Implementing telerehabilitation research for stroke rehabilitation with community dwelling veterans: lessons learned.

Neale R Chumbler,Dorian Rose,Jon Sanford,Helen Hoenig,Patricia Griffiths,Miriam Morey,E Wesley Ely,Patricia Quigley

doi:10.5195/ijt.2010.6047

Abstract

Telerehabilitation (TR) is the use of telehealth technologies to provide distant support, rehabilitation services, and information exchange between people with disabilities and their clinical providers. This article discusses the barriers experienced when implementing a TR multi-site randomized controlled trial for stroke patients in their homes, and the lessons learned. The barriers are divided into two sections: those specific to TR and those pertinent to the conduct of tele-research. The TR specific barriers included the rapidly changing telecommunications and health care environment and inconsistent equipment functionality. The barriers applicable to tele-research included the need to meet regulations in diverse departments and rapidly changing research regulations. Lessons learned included the need for: telehealth equipment options to allow for functionality within a diverse telecommunications infrastructure; rigorous pilot testing of all equipment in authentic situations; and on-call and on-site biomedical engineering and/or IT staff.

Highlights

IntroductionAdvantages of TelerehabilitationTelehealth is the use of any communication modality (e.g., telephone, email, integrated video and audio, video teleconferencing, hand-held messaging), that enables physical separation of patient and practitioner while delivering health care services at a distance (Darkins& Cary, 2000)
Advantages of TelerehabilitationTelehealth is the use of any communication modality, that enables physical separation of patient and practitioner while delivering health care services at a distance (Darkins& Cary, 2000)
Lessons learned included the need for: telehealth equipment options to allow for functionality within a diverse telecommunications infrastructure; rigorous pilot testing of all equipment in authentic situations; and on-call and on-site biomedical engineering and/or IT staff

Summary

Introduction

Advantages of TelerehabilitationTelehealth is the use of any communication modality (e.g., telephone, email, integrated video and audio, video teleconferencing, hand-held messaging), that enables physical separation of patient and practitioner while delivering health care services at a distance (Darkins& Cary, 2000). TR is the use of telehealth technologies to provide distant support, assessment and information to people who have physical and/or neurological/cognitive impairments (Lai, Woo, Hui & Chan, 2004; Russell, 2007; Schwamm et al, 2009). Effective implementation of a TR program can increase access to service and result in improved rehabilitation outcomes for individuals with physical impairments after discharge to home. The farther rehabilitation programs are from rural residents’ homes, the less likely residents are to receive services (Demiris, Shigaki & Schopp, 2005; Johnson, Weinert & Richardson, 1998). An effective TR program can enhance continuity of care by enabling communication with the inpatient therapists who originally treated the patient after discharge home (Burdea, 2003; Sanford et al, 2006). TR has great potential for improving both functional training and exercise training (Castro & King, 2002; Green et al, 2002)

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Conclusion