Clinical Considerations and Practical Strategies in Implementing Telerehabilitation by Veterans Health Administration Rehabilitation Providers

Date Presented 04/02/2022 There exists a paucity of data-driven guidelines specific to practicalities implementing telerehabilitation. This study explicates gains in practical knowledge for implementing telerehabilitation that were accelerated during the Veterans Health Administration health care systems' rapid shift to telerehabilitation during the COVID-19 pandemic and contributes clinical reasoning considerations, supportive strategies, and practical approaches for engaging veterans in telerehabilitation. Primary Author and Speaker: Consuelo Kreider Additional Authors and Speakers: Mackenzi Slamka Contributing Authors: Jennifer L. Hale-Gallardo, John C. Kramer, Sharon Mburu, Kimberly Findley, Keith J. Myers, Sergio Romero

Providers' Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications.

Telerehabilitation provides Veteran patients with necessary rehabilitation treatment. It enhances care continuity and reduces travel time for Veterans who face long distances to receive care at a Veterans Health Administration (VHA) medical facility. The onset of the COVID-19 pandemic necessitated a sudden shift to telehealth-including telerehabilitation, where a paucity of data-driven guidelines exist that are specific to the practicalities entailed in telerehabilitation implementation. This paper explicates gains in practical knowledge for implementing telerehabilitation that were accelerated during the rapid shift of VHA healthcare from out-patient rehabilitation services to telerehabilitation during the COVID-19 pandemic. Group and individual interviews with 12 VHA rehabilitation providers were conducted to examine, in-depth, the providers' implementation of telerehabilitation. Thematic analysis yielded nine themes: (i) Willingness to Give Telerehabilitation a Chance: A Key Ingredient; (ii) Creativity and Adaptability: Critical Attributes for Telerehabilitation Providers; (iii) Adapting Assessments; (iv) Adapting Interventions; (v) Role and Workflow Adaptations; (vi) Appraising for Self the Feasibility of the Telerehabilitation Modality; (vii) Availability of Informal, In-Person Support Improves Feasibility of Telerehabilitation; (viii) Shifts in the Expectations by the Patients and by the Provider; and (ix) Benefit and Anticipated Future of Telerehabilitation. This paper contributes an in-depth understanding of clinical reasoning considerations, supportive strategies, and practical approaches for engaging Veterans in telerehabilitation.