Clinicians' Perspectives of a Novel Home-based Multidisciplinary Telehealth Service for Patients with Chronic Spinal Pain
Chronic spinal pain conditions can often be successfully managed by a non-surgical, multidisciplinary approach, however many individuals are unable to access such specialised services within their local community. A possible solution may be the delivery of care via telerehabilitation. This study aimed to evaluate clinicians’ perspectives on providing clinical care via telerehabilitation during the early implementation of a novel spinal telerehabilitation service. Eight clinicians’ were recruited, completing surveys at four separate time points. Confidence in providing treatment via telerehabilitation significantly improved with time (?2(3)=16.22, p=0.001). Clinicians became significantly more accepting of telerehabilitation being a time- (?2(3)=11.237, p=0.011), and cost-effective (?2(3)=9.466, p=0.024) platform in which they could deliver care. Overall satisfaction was high, with technology becoming easier to use (p=0.026) and ability to establish rapport significantly improved with experience (p=0.043). Understanding clinicians’ perspectives throughout the early implementation phase of a new telerehabilitation service is a critical component in determining long-term sustainability.
Australian Insitute of Health & Welfare. (2013). Allied Health Workforce, 2012. National health workforce series no. 5. Canberra, Australia: AIHW.
Australian Institute of Health & Welfare. (2016). Australia's Health 2016. Australia’s health series no. 15. Cat. no. AUS 199. Canberra: AIHW.
Brewster, L., Mountain, G., Wessels, B., Kelly, C., & Hawley, M. (2013). Factors affecting frontline staff acceptance of telehealth technologies: a mixed-method systematic review. Journal of Advanced Nursing, 70(1), 21-33. http://doi:10.1111/jan.12196
Broens, T. H. F., Huis in't Veld, R. M. H. A., Vollenbroek-Hutten, M. M. R., Hermens, H. J., van Halteren, A. T., & Nieuwenhuis, L. J. M. (2007). Determinants of successful telemedicine implementations: a literature study. Journal of Telemedicine and Telecare, 13(6), 303-309. http://doi:10.1258/135763307781644951
Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J., Shekelle, P., & Owens, D. (2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147, 478-491. https:// 10.7326/0003-4819-147-7-200710020-00006
Cottrell M, Galea O, O'Leary S, Hill A, Russell T. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review & meta-analysis. Clin Rehabilitation. 2016;31(5):625-38.
Cottrell, M., Hill, A., O'Leary, S., Raymer, M., & Russell, T. (2017). Patients are willing to use telehealth for the multidisciplinary management of chronic musculoskeletal conditions: a cross-sectional study. Journal of Telemedicine and Telecare, [Epub ahead of print]. https://doi:10.1177/1357633X17706605
Cottrell M, Hill A, O'Leary S, Raymer M, Russell T. Service provider perceptions of telerehabiltiation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: a qualitative study. Musculoskeletal Science and Practice. 2017b;32:7-16.
Davis, F. D. (1989). Perceived Usefulness, perceived ease of use, and user acceptance of Information Technology. MIS Quarterly, 13(3), 319-340. https://doi:10.2307/249008
Department of Health. (2017). General Practice Statistics: GP Workforce Statistics - 2001-02 to 2016-17. Retrieved Nov 29, 2017, from http://www.health.gov.au/internet/main/publishing.nsf/content/General+Practice+Statistics-1
Eriksson, L., Lindström, B., & Ekenberg, L. (2011). Patients' experiences of telerehabilitation at home after shoulder joint replacement. Journal of Telemedicine and Telecare, 17(1), 25-30. https://doi: 10.1258/jtt.2010.100317
Giordano, R., Clark, M., & Goodwin, N. (2011). Perspectives on telehealth and telecare: Learning from the 12 Whole System Demostrator Action Network (WSDAN) sites. Retrieved Aug 26, 2016, from http://www.kingsfund.org.uk/sites/files/kf/Perspectives-telehealth-telecare-wsdan-paper.pdf
Hines, M., Lincoln, M., Ramsden, R., Martinovich, J., & Fairweather, C. (2015). Speech pathologists' perspectives on transitioning to telepractice: What factors promote acceptance? Journal of Telemedicine and Telecare, 21(8), 469-473.
