Digital rehabilitation has shown to increase therapy adherence and outcomes (1),increase patient satisfaction (2), increase physical therapist satisfaction (3) and lower costs for society (4). Digital solutions should have a place in the services offered in Belgium.
The convention for telerehabilitation was a first step into a state where telerehabilitation becomes an accepted and complementary way to support patients.
The convention has shown that patients appreciate hybrid rehabilitation (remote follow-up and physical sessions), but also its flexibility. The physical therapists appreciate the free access to the platform, the technical support given to the patients and to themselves. The doctors, GP, rehabilitation doctors or surgeons, appreciate the insights generated by the platform and the ability to communicate with the PT doing the follow-up.
In the future, the reimbursement of telerehabilitation should evolve into a more open, more flexible and easier framework.
First, restricting reimbursement to patients operated in certain hospitals is preventing broader adoption and limiting the potential benefits of digitalisation. Every doctor, and every PT, should be able to prescribe and offer digital rehabilitation.
Second, the PT and the patient should have flexibility on the organisation of treatment, to tailor the treatment to the needs of the patients. Alternating physical in patient visits with remote monitoring should be possible over the course of the whole treatment.
Third, the PTs appreciate the quality of the platform, but they lament the applicability of the reimbursement to only hip and knee rehabilitation. The possibility for remote coaching/therapy should be open for more pathologies, so more patients and more PTs can benefit from it.
Finally, the administrative complexity and the restriction of honoraria supplement has been a huge barrier to adoption by a vast number of PTs, and hence their patients.
At moveUP we plead for:
- The creation of a new code for remote therapy monitoring (RTM), which would complement physical rehabilitation and tele consultation. This code enables PTs to interact, monitor and adapt the treatment of their patients in between face to face sessions. This code should be paid not less, not more than a physical or video consultation, and contain no additional restrictions (like honoraria supplements).
- The applicability of this new codes to follow international evidence, meaning no restriction on specific indications.
- The patient and the PT having flexibility on how and when to use these codes, provided that the treating physician has prescribed such rehabilitation and is kept informed on the progress of the patient.
- The guaranteed being given to the social security that these new codes would not create “over usage”, by insuring they come from the same pot of sessions, and that their effective usage can be monitored. For an Fa pathology, patients could have a budget of max 60 sessions, being a mix of physical, video or RTM. Video and RTM could only be attested if proof can be given on their actual usage (duration, acts, etc..)
- A fair reimbursement for the applications that meets the M1-M2-M3 criteria, to insure the solution fit the Belgian system, and are made accessible to most patients or physical therapist at no additional costs compared to standard of care.
Let us know what you think at firstname.lastname@example.org!