Systematic review on tele-wound-care in spinal cord injury (SCI) patients and the impact of telemedicine in decreasing the cost

Abstract

Telehealth refers to health care interactions that leverage telecommunication devices to provide medical care outside the traditional face-to-face, in-person medical encounter. Technology advances and research have expanded use of telehealth in health care delivery. Physical medicine and rehabilitation providers may use telehealth to deliver care to populations with neurologic and musculoskeletal conditions, commonly treated in both acute care and outpatient settings. Patients with impaired mobility and those living in locations with reduced access to care may particularly benefit. Video-teleconferencing has been shown to be effective for management of burn patients during acute rehabilitation, including reduced health care use expenses and less disruptions to care. Telehealth can facilitate developing inter-professional care plans. Patients with neurologic conditions including stroke, spinal cord injury, traumatic brain injury, and amyotrophic lateral sclerosis may use telehealth to monitor symptoms and response to treatment. Telehealth also may facilitate occupational and physical therapy programs as well as improve weight management and skin care in patients with chronic conditions. Other applications include imaging review in sports medicine, symptom management and counselling in concussion, traumatic brain injury, and pain management programs. Limitations of telehealth include barriers in establishing relationship between medical provider and patient, ability to perform limited physical examination, and differences in payment models and liability coverage. The expansion of telehealth services is expected to grow and has potential to improve patient satisfaction by delivering high quality and value of care.Niknamian S (2019) Systematic review on tele-wound-care in spinal cord injury (SCI) patients and the impact of telemedicine in decreasing the cost Volume 4: 2-6

Systematic review of telemedicine in spine surgery

“…Publication dates ranged from 2016 to 2019. Studies were conducted in North America (7), Europe (3), and Asia (2). Three studies included general neurosurgery cohorts, while the remaining studies were strictly spine patients (Table 1).…”

“…We also excluded studies involving the use of TM for patients with spinal cord injury, given that several systematic reviews of this topic have recently been published. 7…”

Case Managers’ Perceptions About Synchronous Telerehabilitation versus Clinic-based Physical Therapy Services for People with Spinal Cord Injury

“…This was evident in the disparate ratings survey respondents assigned to the two models, particularly with regard to service quality, effectiveness, convenience, and access. In fact, with the exception of being easy to schedule around other activities and minimizing transportation barriers, the obtained ratings opposed research findings documenting a telerehabilitation advantage for providing access to expert clinicians (Irgens et al, 2018;Niknamian, 2019;Schmeler et al, 2008), being appropriate regardless of home location (Dunphy & Gardner, 2020), and occurring in a comfortable and private setting conducive to physical progress (Kairy et al, 2013;Theodoros & Russell, 2008). For other issues-such as being safe, yielding accurate assessments and diagnoses, being effective, providing personalized treatment, and fostering client motivation-existing research supports similarity between the two delivery models (Cramer et al, 2019;Kairy et al, 2013;Levy et al, 2015;Neo et al, 2019;Theodoros & Russell, 2008;Turolla et al, 2020) that was not realized in the current respondents' ratings.…”

“…Over subsequent years, however, the value of synchronous telerehabilitation became increasingly apparent. Not only is using technology to access services remotely essential in some circumstances, but it is also a viable and equal alternative to clinic-based service delivery in many respects ( Cramer et al, 2019 ; Dunphy & Gardner, 2020 ; Irgens et al, 2018 ; Kairy et al, 2013 ; Levy et al, 2015 ; Neo et al, 2019 ; Niknamian, 2019 ; Schmeler et al, 2008; Theodoros & Russell, 2008 ; Turolla et al, 2020 ). However, knowledge about synchronous telerehabilitation among case managers responsible for service coordination is less widespread than that about clinic-based services.…”

“…Widely accepted advantages exist for the use of telerehabilitation rather than the more traditional, clinic-based service delivery model. These advantages include the possibility for consultation with top professional specialists regardless of geographic proximity ( Irgens et al, 2018 ; Niknamian, 2019 ; Schmeler et al, 2008), the elimination of travel time and expense for clients as well as reduced reliance on other people or handicapped-accessible transportation ( Kairy et al, 2013 ; Levy et al, 2015 ; Nikmanian, 2019 ; Schmeler et al, 2009 ; Yuen et al, 2015 ), and the receipt of therapy services in the comfort and privacy of home ( Kairy et al, 2013 ; Theodoros & Russell, 2008 ).…”