PR_174: Telemedicine in Rehabilitation Practice: Amputee and Brace Clinic Experience

Abstract

Setting: Host site, a major metropolitan Veterans Affairs medical center (VAMC); remote site, a rural VAMC. Program: Amputee and brace clinic. Program Description: A telemedicine amputee and brace clinic was established at a rural VA hospital in conjunction with the telemedicine and rehabilitation department of a major VAMC. The physiatrist is located at the host site and the physical therapists and vendors are located at the remote site. Assessment/Results: This program has successfully been able to evaluate patients for their prosthetic and orthotic needs. Challenges have included audiovisual issues; equipment needs; computer interfacing issues; and other technical barriers that have needed to be addressed. Discussion: Telemedicine clinics are quickly becoming a popular and cost-effective way to provide care to patients in rural communities that lack access to specialists and specialty care. Rehabilitation in telemedicine clinics provide veterans convenience and ease of access. They also save patients time and money. The number of physiatrists is limited in smaller, rural communities. This can make it difficult for elderly or disabled veterans to receive evaluations and equipment needed to improve their overall function, safety, and ultimately, quality of life. Conclusions: Telemedicine has proven to be an efficient use of time and money. It has brought rehabilitation to sites where it is otherwise not available, decreased travel time to the VAMC, reduced travel costs, increased the number of patients seen, and increased veteran satisfaction. With this successful experience, we expect to include spinal cord injuries and other major disabilities. Some of the special issues in the use of telemedicine rehabilitation practice will be discussed.