Portugal's Health Service Adds AI-Guided Home Physiotherapy From Porto Unicorn Sword Health

Portugal's public health service is about to start prescribing artificial intelligence. Under a deal between the SNS (Serviço Nacional de Saúde, the National Health Service) and the Porto-born technology company Sword Health, family doctors can now refer patients to AI-guided remote physiotherapy at no cost to the user — a first for the state system and a notable vote of confidence in a homegrown unicorn.

The service lets a patient follow a structured rehabilitation programme from home, with sensors and software coaching their movements and a clinician supervising remotely. Doctors began issuing prescriptions this week, with the tool rolling out across public hospitals and health centres.

How the economics work

The contract sets a flat fee of about €200 per user, fixed for one year, in exchange for unlimited physiotherapy sessions over that period. Sword Health puts the cost at roughly a fifth of the traditional model and argues the approach can dramatically shorten waiting lists — the company cites reductions in waiting times of up to 97% and savings of around 45% for the State, figures that will be tested in practice as referrals scale up.

The arrangement was made possible by a government dispatch (Despacho 1211/2026), published in February, that formally allowed remote physiotherapy delivered through certified medical devices to enter the SNS. Until now, Sword's technology had reached Portuguese patients mainly through private health insurers.

A Portuguese success story comes home

Founded in Porto by Virgílio Bento, Sword Health became one of Portugal's best-known unicorns and has pledged substantial new investment in the country over the coming years. Bringing its technology into the public system lands at a moment when the SNS is straining on multiple fronts: the government recently moved to lift locum-doctor pay to keep summer emergency rooms open, demand has pushed private-hospital revenue to record highs, and tighter patient-registry rules have put thousands at risk of losing a family doctor. A cheaper, faster route to physiotherapy is exactly the kind of efficiency the system has been hunting for — and a glimpse of how Portugal's AI ambitions might show up in everyday public services.

What This Means for Expats

• Access runs through your family doctor. To use the service free of charge you will need an SNS prescription, which means being registered with a health centre — the same gateway that unlocks most public care.
• It is built for distance. Home-based, app-guided sessions suit residents in smaller towns or rural areas far from a physiotherapy clinic.
• Check the language and the device. Confirm the app's language options and what equipment is provided before you start; remote care only works if the interface does.
• Newer residents should get registered first. If you have just arrived, sorting out SNS registration and your número de utente is the prerequisite — the same first step covered in our guide to using the SNS for vaccinations.

If the rollout delivers on its promises, it could become a template for folding digital health into the public system elsewhere. If it disappoints — on clinical outcomes, on the human role of physiotherapists, or on the real-world cost — it will fuel an already lively debate about how far AI belongs at the bedside. Either way, Portugal has just made one of Europe's boldest bets on prescribing software instead of scheduling another appointment.