Formulaire de description détaillée de votre projet

A. Sur votre projet

1. Titre du projet

NextStep Rehab

2. Compléter la phrase suivante

Notre projet propose une innovation qui permettra de développer des solutions pour résoudre le problème suivant / satisfaire le besoin suivant : The Rehabilitation Gap Modern rehabilitation works well during supervised care. Unfortunately, many patients gradually lose the benefits once formal rehabilitation ends. Examples include: • Hip replacement • Knee replacement • Cardiac rehabilitation • Pelvic floor rehabilitation • Lymphedema • Lipedema • Type 2 diabetes • Obesity • Cancer rehabilitation • Chronic musculoskeletal conditions Common problems include: • poor exercise adherence • declining motivation • uncertainty about recovery • limited access to clinicians • preventable deterioration • avoidable healthcare utilization

3. Domaine du projet

(Sélectionner au moins une option)

• [x ] Maladies chroniques
• [x ] Déshospitalisation
• [x ] Autonomisation du patient
• [x ] Santé digitale
• [x ] Nouveaux rôles en santé
• [ ] Autre : Préciser ici

4. Type de projet et de solution proposée

• [ ] Produit
• [x ] Service
• [x ] Solution technologique
• [ ] Solution non technologique

5. Votre projet (ou idée) a-t-il été soumis ailleurs pour financement ?

• [ x] Non
• [ ] Oui – préciser source et fonds obtenus

6. Membres de l’équipe

(Minimum 2 au moment de la soumission)

Membre 1

• Nom personne physique / Institution / Industrie : Catherine LaRocco, PT / HESAV / innovation in Rehab
• Position / Fonction : Founder
• Rôle et contribution : Physical Therapist and bioengineer
• E-mail / Tel : catherine.larocco@hesav.ch +41 79 478 21 65

Membre 2

• Nom personne physique / Institution / Industrie :
• Position / Fonction :
• Rôle et contribution :
• E-mail / Tel :

Membre 3

• Nom personne physique / Institution / Industrie :
• Position / Fonction :
• Rôle et contribution :
• E-mail / Tel :

B. Description du projet

1. Buts / objectifs du projet

The overall goal of NextStep Rehab is to extend rehabilitation beyond the point where formal, supervised treatment ends, helping people maintain their gains and transition successfully into long-term self-management.

Core goals

1. Bridge the post-rehabilitation gap Provide structured support during the months and years after patients leave formal rehabilitation, when adherence and motivation can decline.

2. Improve long-term patient outcomes Help people maintain exercise, healthy behaviours, function, and confidence through personalized digital rehabilitation pathways.

3. Support self-management of chronic conditions Provide ongoing tools and education for conditions that require long-term management, including lymphedema, lipedema, diabetes, obesity, cardiac conditions, and pelvic health problems.

4. Extend, not replace, clinical care Give physiotherapists and other healthcare professionals a way to continue monitoring and supporting patients without requiring continuous face-to-face appointments.

5. Improve healthcare efficiency Use digital follow-up to provide appropriate support at lower intensity than traditional one-to-one care, while identifying patients who need additional professional intervention.

6. Create measurable continuity of care Track patient-reported outcomes, adherence, symptoms, function, and progress so that clinicians and healthcare organizations can see what happens after discharge.

7. Develop a scalable rehabilitation model Build one digital infrastructure that can support multiple evidence-based rehabilitation pathways rather than creating a separate product for every condition.

Ultimately

The ambition is to move rehabilitation from:

“Treatment ends when the patient leaves the clinic”

to:

“Rehabilitation evolves from intensive professional care → supported self-management → lifelong health.”

And commercially, the key goal is to demonstrate that this model creates enough value for healthcare providers, insurers, and/or patients that they are willing to pay for it. That is the critical hypothesis NextStep Rehab needs to prove before attempting large-scale expansion.

2. État de l’art de votre concept

State of the art in digital rehabilitation

The field has moved well beyond simply providing teleconsultations or video-based physiotherapy. The current direction is toward hybrid, digitally supported rehabilitation integrated into the wider healthcare pathway.

