Telerehabilitation: Policy Issues and Research Tools
AbstractThe importance of public policy as a complementary framework for telehealth, telemedicine, and by association telerehabilitation, has been recognized by a number of experts. The purpose of this paper is to review literature on telerehabilitation (TR) policy and research methodology issues in order to report on the current state of the science and make recommendations about future research needs. An extensive literature search was implemented using search terms grouped into main topics of telerehabilitation, policy, population of users, and policy specific issues such as cost and reimbursement. The availability of rigorous and valid evidence-based cost studies emerged as a major challenge to the field. Existing cost studies provided evidence that telehomecare may be a promising application area for TR. Cost studies also indicated that telepsychiatry is a promising telepractice area. The literature did not reference the International Classification on Functioning, Disability and Health (ICF). Rigorous and comprehensive TR assessment and evaluation tools for outcome studies are tantamount to generating confidence among providers, payers, clinicians and end users. In order to evaluate consumer satisfaction and participation, assessment criteria must include medical, functional and quality of life items such as assistive technology and environmental factors. Keywords: Telerehabilitation, Telehomecare, Telepsychiatry, Telepractice
American Telemedicine Association. (2008). ATA - American Telemedicine Association. Retrieved October 1, 2008, from http://www.atmeda.org/
American Telemedicine Association Special Interest Group. (2006). Telerehabilitation Bibliography, Spring 2006. Retrieved October 11, 2008, from http://www.atmeda.org/icot/sigtelerehab.htm
Baron, C., Hatfield, B., & Georgeadis, A. (2005). Management of communication disorders using family member input, group treatment, and telerehabilitation. Top Stroke Rehabil, 12(2), 49-56.
Bashshur, R., Shannon, G., & Sapci, H. (2005). Telemedicine evaluation. Telemed J E Health, 11(3), 296-316.
Center for Information Technology Leadership. (2007). The value of provider-to-provider telehealth technologies. Retrieved October 20, 2008, from http://www.atmeda.org/news/ValueofProvidertoProviderTech.pdf
Center for Telemedicine and e-Health Law. (2005). Telehealth & Emerging Technologies - Reimbursement. Retrieved October 13, 2008, from http://www.ctel.org/Reimbursement.html
Cooper, R. A., Fitzgerald, S. G., Bonninger, M. L., Brienza, D. M., Shapcott, N., Cooper, R., et al. (2001). Telerehabilitation: Expanding access to rehabilitation expertise. Proceedings of the IEEE, 89(8), 1176-1191.
Cruise, C. M., & Lee, M. H. M. (2005). Delivery of rehabilitation services to people aging with a disability. Physical Medicine and Rehabilitation Clinics of North America, 16(1), 267-284.
Cusack, C. M., Pan, E., Hook, J. M., Vincent, A., Kaelber, D. C., & Middleton, B. (2008). The value proposition in the widespread use of telehealth. J Telemed Telecare, 14(4), 167-168.
Daly, J. M., Jogerst, G., Park, J. Y., Kang, Y. D., & Bae, T. (2005). A nursing home telehealth system: keeping residents connected. J Gerontol Nurs, 31(8), 46-51.
DeLisa, J. A. (Ed.). (1998). Rehabilitation Medicine: Principles and practice (3rd ed.). New York: Lippincott-Raven.
Demiris, G., Shigaki, C. L., & Schopp, L. H. (2005). An evaluation framework for a rural home-based telerehabilitation network. J Med Syst, 29(6), 595-603.
Egner, A., Phillips, V. L., Vora, R., & Wiggers, E. (2003). Depression, fatigue, and health-related quality of life among people with advanced multiple sclerosis: results from an exploratory telerehabilitation study. NeuroRehabilitation, 18(2), 125-133.
Galea, M., Tumminia, J., & Garback, L. M. (2006). Telerehabilitation in spinal cord injury persons: A novel approach. Telemedicine Journal & E-Health, 12(2), 160-162.
Gray, G. A., Stamm, B. H., Toevs, S., Reischl, U., & Yarrington, D. (2006). Study of participating and nonparticipating states’ telemedicine Medicaid reimbursement status: Its impact on Idaho’s policymaking process. Telemed J E Health, 12(6), 681-690.
Grigsby, J., Brega, A. G., & Devore, P. A. (2005). The evaluation of telemedicine and health services research. Telemed J E Health, 11(3), 317-328.
