Dr. Maurizio Calcagni, Vice Chairman of the Division of Plastic and Hand Surgery at the University Hospital of Zurich (Switzerland), joins the DyCare Medical Board to participate actively in the development of ReHub along with the team and the other medical professionals already on the team. He explains his point of view as a surgeon on the importance of following the patient’s rehabilitation process after surgery.
Interview with Maurizio Calcagni, hand and wrist surgeon
1. Why did you decide to become part of the DyCare Medical Board? What did you see in the Dycare’s project?
Outcome measurements and outcome research coupled together with rehabilitation are among the most important fields of research and development in surgery in general and even more for upper limb surgery. DyCare provides a professional approach to this problem through a new promising device and control platform.
The project is based on measuring the rehabilitation of the patient and sharing the information among therapist and surgeon allowing for a better collaboration and for the improvement of the interaction with the patient based on actual daily measurement, and not only on short visits a few times a week.
There are many other potential advantages, from development, validation and implementation of new rehabilitation protocols to research projects in biomechanics or rehabilitation. The use of objective, very accurate and reproducible data could also be beneficial to researchers allowing a reduction of the number of subjects in the different treatment groups or removing the variability due to unknown compliance.
2. As a surgeon, how important is it for you to follow the process of patient’s rehabilitation after surgery?
Hand surgery relies completely on hand therapy. Rehabilitation is an essential part of the treatment and therefore it is very important for all the professionals involved, that they are informed on the patient’s improvements. The collected data will permit an early recognition of deviation from expected improvements, and an early intervention to adapt better the treatment to the patient and to the situation (complications, additional problems). This new “personalised rehabilitation” is moving away from a one-size-fit-all strategy to one, which uses new approaches to improve patients’ health, and targets therapies to achieve the best outcomes in the management of a patient’s condition.
3. How should communication between the surgeon and other professionals be in order to improve the patient’s recovery process? What role can the patient play in such communication?
The communication should be direct, without any intermediate party. The patient is not the right medium, since he is the subject of the treatment and he might not understand what is relevant or even have other interests or needs in contrast with the therapy. Exercises need time, motivation and should be executed in the right way and regularly, in summary a very good compliance. This is very difficult to achieve and to maintain especially on the middle to long term.
Ideally, surgery and rehabilitation should be in the same place to strengthen the impression of unity and consensus between surgeon and therapist. In modern life, with high mobility, time pressure, this setup is more and more difficult to achieve. A mobile-based solution offers the optimal platform that empowers the patient to fulfil their rehabilitation need, allowing at the same time for a continuous access to surgical and rehabilitative expertise and control.
4. What advantages do you think remote rehabilitation offers for the Health System? In addition, for the patient itself?
A mobile device based solution provides the optimal platform to enhance patient empowerment and meet their rehabilitation needs, while allowing continuous access to the control and monitoring of therapists and physicians.
5. Do you think that ReHub will improve therapeutic efficacy and reduce health care costs?
The clear definition of rehabilitation goals and their monitoring will be beneficial in many ways. The patients will receive a rehabilitation protocol that can continuously adjust to their actual needs leading to a better functional result. Through the DyCare it will be possible to perform reliable study on the efficacy of rehabilitation protocols and increase their cost-effectiveness. The device measure directly the exercises and will tell, in a far more precise way, the real situation of the patients. The partial reduction in need for an actual physical examination, without travel costs or waiting time, sharing information among professionals, and empowering of the patient for his own rehabilitation are further expected benefits.