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.
ABSTRACT
To collaborate with departments across SRAlab to rapidly implement telerehabilitation and continue to provide high-quality therapy. To provide the blueprint for telerehabilitation implementation across all levels of care at SRAlab. To respond to patient feedback to operationally improve telerehabilitation. Mixed methods before and after series. Hospital-based outpatient therapy. Patients participating virtually in Physical Therapy, Occupational Therapy, and Speech Therapy in multiple Outpatient Orthopedic/Neurological, Day Rehabilitation, and Pain Management Clinic sites. In March 2020, outpatient therapy at Shirley Ryan Abilitylab (SRAlab) responded to the suddenly decreased demand for in-person visits due to the rapidly evolving and unclear public health emergency of the COVID-19 pandemic. Therapists from the orthopedic outpatient clinic identified an impending gap in care, so a team of Telerehabilitation Champions formed to pursue options for providing safe and effective therapy virtually. Telerehabilitation was created and offered to patients. Obtain patient feedback to operationally improve telerehabilitation services in the form of a patient satisfaction survey. Patient Satisfaction Survey related to patient experience with telerehabilitation. Telerehabilitation Patient Satisfaction Survey: now IRB approved study. Pilot data from over 200 participants reveals the below, among other data points that will be discussed: 92% rated the care as good/very good. 70% likely to continue with Telerehabilitation visits after COVID-19 pandemic. Patient reported benefits of Telerehabilitation: No travel, Patient chosen location, Improved attendance and exercise compliance, Decreased time away from home. Patient reported opportunities to improve Telerehabilitation: More space available in patient location to participate, Better video connection, Better audio connection, Caregiver to help patient during the session. Telerehabilitation is a safe, effective method for participation in therapy. It successfully allowed patients to receive care during the uncertainty of the COVID-19 pandemic. Telerehabilitation will have a place in therapy beyond the pandemic. SRAlab will use the Telerehabilitation Patient Satisfaction Survey to continuously improve the Telerehabilitation experience and is committed to contributing to the research for establishing best practice guidelines. None.