How do the properties of telerehabilitation technologies change clinical practice and interprofessional communication? A qualitative case-study

Abstract

There has been a steady increase in the number of telerehabilitation programmes, as well as studies of telerehabilitation technology development, efficacy and effectiveness. However, few studies have examined the impact of telerehabilitation when it is actually implemented in a clinical setting. The objective of this study was therefore to explore how the properties of the technologies used for telerehabilitation affect clinical practice and interprofessional communication in a rehabilitation setting. A qualitative case study of an interorganisational telerehabilitation programme for traumatic brain injured and spinal cord injured patients was conducted, using data obtained from focus groups and interviews, along with observations of recordings of videoconference sessions. A conceptual framework based on technology adoption and organisational change theories was used to structure the data collection and thematic analysis. Several key characteristics of the telerehabilitation technologies were identified that impacted on interprofessional and interorganisational collaborations and patient participation, including the audio and video quality, the real-time communication capability, user-friendliness and time restrictions. The technology was used primarily for interdisciplinary care plan meetings, and occasionally for direct patient interventions in speech therapy and sexology, although additional uses had been identified in the planning stages. Implications for the development of future telerehabilitation programmes are discussed, in particular relating to sensitizing team members to each other's roles and organisational cultures.