Online rehabilitation at home established in record time

In March, when the whole country locked down, almost 150 patients were undergoing their rehabilitation stay at the LHL Hospital in Gardermoen, Norway. Within one day, everyone was sent home to prevent COVID-19 from spreading.

“It was a bit chaotic that day,” recalls Anne Edvardsen, head of the rehabilitation department and the outpatient clinic for heart, lung, and sleep assessment. “Many of our patients have significantly impaired function and are a long way from home.”

TLHL Hospital is a leader in Norway in the assessment and rehabilitation of patients with heart and lung problems. The patients are offered a four-week stay, where they get a tailored exercise program along with advice on diet and lifestyle changes.

“The pandemic brought a great deal of uncertainty,” says Edvardsen. “What do we do now? Will the waiting list be even longer? What about the person sitting at home with an oxygen machine who has already been waiting for six months for a rehabilitation stay? Should those in the middle of their rehabilitation be sent home?”

In times of crisis, we mobilize. An application for funding from the Dam Foundation, one of Norway`s largest foundations that provides money for health and research projects, was quickly granted and the patients were admitted to home hospitals. In just two weeks, a solution for digital home rehabilitation was established in collaboration with Siemens Healthineers.

The solution from Siemens Healthineers gave LHL the opportunity to launch home rehabilitation as a new service within two weeks. With their own employees, LHL prepared instructional videos and the digital rehabilitation service for both heart and lung patients. The patients were enrolled in a four-week rehabilitation program tailored to each individual. Sitting safely in their own home, patients used their own equipment in combination with an easy digital solution.

At-home rehabilitation was primarily offered to those adult patients with severe and/or complex lung disease and with comorbidities (two or more independent diseases) for whom the usual rehabilitation in hospital was not possible due to the COVID-19 pandemic. Around 30 patients took advantage of the offer in April/May and feedback from patients show that this was highly appreciated:

"This gave me the motivation to start exercising."

"The video sessions were great. I felt very well looked after."

"This should be available to everyone."

"It gave me a real boost."

“The digital platform is straightforward and flexible,” says Lars Houge, Head of Digital Services at Siemens Healthineers. He is impressed by the focus and the determination at LHL to implement the digital solution and is confident that these types of program are here to stay.

The current research study PCI@Home is intended to show LHL how a digital solution can best contribute to improved" health outcomes after minimally invasive interventions, known as PCI, to repair blocked arteries in the heart. The hope is that this will contribute to greater confidence and an improved quality of life for patients. However, this would require a change in the system of fees and reimbursement at the hospital.

“If the rules remain unchanged, we won’t be able to offer patients a digital alternative. Once a patient has been discharged from hospital, there is no more reimbursement. There is a huge willingness to develop this digital solution and a reliable partner like Siemens Healthineers is essential. Now, we just hope that we can continue," says Edvardsen.