Health Scan: Telemedicine may replace face-to-face therapy

Could it be that in little more than a decade, occupational, physical, behavioral and psychological therapists will not have a one-on-one relationship with their patients? That is the prediction of Prof. Gigore Burdea, a pioneer in the field of virtual rehabilitation and director of the Rutgers University Tele-Rehabilitation Institute, who spoke recently at an international conference at the University of Haifa.

With developments in virtual reality, there will be no longer be a number of therapists for each patient, but one therapist for many patients, Burdea said.

"Rehabilitation in the home of the patient will be provided by a robot in the not-so-distant future. Such a robot will provide occupational, physical, behavioral and psychological therapy - as well as doing the cooking, cleaning, dressing and other household chores," the New Jersey expert said.

The various aspects of therapy must come together, he explained. The technologies that will enable this are likely to be in the form of robotics - a robot that does everything in the patient's home, including cooking, cleaning, dressing and therapy tailored to the patient's continuously changing needs. "A patient might feel more at ease talking to a robot in the comfort of the home and not in a hospital or clinic," he pointed out.

"Cloud rehabilitation" - a term coined by Burdea - will also play a major role in the future of interactive virtual rehabilitation. Use of cloud computing technology will facilitate real-time processing of data, recording patient rehabilitation processes on remote servers and making the information accessible to remote therapists for analysis and feedback. He emphasized, however, that technology will augment and not replace therapists. The future technology will be able to avoid the risks in using today's virtual reality games for rehabilitation, Burdea explained. The Wii and Xbox, for example, have been adopted by therapists but are unsuitable for unassisted patient use due to dangers such as elevated blood pressure and loss of balance. The game-based concept will remain, however, as it provides motivation. "The future," Burdea concluded, "is in low-cost, patient-based devices that will enable the patient to receive continuously tailored therapy at home."

ISRAELI KIDS NOT SAFE ENOUGH

Israel is only 15th among 24 developed countries in a list of those with the least harm to children from accidents on the road, in the home and school, and at leisure. The European Child Safety Alliance recently ranked Israel along with Cyprus with the countries that are safest for children on the top. Beterem, the National Center for Child Safety and Health, has done much to reduce deaths and injuries of children, but much remains to be done.

A total of 150 Israeli children died in accidents last year. Many more were injured. Among the causes were accidental falls, poisoning, drowning, strangling and bicycle and car accidents. Dr. Chezy Levy, the Health Ministry's deputy director-general in charge of the medical branch, says the ministry sees itself as a "leader in the national program for child safety." Beterem chairman Ofer Ne'eman urged the Knesset to lead a national project aimed at drastically reducing the accidental deaths and injuries of children. Beterem director-general Orly Silbinger added that the state must develop, lead and inculcate a multi-system plan based on evidence and budgeted by the Treasury. "I call on all the ministries to join the national child safety program led by the Health Ministry," she said.

SECOND-GENERATION DELIVERY SERVICE

Jerusalem's 107-year-old Shaare Zedek Medical Center is used to treating several generations of specific families, but this case was especially unusual. Dikla Alfi Cohen, who was born at the hospital weighing a meager 730 grams 28 years ago - when successful treatment of very-low-birthweight infants was rare - gave birth recently to a 2.7-kilo baby girl in the same delivery rooms. The mother's survival and good health as a premature infant was regarded as a real achievement, thanks to Prof. Michael Kaplan, then a young doctor in Shaare Zedek's neonatology department. Kaplan was again on hand, this time to take care of Dikla's baby - even though she was born at a good size.

UNITED HATZALAH BUYS
ALL-TERRAIN AMBULANCES

The world's first 4X4 ambulances, which can reach almost any location and are equipped with advanced resuscitation equipment, have been purchased for NIS 250,000 apiece by United Hatzalah from the Israeli company Tomcar. The rescue-and-first-aid organization of religious volunteers has purchased three of the vehicles. Until now, off-road emergencies needed help from military rescue vehicles; waiting for them has led to loss of life, the organization said. United Hatzalah chairman Rabbi Ze'ev Kashash said the vehicles can operate in deserts, forests, snow and mud. There is room in each for two injured people and three staff members.