poland: user satisfaction and the ease-of-use of remote physician's visits","volume":"19","author":"Duplaga","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1089\/tmj.2023.0204","article-title":"Teleconsultation as a modern form of health care service in the case of Poland: assessment of its potential use from the perspective of health care providers and patients","volume":"30","author":"Lubomski","journal-title":"Telemed J E Health"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1037\/amp0000191","article-title":"Journal article reporting standards for quantitative research in psychology: the APA Publications and Communications Board task force report","volume":"73","author":"Appelbaum","journal-title":"Am Psychol"},{"issue":"6","key":"R27","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1089\/tmj.2023.0530","article-title":"Are we adequately measuring patient satisfaction with telemedicine? A systematic review with a meta-analysis","volume":"30","author":"Vinad\u00e9 Chagas","journal-title":"Telemed J E Health"},{"issue":"12","key":"R28","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1089\/tmj.2020.0570","article-title":"A review of patient satisfaction and experience with telemedicine: a virtual solution during and beyond COVID-19 pandemic","volume":"27","author":"Nanda","journal-title":"Telemed J E Health"},{"issue":"6","key":"R29","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1080\/17517575.2020.1850872","article-title":"Factors influencing the adoption of telemedicine health services during COVID-19 pandemic crisis: an integrative research model","volume":"15","author":"Rahi","journal-title":"Enterp Inf Syst"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-023-02348-4","article-title":"Patients\u2019 perspectives and preferences toward telemedicine versus in-person visits: a mixed-methods study on 1226 patients","volume":"23","author":"Moulaei","journal-title":"BMC Med Inform Decis Mak"},{"issue":"8","key":"R31","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1177\/1357633X221139892","article-title":"Telehealth-guided provider-to-provider communication to improve rural health: a systematic review","volume":"30","author":"Totten","journal-title":"J Telemed Telecare"},{"issue":"8","key":"R32","doi-asserted-by":"publisher","DOI":"10.2196\/29575","article-title":"Telehealth interventions and outcomes across rural communities in the United States: narrative review","volume":"23","author":"Butzner","journal-title":"J Med Internet Res"},{"key":"R33","unstructured":"Raport z badania satysfakcji pacjent\u00f3w korzystaj\u0105cych z teleporad u lekarza podstawowej opieki zdrowotnej w okresie epidemii COVID-19 [Report in Polish]. Narodowy Fundusz Zdrowia (National Health Fund), Departament Obs\u0142ugi Pacjenta; 2020. URL: https:\/\/www.nfz.gov.pl\/download\/gfx\/nfz\/pl\/defaultaktualnosci\/370\/7788\/1\/raport_-_teleporady_u_lekarza_poz.pdf [Accessed 02-09-2026]"},{"issue":"3","key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/24582","article-title":"Scale-up of digital innovations in health care: expert commentary on enablers and barriers","volume":"24","author":"Schlieter","journal-title":"J Med Internet Res"},{"issue":"Suppl 1","key":"R35","doi-asserted-by":"publisher","first-page":"S83","DOI":"10.1097\/MLR.0000000000001808","article-title":"Telemedicine impact on the patient-provider relationship in primary care during the COVID-19 pandemic","volume":"61","author":"Andreadis","journal-title":"Med Care"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1198096","article-title":"The feasibility, acceptability, and usability of telehealth visits","volume":"10","author":"Sinha Gregory","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1089\/tmj.2023.0158","article-title":"Patient satisfaction with telehealth at an academic medical center primary care clinic","volume":"30","author":"Verma","journal-title":"Telemed J E Health"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1089\/tmr.2023.0002","article-title":"Patient and provider recommendations for improved telemedicine user experience in primary care: a multi-center qualitative study","volume":"4","author":"Khairat","journal-title":"Telemed Rep"},{"issue":"11","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8775","article-title":"Beyond adoption: a new framework for theorizing and evaluating nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologies","volume":"19","author":"Greenhalgh","journal-title":"J Med Internet Res"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2023.1057347","article-title":"The telemedicine community readiness model-successful telemedicine implementation and scale-up","volume":"5","author":"Otto","journal-title":"Front Digit Health"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:28:05Z","timestamp":1790112485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e88442"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":40,"URL":"https:\/\/doi.org\/10.2196\/88442","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"v28i1e88442"}}