Patient experiences receiving rehabilitation care via telehealth: Identifying opportunities for remote care

Abstract

Use of telehealth has grown substantially in recent times due to the COVID-19 pandemic. Remote care services may greatly benefit patients with disabilities; chronic conditions; and neurological, musculoskeletal, and pain disorders, thereby allowing continuity of rehabilitation care, reducing barriers such as transportation, and minimizing COVID-19 exposure. In March 2020, our rehabilitation hospital, Shirley Ryan AbilityLab, launched a HIPAA-compliant telemedicine program for outpatient and day rehabilitation clinics and telerehabilitation therapy programs. The objective of this study was to examine patients' experiences and satisfaction with telemedicine in the rehabilitation physician practice, including novel virtual multidisciplinary evaluations. The present study examines survey data collected from 157 patients receiving telemedicine services at Shirley Ryan AbilityLab from December 2020–August 2021. Respondents were 61.8% female, predominantly White (82.2%) with ages ranging across the lifespan (69.4% over age 50 years). Diagnostic categories of the respondents included: musculoskeletal conditions 28%, chronic pain 22.3%, localized pain 10.2%, neurological conditions 26.8%, and Parkinson's and movement disorders 12.7%. Survey responses indicate that the telemedicine experiences were positive and well received. The majority of participants found these services easy to use, effective, and safe, and were overall satisfied with the attention and care they received from the providers—even for those who had not previously used telehealth. Respondents identified a variety of benefits, including alleviating financial and travel-related burdens. There were no significant differences in telehealth experiences or satisfaction across the different clinical diagnostic groups. Respondents viewed the integrated physician and rehabilitation therapist telehealth multidisciplinary model favorably, citing positive feedback regarding receiving multiple perspectives and recommendations, feeling like an integrated member of their healthcare team, and having a comprehensive, holistic team approach along with effective communication. These findings support that telemedicine can provide an effective care model in physiatry (physical medicine and rehabilitation) clinics, across different neurological, musculoskeletal, and pain conditions and in multidisciplinary team care settings. The insights provided by the present study expand our understanding of patient experiences with remote care frameworks for rehabilitation care, while controlling for institutional variation, and ultimately will help provide guidance regarding longer term integration of telemedicine in physiatry and multidisciplinary care models.

Addressing Opportunities and Barriers in Telehealth Neurologic Physical Therapy: Strategies to Advance Practice

“…From our review, it was determined that much of the current neurologic telehealth literature is primarily of low methodological quality, includes commonly treated patient diagnoses (stroke, Parkinson disease, and multiple sclerosis), and consists of unsupervised, home-based telehealth interventions for mild to moderate clinical presentations, and therefore, is not well developed to establish practice standards yet 23. On the other hand, greater amount of patient satisfaction and willingness to adopt telehealth across a variety of diagnoses has been found 23. Specific disease-specific considerations are described as follows:…”

“…23 On the other hand, greater amount of patient satisfaction and willingness to adopt telehealth across a variety of diagnoses has been found. 23 Specific disease-specific considerations are described as follows:…”

Patients’ and professionals’ experiences with remote care during COVID-19: a qualitative study in general practices in low-income neighborhoods

“…, 2022; Goldman et al. , 2023). For professionals, remote care could save time and costs by allowing the physician to work from home (DePuccio et al.…”

“…This might suggest that patients' and general practice professionals' satisfaction with remote care was not high. This is problematic, because remote care could greatly save time and costs for both patients and professionals, when both are willing and capable of using it, enhance patient-centered care, empower patients, and benefit patients with chronic conditions (Beheshti et al, 2022;DePuccio et al, 2022;Marques et al, 2022;Goldman et al, 2023). For professionals, remote care could save time and costs by allowing the physician to work from home (DePuccio et al, 2022).…”

The potential of virtual healthcare technologies to reduce healthcare services’ carbon footprint

“…Telehealth services, which include telephone and video consultations as well as digital monitoring devices, also have benefits for the consumer. Travel costs and time away from home/work/family are reduced, access to services, especially specialist services for people living in rural and remote areas, is enhanced, chronic conditions are better managed as telehealth makes regular follow-up possible, wait times to see specialists are reduced, readmissions are decreased, and exposure to other patients and the general public in waiting rooms and during travel is reduced ( 7 , 8 ). In addition, given that evidence suggests virtual student education has similar outcomes to real-life clinical placements ( 9 ), efforts need to be made to increase these opportunities for students.…”