Telerehabilitation: Policy Issues and Research Tools


  • Katherine D. Seelman University of Pittsburgh, Pittsburgh, PA
  • Linda M. Hartman University of Pittsburgh, Pittsburgh, PA



The 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


Author Biographies

Katherine D. Seelman, University of Pittsburgh, Pittsburgh, PA


Linda M. Hartman, University of Pittsburgh, Pittsburgh, PA

Reference Librarian Health Sciences Library System University of Pittsburgh


American Telemedicine Association. (2008). ATA - American Telemedicine Association. Retrieved October 1, 2008, from

American Telemedicine Association Special Interest Group. (2006). Telerehabilitation Bibliography, Spring 2006. Retrieved October 11, 2008, from

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

Center for Telemedicine and e-Health Law. (2005). Telehealth & Emerging Technologies - Reimbursement. Retrieved October 13, 2008, from

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

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

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

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

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

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

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

U.S. Department of Health and Human Services Health Resources and Services Administration. (n.d.). Telehealth. Retrieved September 18, 2008, from

U.S. Department of Health and Human Services Health Resources and Services Administration. (2006). TeleHealth for Kansans (OAT Grant). Retrieved October 10, 2008, from

U.S. Department of Veterans Affairs. (2008). Office of Care Coordination Services Home Telehealth. Retrieved September 30, 2008, from

Vo, A. H. (2008). The telehealth promise: Better health care and cost savings for the 21st century. Retrieved October 9, 2008, from

Waters, R. J. (2007). Let’s make a deal -- How to structure telehealth ventures. Retrieved October 8, 2008, from

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

Wipf, K. R., & Langner, B. (2006). Policy approaches to chronic disease management. Home health care management practice, 18(452-462).



How to Cite

Seelman, K. D., & Hartman, L. M. (2009). Telerehabilitation: Policy Issues and Research Tools. International Journal of Telerehabilitation, 1(1), 47–58.



White Papers