Patient, Provider, and Organizational Considerations for Implementing Rehabilitation Telehealth

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Digital Health

Background:

• Telehealth services (THS) are increasingly adopted in rehabilitation, offering an alternative to traditional face-to-face care.
• While THS demonstrate comparable effectiveness and are valued by patients and clinicians, their implementation poses significant challenges.
• Effective patient triage and management are crucial for successful THS delivery in rehabilitation settings.

Purpose of the Study:

• To explore clinician perceptions regarding the implementation of THS in rehabilitation services.
• To identify key challenges encountered during THS implementation in rehabilitation.
• To develop strategies for overcoming these implementation challenges based on clinician insights.

Main Methods:

• An anonymous electronic survey was distributed to 234 rehabilitation clinicians at a large urban hospital.
• Qualitative analysis of open-ended responses was conducted using an iterative, consensus-driven interpretivist approach.
• Strategies were employed to minimize bias and enhance the trustworthiness of the findings.

Main Results:

• Four major themes emerged from the 48 responses: unique benefits of THS, challenges across clinical, technological, environmental, and regulatory domains, essential clinician competencies, and patient selection criteria.
• Clinicians perceived THS as beneficial for patients, providers, and organizations.
• Key challenges were identified in clinical practice, technology, environment, and regulations, necessitating specific clinician skills and careful patient selection.

Conclusions:

• A conceptual framework for effective THS implementation in rehabilitation was developed, addressing multi-domain challenges at patient, provider, and organizational levels.
• Recommendations are provided to guide clinicians and organizations in advocating for and designing effective THS programs.
• Educators can utilize these findings to train clinicians in navigating THS implementation challenges in rehabilitation.