Telemedicine is a concept born in the 70s with the development of technologies - computers, internet, mobiles...-. Its appearance responds to the need to deal with geographical barriers, in order to increase accessibility to health care, especially in isolated areas and developing countries.
The term telemedicine means providing health services at a distance using technological resources, in order to optimize care, time, costs, and increase accessibility. Currently, however, this term has evolved and has also been permeated by the implicit philosophy of these technologies - new ways of thinking, networking, global thinking, sharing as a value - giving way to the term eHealth (eHealth), with a more holistic view of the entire administrative and care process experienced by the person.
Following the pandemic caused by COVID-19, which acted as a catalyst for the start-up and accelerated introduction of technologies applied to Health, we want to highlight the challenges and opportunities that this learning offers us in the field of telemedicine with respect to the group of people with multiple disabilities, cerebral palsy and other neurodevelopmental pathologies.
There is evidence that the use of eHealth technologies is useful for the treatment and monitoring of chronic conditions, including those with movement disorders. Even so, it has been an underutilized resource, given the technical complexity it entails for the person who presents these disorders.
The Support Technologies Service of the Aspace Catalunya Foundation, advises on the accessibility options available for smartphones, tablets and computers, so that people with high complexity can make use of this eHealth resource. In this way, a new channel of communication with health professionals is facilitated which allows to increase adherence to the care process, thus facilitating accessibility to health care.
In the field of multiple disabilities, a global and highly specialized portfolio of services is required in order to support the needs of the person, which requires continuous attention adapted to the needs that appear. According to the options offered by eHealth technologies, many actions can be carried out electronically, promote the care continuum, such as: adjust mediation, perform orthopedic follow-up, perform rehabilitation and mental health assessments or follow-up of motor, sensory and behavioral symptoms, among others.
Non-progressive neurological damage defines cerebral palsy, but this does not imply a uniform and unchanging clinical behavior. Therefore, people with cerebral palsy have alterations in muscle tone that can interfere with daily life activities, limiting the opportunity to participate actively in society. These alterations can also lead to skeletal changes, such as osteoarticular deformities, which can cause pain and dysfunction, affecting health, well-being and quality of life.
Thanks to the introduction of the different technologies based on eHealth - communication channels, portable devices, monitoring through web platforms, etc. - new opportunities are presented, such as telesurveillance. This can become a decision support system by combining electronic medical record information with physical assessments and clinical practice guidelines, facilitating follow-up for early detection, as well as the rapid interventions, which contribute to the prevention of hospital readmissions or worsening of the person's quality of life.
The health care model has been transforming towards one participatory medicine towards the previous paternalistic behavior. This one predictive, personalized, preventive and participatory medicine, it has great relevance in chronic disorders, as it presents us with the opportunity to make a change in therapeutic presence. The patient can do his consultations from home, without the need to travel to the hospital, beyond the physical examination, this model allows us to functional observation in the person's natural environment, thus facilitated a holistic approach and not only somatic.
We can affirm, therefore, that the use of specialized technologies in eHealth has a positive impact on offering multidisciplinary care, facilitating accessibility to several health professionals at the same time. In this way, it facilitates real-time monitoring therapeutic options for patients and relatives, regardless of geographical distance, thus promoting the participation of people with neurodevelopmental pathologies, cerebral palsy and multiple disabilities.
This is why we consider it a strategic and complementary resource to face-to-face care, which allows us to minimize deterioration and irreversible physical, functional, emotional and behavioral damage, affecting the quality of life and autonomy of the people cared for.
BIBLIOGRAPHY:
Ben-Pazi H, Beni-Adani L, Lamdan R. Accelerating Telemedicine for Cerebral Palsy During the COVID-19 Pandemic and Beyond. Front Neurol. 2020 Jun 26;11:746.
Rodríguez Mariblanca M, Cano de la Cuerda R. Mobile applications in children with cerebral palsy. Neurology (Engl Ed). 2021 Mar;36(2):135-148. English, Spanish.
Cankurtaran D, Tezel N, Yildiz SY, Celik G, Unlu Akyuz E. Evaluation of the effects of the COVID-19 pandemic on children with cerebral palsy, caregivers' quality of life, and caregivers' fear of COVID-19 with telemedicine. Ir J Med Sci. 2021 Nov;190(4):1473-1480.
