eHealth is a fast growing area of health care. Its development is strongly supported by the European Commission (EC). In Poland, eHealth is connected mainly to medical information systems. Little attention is given to its clinical aspects. The paper aims at describing barriers and opportunities of public eHealth development in Poland. It is based on desk search studies and interviews conducted in Poland in the spring of 2015. An attempt to estimate size of the eHealth market was made. In the study 227 eHealth (and related) tenders announced in 2009-2015 (first half of the year) were identified and analysed. The results show that eHealth is still underdeveloped in Poland, and that it is not effectively supported by central government and the National Health Fund, the public purchaser of health services, which still does not recognize eHealth as a medical procedure. Identified eHealth initiatives can be described as pilot projects.

E-health has experienced a dynamic development across the European Union in the recent years and enjoys support from the European Commission that seeks to achieve interoperability of national healthcare systems in order to facilitate free movement. Differences that can be observed between the member states in legal regulations, cultural approaches and technological solutions may hinder this process. This study compares the legal standing of e-health in Denmark, Poland, Spain and the UK, along with key legal acts and their implications. The academic literature review along with an analysis of materials found through the desk study research (reports, legal acts, press articles, governmental web pages and so on) was performed in order to identify aspects relevant to e-health interoperability. The approach to legal regulation of e-health substantially differs by country. So do the procedures that they have developed regarding the requirement for patient's consent for the processing of their data, their rights to access to the medical data, to change the data, data confidentiality and types of electronic health records. The principles governing the assignment of responsibility for data protection are also different. These legal and technological differences must be reconciled if interoperability of European national e-health systems is to be achieved. Copyright © 2016 John Wiley & Sons, Ltd.

Development of e-health in Poland has suffered from multiple setbacks and delays. This paper presents views on and experiences with implementation of e-health solutions of three groups of respondents: buyers, suppliers and external experts with the aim of establishing to what extent and in what way e-health development was taking place in Polish public health care and if there were any national policy targets or European targets influencing this development. It is based on desktop studies and interviews conducted in Poland in the spring and summer of 2015. The interviews largely confirmed findings from the desktop study: legal obstacles were the decisive factor hindering the development of e-health, especially telemedicine, with extensive insufficiency of basic IT infrastructure closely following. Stakeholders were deterred from engaging with telemedicine, and from procuring e-health using non-standard procedures, from fear of legal liability. Some doctor’s resistance to e-health was also noted. There are reasons for optimism. Amendment to the Act on the System of Information in Health Care removed most legal obstacles to e-health. The Polish national payer (NFZ) has started introducing reimbursement for remote services, though it is still too early see results of these changes. Some doctors′ reluctance to telemedicine may change due to demographic changes in this professional group, younger generations may regard ICT-based solutions as a norm. In the same time, poor development of basic IT infrastructure in Polish hospitals is likely to persist, unless a national programme of e-health development is implemented (with funds secured) and contracting e-health services by NFZ is introduced on a larger scale.

The article presents findings of research on e‑health development in four European Union (EU) Member States in the context of public procurement of innovation (PPI). EU policies attempt to make public procurement leverage for innovation by introducing a number of new tender procedures. Policies and practices in PPI, including e‑health, were investigated for Denmark, Great Britain, Spain and Poland. For various reasons, all four countries struggle with the introduction of the European PPI procedures, and with making a transition to outcome‑based tenders. Though they all introduced policies implementing these procedures, Denmark and Great Britain seem to have achieved better results, having well‑established public‑private collaboration. This correlates with a more efficient adoption of e‑health solutions in those countries. With some minor successes, Spain, and particularly Poland, display attachment to traditional procedures despite changes in the public procurement regulations.

Information and Communication Technologies (ICT) have become an essential tool used in all areas of society and health sector is no exception to this regard. Though eHealth is one of the most dynamic areas of health care, usage of ICT solutions is considered low compared to other sectors of economy.EPP eHealth project aims at identifying common needs in the area of eHealth, exploring the best available solutions and stimulating the market with the aim of creating a Public Procurement of Innovation (PPI) / Pre Commercial Procurement (PCP) strategy for the eHealth sector.The project goal is to understand health care public procurers' unmet needs in eHealth. Project consortium conducted desk research study and qualitative research to investigate barriers and opportunities of eHealth development. Desk research shows that use of both PPI and eHealth differs in countries participating in the project (Denmark, Poland, Spain and the UK). This can be attributed to a variety of reasons, including the structure of health care (different healthcare system models) and cultural differences among mentioned countries.Barriers of eHealth development on the EU level were defined as: -Lack of awareness of, and confidence in eHealth solutions among patients, citizens and healthcare professionals, -Lack of interoperability between eHealth solutions, -Limited large-scale evidence of the cost-effectiveness of eHealth tools and services, -Lack of legal clarity for health and wellbeing mobile applications and the lack of transparency regarding the utilisation of data collected by such applications, -Inadequate or fragmented legal frameworks including the lack of reimbursement schemes for eHealth services, -High start-up costs involved in setting up eHealth systems, -Regional differences in accessing ICT services and limited access in deprived areas.