Role of telehealth in seating clinics: a case study of learners' perspectives

Abstract

We conducted a qualitative case study of the introduction of telehealth in a seating clinic, which was an existing outreach service between two hospitals in Alberta, approximately 300 km apart. Interviews were conducted with the staff who were involved in planning and implementing the telehealth initiative. The study showed that, from the perspective of the staff (who were learners), implementation of telehealth in seating clinics differs from other less tactile telehealth applications in certain ways: (1) the importance of multidisciplinary teams in the procedures, (2) the importance of proper visualization and communication among the staff to convey the pressure changes and measurements to the technicians at the major centre to help them build or adjust the seating devices and (3) the reluctance of staff to trust others' judgements. Planning of service provision and telelearning for seating clinics requires the involvement of staff at all stages. Thus, the implementation of telehealth should be a stepwise process, allowing a highly interactive approach, without affecting the multidisciplinary nature of seating clinics.

Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint)

“…The two studies with negative findings reported that training for the tele-WS users was limited or that involvement in the tele-service design was low [27,32] indicating the importance of establishing fidelity in the underlying assessment protocol for any comparative research between tele-and IP-WS assessment.…”

“…Publication dates were from 1998 to 2010 with 5/13 (39%) of publications occurring in 2010. Research methods employed in the 9 studies were largely exploratory, and some studies used more than one method, including quasi experimental designs (n=8), [21][22][23][24][25][26][27][28][29], case reports (n=2), [30,31] or studies wholly or partly inclusive of qualitative methods exploring stakeholder views about remote wheelchair assessment (n=2) [28,32]. Of those studies comparing tele-and IP-WS assessment, only one study included randomisation [27].…”

“…Four studies examined the views of wheelchair users [23][24][25]28] and in three studies assessor's views were reported [23,28,32]. One study included service managers [32] but did not report managers' views separate to therapist's views. Collectively, findings suggest that tele-WS assessment is viewed as generally acceptable by wheelchair users and clinicians.…”

“…Some inter-professional challenges were described, such as the importance of trust between remote and specialist assessor (i.e., specialist assessors trusting remote colleagues to measure accurately) [23,31,32].…”

“…Conversely, at another service, assessors (N=12) described tele-WS assessment as being a difficult environment for learning wheelchair assessment skills and that a lack of ability to feel wheelchair user 'pressure points' (sic) through hands-on assessment was a concern [32]. Participants in this study also reported a lack of involvement in the design of a tele-WS assessment service (with some implied resentment of this) and a lack of training in use of the technology.…”