Distance medicine: a trend that is here to stay

The emergence of the pandemic has changed the world as we know it. Processes that were already underway had to be rushed, but systems also had to be built from scratch. It is in this context that Covid-19 accelerated the development and application, by health teams, of novel ways to provide care to patients.

Telemedicine is medicine at a distance and can be applied both to the diagnosis and to the treatment of different pathologies. During the last time, it has been possible to apply it with good results in patients with chronic neurological diseases, thus reducing the need to transfer patients to medical centers and also favoring access to those who live in more remote areas. In this particular epidemiological situation, this reduces both the risk and thus also reduces the cost of transfers from home to the institution and the time required for it.

On the other hand, this also allowed all the medical teams to be able to continue monitoring the patients and, in this way, help to detect complications early and minimize the consequences of isolation at a cognitive and motor level.

Now, like any paradigm shift, this also has an adaptation process and that is where it could be said that the disadvantage of telemedicine lies: in the adaptation of patients and the health team. When evaluating a patient to start a neurorehabilitation program, one must consider what he or she needs, set goals and thus put together an interdisciplinary treatment plan seeking to improve the quality of life, reducing functional impairment whenever possible. In this way, cases are presented that, due to the risk involved in performing rehabilitation with little supervision, give a better result with mixed rehabilitation plans in person / at a distance or only treatment in a traditional way. Some reasons why this occurs may be due to difficulties in the use of technology or even due to little acceptance of the lack of human contact. For this reason, it is essential to evaluate each case in particular.

Yet despite this, during mandatory isolation, we have been amazed at the ability of many patients and their families to participate and adhere to treatments. The usefulness of telemedicine is proven. Indeed, multiple studies have been carried out in different parts of the world to evaluate the efficacy of treatments and the acceptance of health teams and patients. So much so that, in studies carried out in the United States and Italy in recent years, the similarity between telemedicine and face-to-face care was evidenced, not finding significant differences between the two systems.

Likewise, an advantage of great importance for this type of treatment is the ease of access for rehabilitative care beyond the hospital environment, in a more ecological and “real” environment, where new limitations can be detected and the efficacy of the interventions evaluated in relation to the activities of daily living of patients.

In conclusion, developing interdisciplinary telerehabilitation programs with personalized activities, guided by therapists in a safe, controlled manner and maintaining the privacy of patients, implies a challenge that has been faced with good results. Certainly, the future that we will be able to develop comes with new tools for the benefit of a more accessible and modern medicine.

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