Telerehabilitation in Bulgarian health care system

The rapid spread of the highly contagious Omicron variant of SARS-CoV-2 globally will challenge the accessibility and the delivery of physical and rehabilitation medicine (PRM) services. In Bulgaria, TR is still not regulated by law, and terms such as teleconsultation and tele-education have not yet been introduced. The adoption of TR in the Bulgarian health care system will undoubtedly increase the accessibility to rehabilitation treatment for a larger group of Bulgarian patients with various neurological, cardiorespiratory, musculoskeletal, and oncological conditions and will significantly contribute to the PRM services modernization in Bulgaria.

• 1
  TR is a subfield of telemedicine (TM), defined as the provision of rehabilitation services to patients at a remote location via telecommunication technologies and teleconference apps such as Skype (Microsoft Co), Facebook Messenger (Facebook Inc), Viber (Rakuten Group Inc), and WhatsApp (Facebook Inc).
• 2
  Recent studies suggest that TR visits are safe and effective treatment approach for people with disabilities,2 and has several advantages over in-person rehabilitation such as early access to rehabilitation, reduced health care costs, improved treatment adherence, and health-related quality of life.
• 3
  Nonetheless, we identified several barriers such as the lack of legislative framework, data privacy, patient safety, reimbursement, and NHIF coverage, as well as the lack of established national TR guidelines, which limiting its implementation in the Bulgarian rehabilitation practice.