By Eneya Georgieva
The National Health Insurance Fund (NHIF) covers ten procedures and two examinations for injury treatment. However, according to experts this is extremely insufficient to fully recover. For example, in the case of knee surgery for a torn meniscus, state support will cover only 10 days of treatment instead of the required 30.
However, patients do not know what they need for their recovery. The lack of long-term and personalized rehabilitation slows down the process and is associated with a loss of initial progress. In these cases, the person who has undergone surgery is most affected because he cannot continue his life normally. Moreover, his employer cannot rely on him, and the National Social Security Institute pays for sick leave for a longer period of time, instead of covering the necessary funds for reimbursement at the very beginning.
The problems for patients are not limited to the lack of effective practices, insufficient financial support from the NHIF and poor awareness of how to overcome the trauma. One of the biggest challenges is outdated understandings and the lack of modern rehabilitation centers.
“Most centers in the country work on an outdated system and methods, many of which have been controversial for the past 20 years,” said Dr. Marin Benkin, an orthopedic traumatologist and head of the arthroscopic surgery department at Serdika Hospital. The so-called physiotherapy in our country is very different from that in the world. In our country, physical methods of treatment are used, which do not find a place in the major rehabilitation hospitals in Europe.
According to him, many of the applied methods of physiotherapy do not take into account the patient’s condition, the operation and the time elapsed since the trauma. High-frequency electric current and radar, for example, can have a negative effect on the patient if administered less than 3 months after surgery. The expert emphasizes the need for gymnastics to move the affected area and return it to normal movement. And this is done by activating the muscles, which are important to work as before with the help of proper exercise.
Properly performed restorative gymnastics allows the patient to return much faster to their daily activities and, most importantly, prevents the possibility of the problem deepening over time.
Is there a solution?
In addition to being a health expert, Dr. Benkin is the founder of Play Reha rehabilitation platform. The platform is based on fast and secure access to modern kinesitherapy. A wide range of rehabilitation programs and general rehabilitation programs are provided, thus patients can take care of themselves and doctors can monitor the progress of the recovery period quickly and easily.
“I had nowhere to send my patients for rehabilitation and in 2016 I created PlayReha. At that time, many people in the industry did not believe in my approach, despite all the research. Today, the same people send their patients to our center. Rehabilitation is a recovery process that begins with the hospital discharge and continues until recovery, and gymnastics is at its core”, says Dr. Benkin.
The Play Reha platfom he manages, brings a large part of the rehabilitation process into the digital space and looks visionary at a global problem – recovery from physical trauma. The platform offers personalized rehabilitation programs tailored to the problem of patients and fully adapted to the needs of the recovery process. In addition to the possibilities for electronic patient record, teleconsultations and personalized approach, the platform analyzes the patient’s data, monitors his progress and proposes changes in the program, according to the processed information about the status of the condition. The digitalization of the rehabilitation process also allows for an interdisciplinary approach to physicians, which is essential in a more serious problem, requiring a team of experts to simultaneously monitor the recovery of a patient.
Contrary to the visionary, the participants in the traditional centers have no interest in changing the model of work. At the moment, their pay is low due to the weak support from the health insurance fund, and if they start applying new methods of working with their patients, it would take them much more time, which no one will pay for.
“The National Health Insurance Fund gives about BGN 67 for rehabilitation. They include 2 examinations, 10 procedures and taxes. This leaves less than BGN 2 for rehabilitators per hour of work with a patient “, says Dr. Benkin. Low payment rates for the professionals in the sectorlead to lack of attention towards innovative solutions. The real work for them begins after working hours in their own premises. There they practice gymnastics with the patients, but the payment does not go to the Health Insurance Fund.
In 2020, 1,400 people used the services of Play Reha. For them, Dr. Benkin’s team builds a standardized or personalized programme. It is noticed that as in other sectors of the economy, a specially designed customer service is increasing. For the last 2 years this growth is about 15%. The reason for the great interest in Play Reha is in the modern approach and the attention to doctors. In addition to the convenience of choosing the time yourself, to be independent of someone else’s schedule and not to leave the comfort of your home when your movement is difficult. This builds engagement and patients are consistent in their recovery. The digitalisation of rehabilitation is an innovative, Europe-wide approach that saves time, reduces health inequalities, engages the patient with responsibility for their own health and promotes a personalized and interdisciplinary approach to treatment, something health systems around the world have been striving for years.
Due to this approach the company became a member of the Digital Health and Innovations Cluster Bulgaria (DHI Cluster Bulgaria). In 2020, the company joins the digital healthcare ecosystem, driven by the ambition for improved and more efficient healthcare, based on data and technology, with the patient and its needs in the centre.