Hersh, W. R., Hickam, D. H., Severance, S. M., Dana, T. L., Krages, K. P., & Helfand, M. (2006). Telemedicine for the Medicare population: Update. Evid Rep Technol Assess (Full Rep)(131), 1-41.
Jennett, P. A., & Andruchuk, K. (2001). Telehealth: ‘real life’ implementation issues. Comput Methods Programs Biomed, 64(3), 169-174.
Jennett, P. A., Scott, R. E., Affleck Hall, L., Hailey, D., Ohinmaa, A., Anderson, C., et al. (2004). Policy implications associated with the socioeconomic and health system impact of telehealth: A case study from Canada. Telemed J E Health, 10(1), 77-83.
Kaplan, B., & Litewka, S. (2008). Ethical challenges of telemedicine and telehealth. Cambridge Quarterly of Healthcare Ethics, 17(4), 401-416.
Kinsella, A. (1999). Disabled populations & telerehabilitation--new approaches. Caring, 18(8), 20-22.
Kinsella, A. (2008). The Home Telehealth Primer. Retrieved October 10, 2008, from http://tie.telemed.org/articles/article.asp?path=articles&article=homeTelehealthPrimer_ak_tie08.xml
Krupinski, E., Dimmick, S., Grigsby, J., Mogel, G., Puskin, D., Speedie, S., et al. (2006). Research recommendations for the American Telemedicine Association. Telemedicine Journal & E-Health, 12(5), 579-589.
Lehoux, P., & Blume, S. (2000). Technology assessment and the sociopolitics of health technologies. Journal of Health Politics, Policy & Law, 25(6), 1083-1120.
Marschollek, M., Mix, S., Wolf, K. H., Effertz, B., Haux, R., & Steinhagen-Thiessen, E. (2007). ICT-based health information services for elderly people: Past experiences, current trends, and future strategies. Medical Informatics and the Internet in Medicine, 32(4), 251-261.
Marziali, E., Serafini, J. M. D., & McCleary, L. (2005). A systematic review of practice standards and research ethics in technology-based home health care intervention programs for older adults. Journal of Aging & Health, 17(6), 679-696.
McCarthy, D., & Fox, K. (2007). Case study: University of Tennessee Health Science Center’s Telehealth Networks. Retrieved October 10, 2008, from http://www.commonwealthfund.org/innovations/innovations_show.htm?doc_id=468916
Pak, H. S., Brown-Connolly, N. E., Bloch, C., Clarke, M., Clyburn, C., Doarn, C. R., et al. (2008). Global forum on telemedicine: Connecting the world through partnerships. Telemedicine Journal & E-Health, 14(4), 389-395.
Palsbo, S. E. (2004). Medicaid payment for telerehabilitation. Arch Phys Med Rehabil, 85(7), 1188-1191.
Phillips, V. L., Vesmarovich, S., Hauber, R., Wiggers, E., & Egner, A. (2001). Telehealth: reaching out to newly injured spinal cord patients. Public Health Rep, 116 Suppl 1, 94-102.
Powell, J. A., Lowe, P., Griffiths, F. E., & Thorogood, M. (2005). A critical analysis of the literature on the Internet and consumer health information. J Telemed Telecare, 11 Suppl 1, 41-43.
Puskin, D. S. (2001). HHS Perspective on Telehealth. Retrieved October 5, 2008, from http://www.ieeeusa.org/committees/MTPC/Saint2001/saint2001puskin.ppt
Puskin, D. S., & Urka, M. A. (1999). A policy maker’s glimpse of the road ahead: Telerehabilitation in the 21st century. Top Spinal Cord Inj Rehabil, 5(3), 70-74.
Rehabilitation Engineering Research Center on Telerehabilitation. (2007). Telerehabilitation: meeting consumer needs through rehabilitation engineering research. Retrieved October 18, 2008, from http://www.atmeda.org/news/2006_presentations/t4c3.ppt
Roine, R., Ohinmaa, A., & Hailey, D. (2001). Assessing telemedicine: A systematic review of the literature. Cmaj, 165(6), 765-771.
Rosen, M. J. (2004). Telerehabilitation. Telemed J E Health, 10(2), 115-117.
Rumberger, J. S., & Dansky, K. (2006). Is there a business case for telehealth in home health agencies? Telemed J E Health, 12(2), 122-127.