Kruse, C. S., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2016). Evaluating barriers to adopting telemedicine worldwide: a systematic review. Journal of Telemedicine and Telecare, 24(1), 4-12. https://doi: 10.1177/1357633X16674087
Maher, C., Williams, C., Lin, C., & Latimer, J. (2011). Managing low back pain in primary care. Australian Prescriber, 34, 128-132. https://doi:10.18773/austprescr.2011.069
Mair, F., Finch, T., May, C., Hiscock, J., Beaton, S., Goldstein, P., & McQuillan, S. (2007). Perceptions of risk as a barrier to the use of telemedicine. Journal of Telemedicine and Telecare, 13(suppl 1), 38-39. https://doi:10.1258/135763307781645158
Mair, F. S., Goldstein, P., May, C., Angus, R., Shiels, C., Hibbert, D., . . . Capewell, S. (2005). Patient and provider perspectives on home telecare: preliminary results from a randomized controlled trial. Journal of Telemedicine and Telecare, 11(suppl 1), 95-97. https://doi:10.1258/1357633054461976
MBS Online. Connecting health services with the future: Technology and technical issues for telehealth. Retrieved Dec 1, 2017, from http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/connectinghealthservices-techandclinical
Moffatt, J., & Eley, D. (2010). The reported benefits of telehealth for rural Australians. Australian Health Review, 34, 276-281. https://doi: 10.1071/AH09794
Moffet, H., Tousignant, M., Nadeau, S., Mérette, C., Boissy, P., Corriveau, H., . . . Dimentberg, R. (2017). Patient satisfaction with in-home telerehabilitation after total knee arthroplasty: results from a randomized controlled trial. Telemedicine and eHealth, 23(2), 80-87. https://doi:10.1089/tmj.2016.0060
National Institute for Health and Care Excellence. (2016). Low back pain and sciatica in over 16s: assessment and management. London: NICE.
Newman, L., Bidargaddi, N., & Schrader, G. (2016). Service providers’ experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service. International Journal of Medical Informatics, 94, 8-20. http://dx.doi.org/10.1016/j.ijmedinf.2016.05.006
Odeh, B., Kayyali, R., Gebara, S., & Philip, N. (2014). Implementing a telehealth service: nurses' perceptions and expectations. British Journal of Nursing, 23(21), 1133-1137. https://doi:10.12968/bjon.2014.23.21.1133
Puskin, D. S., Cohen, Z., Ferguson, A. S., Krupinski, E., & Spaulding, R. (2010). Implementation and evaluation of telehealth tools and technologies. Telemedicine Journal and e-Health, 16(1), 96-102. doi: 10.1089/tmj.2009.0182
Queensland Health. (2016). Queensland Health - Telehealth Support Unit. Retrieved Dec 1, 2017, from https://www.health.qld.gov.au/telehealth/html/health_professionals
Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User Acceptance of Information Technology: Toward a Unified View. MIS Quarterly, 27(3), 425-478. https://doi:10.2307/30036540
Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., . . . Murray, C. J. L. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386(9995), 743-800. https://doi:10.1016/S0140-6736(15)60692-4
Wade, V., Eliott, J., & Hiller, J. (2014). Clinician acceptance is the key factor for sustainable telehealth services. Qualitative Health Research, 24(5), 682-694. https://doi:10.1177/1049732314528809
Wade, V. A., Karnon, J., Elshaug, A. G., & Hiller, J. E. (2010). A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Services Research, 10(1), 233. https://doi: 10.1186/1472-6963-10-233
Ward, E. C., Burns, C. L., Theodoros, D. G., & Russell, T. G. (2013). Evaluation of a clinical service model for dysphagia assessment via telerehabilitation. International Journal Of Telemedicine and Applications, 2013. http://doi:10.1155/2013/918526
Whitten, P., & Holtz, B. (2008). Provider utilization of telemedicine: the elephant in the room. Telemedicine and e-Health, 14(9), 995-997. https://doi:10.1089/tmj.2008.0126
Whitten, P. S., & Mackert, M. S. (2005). Addressing telehealth's foremost barrier: Provider as initial gatekeeper. International Journal of Technology Assessment in Health Care, 21(04), 517-521. https://doi:10.1017/S0266462305050725
Zanaboni, P., & Wootton, R. (2012). Adoption of telemedicine: from pilot stage to routine delivery. BMC Medical Informatics and Decision Making, 12(1). https://doi.org/10.1186/1472-6947-12-1
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