The pressure on healthcare systems, especially in primary care, demands new intervention methods that provide quality care without compromising resource sustainability.
In this context, telerehabilitation emerges as one of the most innovative and effective solutions.
One of the strongest examples of its clinical implementation can be found at the Hospital of Denia, where during the COVID-19 pandemic the use of the ReHub® platform drastically reduced physiotherapy waiting lists and increased patient adherence to therapy.
In just four months of operation, the average waiting time to start treatment dropped from 40 days to only 7.
Additionally, a total adherence rate of 73% was achieved—figures that demonstrate not only the model’s viability but also its clinical and organizational impact.
The success of telerehabilitation implementation in primary care at this hospital has been so significant that the tool is still in use today.
This article takes an in-depth look at how telerehabilitation has been integrated into primary care, which elements have been key to its success, and what lessons can be drawn for scaling in other healthcare settings.
What Is Telerehabilitation in Primary Care?
Telerehabilitation is a healthcare modality that uses digital technologies to provide remote physiotherapy services.
When applied at the primary care level, it allows patients to access therapeutic exercise plans from home, remotely supervised by physiotherapists, without the need for continuous visits to the health center.
This is especially useful in contexts where waiting times are long, patient mobility is limited, or the available human resources are insufficient to meet demand.
Unlike the traditional in-person model, telerehabilitation in primary care offers:
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Faster access to treatment
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Greater patient autonomy
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Optimization of healthcare system resources
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Clinical monitoring through objective data
Far from being a temporary solution, it is a complementary, scalable, and effective care model.
The ReHub® Model: Technology Applied to Therapeutic Exercise
ReHub® is a telerehabilitation platform that allows physiotherapists to design, monitor, and adapt therapeutic exercise programs remotely.
It combines an intuitive patient interface with inertial sensors that collect objective data on physical performance: number of repetitions, range of motion, speed, and quality of exercise.
From the professional’s perspective, it offers a rigorous, real-time clinical control system.
From the patient’s perspective, it provides autonomy, flexibility, and an interactive experience that encourages therapeutic engagement.
The use of ReHub® in the Denia Health Department represents a paradigmatic case of how technology can be integrated into the healthcare circuit without losing sight of quality, personalization, and clinical safety.
Implementation Process at the Hospital of Denia
The incorporation of ReHub® into the Physiotherapy Service at the Hospital of Denia was carried out progressively, following a “less to more” approach.
This strategy allowed controlled and adaptive integration, which was key to the project’s success.
Deployment Timeline
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May–July 2021: obtaining licenses, staff training, and launch.
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August–September 2021: first patients included, workflow creation, IT management, and operational adjustments.
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October 2021 onward: formal implementation and consolidation of the model.
This initial phase was characterized by the absence of strict protocols by injury type, which facilitated a more flexible application based on real clinical practice rather than a rigid normative approach.
The model was built through trial and error, with constant feedback between the care team and platform managers.
Keys to Success
Although ReHub® usage is the core of the system, the project’s success is not explained solely by technology but by how it was integrated into the care model.
1. Continuous adaptation of procedures
The physiotherapy team developed a standardized working procedure (SWP) that included inclusion/exclusion criteria, flowcharts, roles of different professionals (physiotherapist, rehabilitation physician, administrative staff), and follow-up guidelines.
This framework allowed scaling the project without losing care quality or clinical traceability.
2. Training of professionals
Regular training and the progressive increase in physiotherapists skilled in the platform were decisive.
The team grew from 2 initial physiotherapists to 5, creating a strong core of advanced users able to support the learning curve of new professionals.
The approach was not only technical but also clinical: ReHub® was understood from the beginning as a therapeutic tool, not just technology.
3. Patient acceptance
Patient willingness was an inclusion criterion. The experience started with an initial in-person visit where the physiotherapist performed a physical assessment, created the digital profile, and explained how the platform works.
This 15–20 minute session established a fundamental trust relationship for the success of remote treatment.
This initial contact also helped identify and resolve potential technological barriers before the effective start of the program.
4. Internal and external dissemination
Communication was key. Efforts were made both in patient outreach and coordination with the broader healthcare environment: primary care physicians, administrative staff, and other department professionals.
This facilitated referrals, streamlined workflows, and increased program visibility.
Clinical and Organizational Results
Data from the first two years of implementation are compelling:
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462 patients treated with ReHub® between October 2021 and September 2023
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More than 47,000 exercises completed
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A total of 164,695 minutes of therapy, equivalent to 2,744 active hours on the platform
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An average of 150 active patients per month
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A 120% increase in activity between 2022 and 2023
But the most relevant are the clinical impact and efficiency indicators:
Reduction in waiting time
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Average delay to start telerehabilitation: 7.18 days
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Average delay for conventional physiotherapy: 42.56 days
This represents a reduction of over 80% in waiting times, with almost immediate access to treatment after medical referral.
Adherence to treatment
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73% total adherence
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91% adherence in cases combining ReHub® and in-person sessions
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78% of patients experienced symptomatic improvement
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Only 22% required referral for subsequent hospital rehabilitation
These data are particularly significant compared to the dropout rates commonly seen in prolonged or poorly supervised treatments.
ReHub® in Primary Care: A Scalable Solution
The model implemented in Denia demonstrates that telerehabilitation in primary care is not only feasible but desirable.
It enables faster, more efficient, and patient-centered care without sacrificing clinical rigor or monitoring capability.
Furthermore, it frees up in-person resources for more complex cases or those requiring intensive physical intervention.
The integration of hybrid models, combining in-person sessions and digital follow-up, represents a logical evolution of the healthcare system.
Conclusion
The Hospital of Denia’s experience with ReHub® is a clear and replicable example of how telerehabilitation in primary care can transform access to physiotherapy, improve clinical outcomes, and optimize available resources.
Thanks to careful implementation, solid training, and a patient-centered strategy, the project has drastically reduced waiting lists and increased therapeutic adherence—two of the historic main challenges in public physiotherapy.
The future of rehabilitation lies in hybrid models, where technology does not replace the professional but empowers them. ReHub® is not just a tool but a new way of understanding physiotherapy: more accessible, more efficient, and more human.