Implementation of physiotherapy telerehabilitation before and post Covid-19 outbreak: A comparative narrative between South American countries and Australia

Abstract

The continuous development in telecommunication tech­nologies has created opportunities for health professionals to optimise healthcare delivery by adopting digital tools into rehabilitation programs (i.e., telerehabilitation). These tech­nological advances, along with the demographic and social characteristics of each country, have made the implementa­tion of telerehabilitation a disparate process across regions. We have gathered the experience of four countries (Australia, Chile, Brazil, and Colombia) in two different regions (Ocea­nia and South America) to recompile the history pre- and post-Covid-19 outbreak until January of 2021, the barriers to, and facilitators of telerehabilitation, and outline the future challenges for these countries.

Analysis of the virtual healthcare model in Latin America: a systematic review of current challenges and barriers

“…Problems associated with Internet access and connectivity ( 17 , 19 - 21 , 23 , 26 ), the need for specialized equipment and software (e.g., smartphone, camera, among others) ( 16 , 21 , 26 , 29 , 32 ), as well as having the technical skills in the use of technological tools to provide and receive virtual service delivery ( 17 , 22 , 25 , 30 , 33 ) were the main barriers associated with the care process in the studies analyzed (n=14). Although the lack of connectivity during virtual care was a recurring complaint among patients, non-attendance at virtual appointments did not exceed 5% of cases ( 20 ), but it was recognized as a factor that increases the perception of poor clinical care ( 21 , 28 ). From the point of view of healthcare workers, the lack of specialized software and equipment for the correct professional practice and issues of interoperability with existing institutional programs were identified as factors that affect productivity and generate the perception of work overload due to the additional procedures required compared to face-to-face care ( 21 , 26 , 29 ).…”

“…Lack of privacy was one of the main barriers expressed by patients due to the risks of cyber-attacks and reliability in handling data and their clinical information ( 17 , 28 ). This aspect was also found to be compromised because some patients reported requiring support from their caregivers during the provision of the service, which diminished the privacy of the information shared with their treating physician and the quality of the physician-patient relationship ( 25 , 27 ).…”

“…This aspect was also found to be compromised because some patients reported requiring support from their caregivers during the provision of the service, which diminished the privacy of the information shared with their treating physician and the quality of the physician-patient relationship ( 25 , 27 ). Some patients have the misconception belief that the virtual care model is not good for therapeutic benefit ( 22 , 28 ). In the study by Morais et al ( 18 ) which included a face-to-face encounter for home health care, some patients or caregivers showed resistance to accepting healthcare staff inside their homes because they believed their privacy is violated.…”

“…Four studies identified barriers to the use of the virtual care model associated with healthcare personnel’s beliefs or perceptions about service delivery ( 18 , 28 , 29 , 32 ). Among clinicians, a concern about the benefit or effectiveness of the care model in treating patients’ health conditions was identified ( 28 ), which consequently led to an increased perception of the risk of committing medical malpractice and jeopardizing patient safety ( 33 ).…”

“…Four studies identified barriers to the use of the virtual care model associated with healthcare personnel’s beliefs or perceptions about service delivery ( 18 , 28 , 29 , 32 ). Among clinicians, a concern about the benefit or effectiveness of the care model in treating patients’ health conditions was identified ( 28 ), which consequently led to an increased perception of the risk of committing medical malpractice and jeopardizing patient safety ( 33 ). In the context of performing specialized teleconsultation with support from a general practitioner at the remote site of care, a concern was found regarding the use of this model by specialists due to shared medical responsibility ( 29 ).…”