Abstract
In catastrophic situations such as pandemics, patients' healthcare including admissions to hospitals and emergency services are challenged by the risk of infection and by limitations of healthcare resources. In such a setting, the use of telemedicine interventions has become extremely important. New technologies have proved helpful in pandemics as a solution to improve the quality of life in vulnerable patients such as persons with neurological diseases. Moreover, telemedicine interventions provide at-home solutions allowing clinicians to telemonitor and assess patients remotely, thus minimizing risk of infection. After a review of different studies using telemedicine in neurological patients, we propose a telemedicine process flow for healthcare of subjects with chronic neurological disease to respond to the new challenges for delivering quality healthcare during the transformation of public and private healthcare organizations around the world forced by COVID-19 pandemic contingency. This telemedicine process flow represents a replacement for in-person treatment and thereby the provision equitable access to the care of vulnerable people. It is conceptualized as comprehensive service including (1) teleassistance with patient counseling and medical treatment, (2) telemonitoring of patients' health conditions and any changes over time, as well as (3) telerehabilitation, i.e., interventions to assess and promote body functions, activities, and consecutively participation. The hereby proposed telemedicine process flow could be adopted on a large scale to improve the public health response during healthcare crises like the COVID-19 pandemic but could equally promote equitable health care independent of people's mobility or location with respect to the specialized health care center.
Highlights
On 20 March 2020, the World Health Organization (WHO) declared the pandemic state due to the spread of SARS-CoV2 [1]
Doctors had to face the dilemma of who can be treated at the hospital or at home, or who can be admitted to the limited number of beds in the intensive care units (ICU)
People with a severe chronic neurological condition who depend on a caregiver for their needs and/or to carry out their daily life routine had to face a difficult situations during the pandemic [5]
Summary
On 20 March 2020, the World Health Organization (WHO) declared the pandemic state due to the spread of SARS-CoV2 [1]. We propose a telemedicine process flow representing a viable alternative to respond to the new challenges for patient care forced by the transformation of public and private healthcare organizations due to the COVID19 pandemic This network will represent a replacement for in-person treatment, providing equitable access to care for vulnerable people, including subjects with chronic neurological disorders. With the current limitations in assisting patients at the hospital, the use of new telecommunication technologies by means of integrating telemedicine systems into the clinical routine may facilitate the maintenance of the remote relationship between healthcare providers and neurological patients [17, 35, 36] In this framework, the concept of “telemedicine” involves three treatment categories allowing to assist, monitor, and counseling patient remotely: [1] tele-assistance, [2] telemonitoring, and [3] telerehabilitation [37, 38]. We propose an integrated telemedicine system for assisting, monitoring, and treating subjects with chronic neurological diseases during this pandemic situation and beyond
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