Role of Telerehabilitation in the Rehabilitation Medicine Training Program of a COVID-19 Referral Center in a Developing Country

Abstract

This article describes the impact of the pandemic on physical medicine and rehabilitation in a COVID-19 referral center of a developing country. It describes how telerehabilitation can be leveraged to fill in the gaps in service, training, and research arms of the physical medicine and rehabilitation specialty. The ITAWAG (“to call”) telerehabilitation program is the response of the Department of Rehabilitation Medicine at Philippine General Hospital, which is the country’s national university hospital, to the ongoing COVID-19 crisis that continues to limit face-to-face access to physical medicine and rehabilitation services throughout the country. With the significant decline in the number of patients served since the start of the pandemic, the ITAWAG program aimed to bridge the physical distance between patients and clinicians after a set of eligibility criteria for teleconsultation or teletherapy and a step-by-step process used before, during, and after each virtual encounter. However, because many physical medicine and rehabilitation consultants, residents, and therapists were not trained for the virtual approach to patient care, a telerehabilitation curriculum was developed to help in providing quality and competent services. Finally, despite the growing awareness of telerehabilitation throughout the country, several research gaps about this emerging technology are identified to determine its acceptance, applicability, and cost-effectiveness among others.

Global Online Interest in Telehealth, Telemedicine, Telerehabilitation, and Related Search Terms Amid the COVID-19 Pandemic: An Infodemiological Study

“…Their relatively more expansive and growing experience with telerehabilitation in terms of service, training, and research might have catalyzed the increased awareness regarding "telerehabilitation" or "telerehab" among stakeholders, whether patients, therapists, or other specialists, throughout the country. 8 In this digital age, the word could have easily spread through local and international webinars and social media, especially during the COVID-19 pandemic, when telerehabilitation became suddenly more relevant than in previous years.…”

“…2 Of particular interest in this article, although telerehabilitation (telerehab), a subset of telehealth and telemedicine, had been present before the pandemic, it has suddenly received greater attention these days. [3][4][5][6][7][8] Because this non-traditional approach to rehabilitation has neither been widely known nor implemented in many parts of the world, including the Philippines, telerehab brought about a lot of apprehensions and questions among stakeholders (e.g., patients, clinicians, administrators, educators) regarding its different aspects of implementation and outcomes. 9 Hence while in quarantine, stakeholders turned to online resources, such as Google™, for various reasons, such as to feed their curiosity, guide themselves in health-related decisions, and resume healthcare access or delivery.…”

“…In parallel, healthcare providers might have been interested in incorporating telerehabilitation into their practice. [3][4][5][6]8 As Google™ became the most popular search engine possibly because of its efficient indexing and ability to "produce much more satisfying search results" compared to other existing engines, the word "google" was eventually used globally as a verb that means "to search (something) on the Google™ search engine." [10][11][12] "Googling" telehealth, telemedicine, telerehabilitation, and other related or synonymous search terms were suddenly on the rise based on Google Trends™.…”

“…17 The patients and rehabilitation professionals alike have reported telerehabilitation as beneficial and safe. 8 In general, however, the rehabilitation workforce (i.e., physiatrists or Rehabilitation Medicine physicians; therapists or allied medical professionals) in the clinical and academic settings in public and private sectors needed more information on telerehabilitation apprehensions emerged about its use. 17 Various sources of information to meet the urgent need for knowledge and skills regarding telerehabilitation became popular in the forms of interaction with colleagues, interim guidelines from international and local professional societies, webinars, and many other online resources based on anecdotal reports.…”

Feasibility of Speech Telerehabilitation for a Patient with Parkinson's Disease in a Low-Resource Country during the Pandemic: A Case Report

“…In telerehabilitation, which is the innovative and remote delivery of usual Rehabilitation Medicine services, teleconsultations and teletherapy go hand-in-hand. 23 Currently, there are only 259 fellows of the Philippine Academy of Rehabilitation Medicine and 673 members of the Philippine Association of Speech Pathologists. 17 With the shortage of rehabilitation workforce and facilities that are mostly located in the urban areas in the Philippines, telerehabilitation can be leveraged to improve access to specialized services to patients, especially in remote areas.…”