Conducting community rehabilitation review sessions via videoconference: A feasibility study

Abstract

Objective To determine the feasibility of conducting a single videoconferencing session (telerehabilitation) instead of a face‐to‐face home visit for a review appointment in a community rehabilitation program. Design A feasibility study based on Bowen's framework was used to determine demand, acceptability, limited efficacy and practicality of telerehabilitation. The study involved qualitative and quantitative data analysis. Setting Two Victorian community rehabilitation programs providing services to large geographical catchment zones in the outer fringe of a metropolitan area. Participants Ten adult clients receiving home‐based therapy and 5 allied health clinicians working in the program. Interventions Clients participated in a single review therapy appointment (telerehabilitation) from physiotherapy, dietetics or speech pathology using the health network's videoconferencing platfrom and the client's own electronic device. Main outcome measures Demand was assessed by calculating the percentage of eligible clients able to participate compared to total number of home‐based clients. Acceptability, practicality and limited efficacy were explored through qualitative analysis of semi‐structured interviews. Results Nearly one quarter of clients screened met eligibility criteria, indicating a large potential demand for telerehabilitation. Telerehabilitation was highly acceptable for clinicians and clients participating in speech pathology and dietitian sessions as these contain targeted education and talking‐based therapy. It was less accepted in physiotherapy, where there is a more hands‐on approach. Telerehabilitation was practical and efficient for both clinicians and clients, especially when time was allowed for training and initial troubleshooting. Conclusion Telerehabilitation is a feasible modality for review sessions in community rehabilitation and helps improve efficient use of clinician and client time. It is more appropriate for disciplines that use education and talking‐based therapy compared with hands‐on therapy. Older clients are accepting of new technology with support and education.

COVID‐19 restrictions increased perceptions of social isolation for older people discharged home after rehabilitation: A mixed‐methods study

“…25 To address these barriers, both patients and therapists likely require support and education in the use of new technology. 26 Physical limitations and restrictions to socialising and face-to-face rehabilitation appeared to limit participants' incidental activity, with participants mostly limited to light domestic activities. In the short term, reductions in physical activity may lead to poorer mental health and wellbeing.…”

“…Education and resources on the use of communication technologies could help to increase the uptake of these technologies, by older people and therapists, to facilitate community reintegration following hospitalisation. 26 These resources could be useful during the COVID-19 pandemic and also following the pandemic for older people who are socially isolated and/or have limited access to rehabilitation services, such as those living remotely, those with impairments that limit their travel, and those who are immunocompromised. Policies supporting the provision of telehealth, such as the recent extension of funding for telehealth services through the Medicare Benefits Schedule, 32 should also provide incentive for health providers to increase the use of communication technologies in their clinical practice.…”

Cross‐sectional survey of rehabilitation service availability for stroke and hip fracture in Australian public hospitals

“…52 A recent study demonstrated that 25% of people receiving home-based rehabilitation were suitable for telerehabilitation and that telerehabilitation was a feasible, acceptable and efficient way of delivering community rehabilitation to people from outer metropolitan and rural areas. 53 Provided sufficient infrastructure is in place to support implementation, telerehabilitation models thus appear promising in this context. 53 In the present study, the majority of community rehabilitation services were found to provide physiotherapy and occupational therapy, with only a low proportion of services reporting to have input from medical, nursing or allied health disciplines such as dietetics, and social work.…”

“…53 Provided sufficient infrastructure is in place to support implementation, telerehabilitation models thus appear promising in this context. 53 In the present study, the majority of community rehabilitation services were found to provide physiotherapy and occupational therapy, with only a low proportion of services reporting to have input from medical, nursing or allied health disciplines such as dietetics, and social work. This suggests that the majority of current community service provision is focused primarily on mobility and activities of daily living.…”

Consumer perspectives of telehealth in ambulatory care in an Australian health network

“…For example, consultations with these professionals often require physical assessments and interactions, prescription of exercise, inspection of the environment or in‐depth psychological interactions requiring building of rapport. While studies have shown that telehealth can be feasible and effective in these types of services (Hwang et al., 2017; Speyer et al., 2018; Wundersitz et al., 2020) large studies of the consumer perspective or examination of different telehealth modalities in these settings are lacking (Iacono et al., 2016).…”