1. Rehabilitation is increasingly viewed as a continuum

WHO now explicitly emphasizes that rehabilitation should be integrated across levels of care and continue alongside other health interventions, rather than being treated as an isolated episode of care. Recent WHO work also highlights fragmentation and lack of continuity as important problems and identifies digital platforms for remote consultation as potentially useful in underserved settings. (World Health Organization)

This strongly supports the fundamental premise behind NextStep Rehab:

rehabilitation shouldn't simply stop at discharge.

2. Tele-rehabilitation is already established

There is substantial evidence and implementation experience with:

• video consultations
• remotely prescribed exercise
• digital education
• remote monitoring
• asynchronous communication
• patient-reported outcomes
• wearable/device integration

So “we deliver physiotherapy digitally” is no longer novel.

That is important for NextStep: we should not position the technology itself as the innovation.

3. Digital self-management is increasingly important

The more interesting development is the movement from:

clinician delivers treatment → patient follows instructions

toward:

clinician + digital system → patient develops supported self-management.

This is particularly relevant for chronic and recurrent conditions.

For example, a 2024 systematic review of eHealth/mHealth interventions for lymphedema identified online education, telehealth and digital interventions and found encouraging effects on self-care, psychosocial outcomes and lymphedema-related outcomes, although the evidence base remains relatively small and heterogeneous. (ScienceDirect)

That is almost exactly the space NextStep could occupy.

4. The gap is particularly interesting after formal rehabilitation

The technology exists.

The clinical knowledge exists.

Digital exercise platforms exist.

Telehealth exists.

What is still relatively poorly solved is the transition between supervised rehabilitation and long-term independent self-management.

That is where I think NextStep has a potentially interesting proposition.

Instead of:

Telehealth

NextStep could provide:

Digital continuity of rehabilitation.

The patient doesn't necessarily need another 30-minute video appointment every week.

They may need:

a personalized programme → progression → reminders → education → monitoring → reassurance → occasional professional review → escalation when necessary.

This is where lymphedema/lipedema become interesting

They could actually provide a particularly good test case for the model.

Lymphedema is inherently a chronic self-management condition, with ongoing daily management requirements. Existing evidence suggests that professional support combined with self-management can be valuable, while digital interventions are promising but still relatively underdeveloped. (ScienceDirect)

So NextStep could potentially demonstrate:

Can a digital system make long-term rehabilitation/self-management more effective without requiring continuous face-to-face care?

If that works in lymphedema, the underlying model could then be adapted to:

• hip/knee replacement
• cardiac rehabilitation
• diabetes
• obesity
• pelvic health
• lipedema
• cancer rehabilitation
• healthy ageing

The potential innovation is how they are assembled into a clinically integrated continuity-of-care model, and—crucially—whether that model produces better outcomes at an acceptable cost.

That gives us a very good research/business question:

Can digitally supported continuity of rehabilitation improve long-term adherence, self-management and outcomes while reducing the intensity and cost of ongoing professional care?

That is a much stronger proposition than “we have a digital physiotherapy platform.”

NextStep has something very important: a measurable economic value proposition. WHO itself identifies rehabilitation as potentially reducing long-term health-system reliance, hospitalizations and readmissions and supporting return to work and participation. (World Health Organization)

3. Plan de votre travail

• A – Défi à relever / problème à résoudre / besoin à remplir Bridge the gap between formal rehabilitation and long-term self-management. Many patients require continued support after supervised rehabilitation ends, particularly those with chronic or recurring conditions such as lymphedema, lipedema, cardiac disease, diabetes, obesity, and pelvic health conditions. NextStep Rehab aims to develop a scalable digital solution that enables healthcare providers to extend evidence-based rehabilitation and self-management support beyond the clinic while maintaining appropriate professional oversight.
• B – Idée / Solution envisagée Develop NextStep Rehab, a digital rehabilitation continuity platform that extends rehabilitation beyond the clinic. The platform will provide personalized exercise and self-management programmes, education, progress and symptom monitoring, behaviour-change support, and communication with healthcare professionals when needed. The solution will be designed with patients and healthcare professionals to ensure that it is clinically relevant, usable, accessible, and compatible with existing care pathways.
• C – Activités planifiées au cours du projet Engage with patients, physiotherapists, physicians, and other relevant healthcare professionals to identify unmet needs and priorities. Visit and interact with healthcare facilities providing rehabilitation and chronic disease management. Map existing rehabilitation pathways and identify where patients currently lose support after discharge. Conduct user interviews and co-design workshops to develop the solution and define priority features. Review existing digital rehabilitation and self-management solutions to identify gaps and opportunities for differentiation. Develop and test an initial prototype/MVP with potential users. Assess usability, acceptability, feasibility, and willingness to use and/or pay for the solution. Identify an initial clinical pathway for pilot implementation and establish potential healthcare partners. Develop an initial business and implementation model based on findings from users and healthcare organizations.
• D - Infrastructures / collaborations / ressources disponibles utiles au projet NextStep Rehab can build on an existing network and expertise in physiotherapy, rehabilitation, research, digital health, and healthcare innovation. Available resources include access to healthcare professionals and rehabilitation settings through professional and academic networks, as well as expertise in evidence-based physiotherapy, implementation science, patient-reported outcomes, and qualitative research.