Scalvini, S., Vitacca, M., Paletta, L., Giordano, A., & Balbi, B. (2004). Telemedicine: A new frontier for effective healthcare services. Monaldi Arch Chest Dis, 61(4), 226-233.
Scheideman-Miller, C., Clark, P. C., Moorad, A., Post, M. L., Hodge, B. G., & Smeltzer, S. (2002). Efficacy and sustainability of a telerehabilitation program. Retrieved October 5, 2008, from http://portal.acm.org/citation.cfm?id=820753.821657&jmp=cit&coll=GUIDE&dl=GUIDE&CFID=8595260&CFTOKEN=80249238#CIT
Schmeida, M., McNeal, R., & Mossberger, K. (2007). Policy determinants affect telehealth implementation. Telemed J E Health, 13(2), 100-107.
Scott, R. E., Chowdhury, M. F., & Varghese, S. (2002). Telehealth policy: looking for global complementarity. J Telemed Telecare, 8 Suppl 3, S3:55-57.
Stein, J. (2005). Commentary: J. Stein. CyberPsychology & Behavior, 8(3), 216-217.
Telemedicine Information Exchange. (2005). Telemedicine 101. Retrieved October 10, 2008, from http://tie.telemed.org/articles/article.asp?path=telemed101&article=tmcoming_nb_tie96.xml
Theodorus, D., & Russell, T. (2008). Telerehabilitation: Current perspectives. In R. Latifi (Ed.), Current principles and practices of telemedicine and e-Health (pp. 119-209). Amsterdam: IOS Press.
U.S. Centers for Disease Control. (n.d.). Healthy People 2010. Chapter 6. Disability and secondary conditions.
U.S. Department of Health and Human Services Health Resources and Services Administration. (1994). Rural Telemedicine Projects. Retrieved September 30, 2008, from http://www.dhhs.gov/news/press/pre1995pres/941110a.txt
U.S. Department of Health and Human Services Health Resources and Services Administration. (n.d.). Telehealth. Retrieved September 18, 2008, from http://www.hrsa.gov/telehealth/
U.S. Department of Health and Human Services Health Resources and Services Administration. (2006). TeleHealth for Kansans (OAT Grant). Retrieved October 10, 2008, from http://www2.kumc.edu/telemedicine/2008Programs/telehealthforkansans.htm
U.S. Department of Veterans Affairs. (2008). Office of Care Coordination Services Home Telehealth. Retrieved September 30, 2008, from http://www.carecoordination.va.gov/
Vo, A. H. (2008). The telehealth promise: Better health care and cost savings for the 21st century. Retrieved October 9, 2008, from http://ehealthvirginia.org/downloads/20080529/UTMB%20Telemedicine%20White%20Paper%2019May2008.pdf
Waters, R. J. (2007). Let’s make a deal -- How to structure telehealth ventures. Retrieved October 8, 2008, from http://www.ctel.org/CTeLsSeminaratATA.html
Waters, R. J. (2008). Telehomecare is essential to long-term home care. Caring : National Association for Home Care magazine, 27(2), 52-53.
Waters, R. J. (2008). A tripartite relationship for home care in the future. Caring : National Association for Home Care magazine, 27(1), 48-49.
Waters, R. J., & Eder-Van Hook, J. (2005). Retiring baby boomers create opportunities for innovation. Caring : National Association for Home Care magazine., 24(10), 84-86.
Weinstein, R. S., Lopeez, A. M., Krupinski, E. A., Beinar, S. J., Holcomb, M., McNeely, R. A., et al. (2008). Integrating telemedicine and telehealth: Putting it all together. In Current principles and practices of telemedicine and e-Health (pp. 23-38). Amsterdam: IOS Press.
Whitten, P., & Buis, L. (2007). Private payer reimbursement for telemedicine services in the United States. Telemed J E Health, 13(1), 15-23.
Whitten, P., & Sypher, B. D. (2006). Evolution of telemedicine from an applied communication perspective in the United States. Telemed J E Health, 12(5), 590-600.
Winters, J. (1999). Workshop on home care technologies for the 21st century. Retrieved October 15, 2008, from www.eng.mu.edu/wintersj/jack/pubs.htm
Wipf, K. R., & Langner, B. (2006). Policy approaches to chronic disease management. Home health care management practice, 18(452-462).
Copyright (c) 2009 Katherine D. Seelman, Linda M. Hartman
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.