Potential collaborations include HESAV/HES-SO and CHUV, rehabilitation and healthcare institutions, physiotherapy practices, relevant professional associations, and patient organizations. These networks can support user research, co-design, clinical validation, pilot implementation, and evaluation of the solution.

The project will also leverage existing digital health technologies and infrastructure rather than developing all technology from scratch, allowing resources to focus on the clinical model, user experience, personalization, outcome monitoring, and integration into existing rehabilitation pathways.

4. Aspects innovants de votre technologie / solution / concept

1. Clinical model

A structured transition:

intensive rehabilitation → supported transition → self-management → maintenance

rather than an abrupt discharge.

2. Technology

A platform that adapts the level of support to the patient's needs:

low need → digital self-management

moderate need → asynchronous clinician support

higher need → teleconsultation / face-to-face referral

This is potentially much more scalable than treating everyone as a telehealth patient.

3. Health-system integration

The platform becomes part of the care pathway, rather than another app patients have to discover independently.

That distinction is important because WHO's current direction is toward integrating rehabilitation across health systems and primary care, rather than creating isolated digital services. (World Health Organization)

5. Capacité envisagée à améliorer la qualité des soins

NextStep Rehab has the potential to improve the quality of care by extending evidence-based rehabilitation beyond the period of supervised treatment and supporting patients during the transition to long-term self-management. The platform would enable personalized exercise and education, regular monitoring of symptoms and outcomes, and timely professional intervention when patients require additional support. This could improve adherence, continuity of care, patient engagement, and long-term functional outcomes while helping healthcare professionals identify patients who are not progressing as expected. By integrating digital follow-up into existing rehabilitation pathways rather than replacing professional care, NextStep Rehab aims to provide more continuous, patient-centred, and potentially more efficient care.

6. Impact potentiel sur l’économie ou l’efficience du système de santé

NextStep Rehab has the potential to improve healthcare-system efficiency by providing structured, evidence-based support after formal rehabilitation, when patients may otherwise require repeated face-to-face consultations or receive little ongoing support. By combining personalized digital follow-up with remote monitoring and targeted professional intervention, the platform could allow healthcare professionals to focus their time on patients with greater clinical needs while supporting lower-risk patients through digital self-management.

At a system level, improved adherence and earlier identification of problems could potentially reduce avoidable deterioration, unnecessary consultations, and healthcare utilization, while supporting better long-term functional outcomes. For patients with chronic conditions such as lymphedema, lipedema, diabetes, obesity, and cardiovascular disease, sustained self-management may also contribute to maintaining participation, independence, and ability to work.

The project will therefore evaluate not only usability and clinical outcomes, but also the feasibility and economic value of integrating digital rehabilitation continuity into existing care pathways.

7. Plans futurs

Development plan

The immediate future isn't about building a huge commercial platform. It's about validation and staged development:

1. Validate the problem Talk with patients, physiotherapists and other healthcare professionals to understand where rehabilitation currently breaks down and what support is actually wanted.

2. Co-design the solution Work with potential users and healthcare experts to determine what NextStep should actually do.

3. Develop and test an MVP Build the minimum viable version rather than trying to solve all of digital rehabilitation at once.

4. Test real-world feasibility Determine whether it can fit into existing clinical pathways and workflows.

5. Demonstrate value Generate evidence around engagement, clinical outcomes, professional workload, healthcare utilisation and ultimately economic value.

6. Commercialise and scale Once the model is validated, develop a marketable solution and progressively expand across rehabilitation conditions.