Veteran and Provider Satisfaction with a Home-Based Telerehabilitation Assessment for Wheelchair Seating and Mobility

Keywords: Satisfaction, Service delivery, Telerehabilitation, Wheeled mobility

Abstract

The objective of this project was to measure Veteran and provider satisfaction with a home-based telerehabilitation assessment for wheelchair seating and mobility. Forty-three Veterans were seen remotely at their place of residence by a provider, using a VA Video Connect synchronous videoconferencing system. Veteran and provider satisfaction were collected using the Telerehabilitation Questionnaire (TRQ). Mean individual TRQ scores for both Veterans and providers were significantly higher than the scale midpoint of 3.5. Veterans had higher scores than providers for five individual items on the TRQ. Higher scores by Veterans on the technology and quality and clarity of the video and audio likely correspond to the differences in environmental settings in which the visit occurred for the Veteran compared with the provider. High satisfaction scores with the telerehabilitation assessments are likely attributed to the positive working relationship between the provider and the rehabilitation technician, who provided in-person technical support to the Veteran in the home during the wheeled mobility evaluation. Overall, the results indicate a high level of Veteran and provider satisfaction using telerehabilitation for wheelchair seating and mobility evaluations.

  

Author Biographies

Richard M. Schein, University of Pittsburgh

Richard M. Schein is a Research Health Scientist within the Department of Rehabilitation Science & Technology at the University of Pittsburgh. He received his Masters of Science in Rehabilitation Technology, a Masters of Public Health in Health Policy and Healthcare Management, and Doctorate of Philosophy in Rehabilitation Science all at the University of Pittsburgh. Schein interacts with various levels within or outside the University including Principal Investigators and collaborators, Directors, and Department Heads serving as an investigator and manager in the conduct of research projects, solving problems, coordinating projects & budgets, and day-to-day operations.

Andi Saptono, University of Pittsburgh

Andi Saptono is an assistant professor in the Department of Health Information Management at the University of Pittsburgh. He has extensive experience in developing and supporting telehealth technologies, as well as implementing various telehealth services at national and international field. His work includes platform to deliver telehealth services; learning health system platform for healthcare and rehabilitation; and personal health record application for mobile technology. He has strong technical qualifications with track record of more than 15 years of hands-on experience in information technology system development, and project and product management, with extensive knowledge in designing innovative, cost-effective solutions for enhancing the efficiency and effectiveness of healthcare and rehabilitation service, and conducting usability studies through the use of formal user-centric approach. His current research interests are Telehealth, Assistive Technology outcome, and m-Health.

Brad E Dicianno, University of Pittsburgh

Dr. Dicianno is the Medical Director of the UPMC Center for Assistive Technology, Director of the UPMC Adult Spina Bifida Clinic, Medical Director and COO of the Human Engineering Research Laboratories, and Medical Director of the VA Center of Excellence on Wheelchairs and Associated Rehabilitation Engineering. His clinical interests are in the areas of spina bifida and assistive technology. His research interests focus on developing and studying interventions targeted to improving health and wellness in individuals with complex disabilities (such as wheelchairs, mobile health, and preventative care programs).

Mark R. Schmeler, University of Pittsburgh

Mark Schmeler is the Vice Chair for Education & Training and an Associate Professor in the Department of Rehabilitation Science & Technology at the University of Pittsburgh. He oversees all aspects of the Master of Science curriculum in Rehabilitation Technology. Schmeler has 30 years of clinical experience and continues to practice as an Occupational Therapist and Assistive Technology Professional in the Center for Assistive Technology at the University of Pittsburgh Medical Center which he helped establish in 1996. His research interests include the application of telerehabilitation, product development, functional outcomes, and online education.

References

Barlow, I.G., Liu, L., & Sekulic, A. (2009). Wheelchair seating assessment and intervention: A comparison between telerehabilitation and face-to-face service. International Journal of Telerehabilitation, 1(1), 17–28. https://doi.org/10.5195/ijt.2009.868

Cooper RA, Fitzgerald, S.G., Boninger, M.L., Brienza, D.M., Shapcott, N., Cooper, R., & Foot, K. (2001). "Telerehabilitation: Expanding access to rehabilitation expertise," in Proceedings of the IEEE, 89(8), 1174-1193. https://doi.org/10.1109/5.940286

Crandall, L.A., & Coggan, J.M. (1994). Impact of new information technologies on training and continuing education for rural health professionals. The Journal of Rural Health, 10(3), 208–215. https://doi.org/10.1111/j.1748-0361.1994.tb00231.x

Donelan, K., Barreto, E. A., Sossong, S., Michael, C., Estrada, J. J., Cohen, A. B., Wozniak, J., & Schwamm, L. H. (2019). Patient and clinician experiences with telehealth for patient follow-up care. American Journal of Managed Care, 25(1), 40–44.

Gladden, C., Beck, L., & Chandler, D. (2015). Tele-audiology: Expanding access to hearing care and enhancing patient connectivity. Journal of the American Academy of Audiology, 26(9), 792–799. https://doi.org/10.3766/jaaa.14107

Graham, F., Boland, P., Grainger, R. & Wallace, S. (2020) Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review. Disability and Rehabilitation, 42, 3538-3548. https://doi.org/10.1080/09638288.2019.1595180

Grenier, Kaila (2018). Veteran and provider satisfaction of a home-based telerehabilitation assessment for wheelchair seating and mobility. [Unpublished master's thesis]. University of Pittsburgh.

Gustke, S.S., Balch, D.C., West, V.L. & Rogers, L.O. (2000). Patient satisfaction with telemedicine. Telemedicine Journal, 6(1), 5-13. https://doi.org/10.1089/107830200311806

Kruse, C.S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017). Telehealth and patient satisfaction: a systematic review and narrative analysis. British Medical Journal – Open, 7(8), 1-12. https://doi.org/10.1136/bmjopen-2017-016242

Lemaire, E.D., Boudrias, Y., & Greene, G. (2001). Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations. Journal of Telemedicine and Telecare, 7(2), 82–89. https://doi.org/10.1258/1357633011936200

Mair, F., & Whitten, P. (2000). Systematic review of studies of patient satisfaction with telemedicine. British Medical Journal (Clinical research ed.), 320(7248), 1517–1520. https://doi.org/10.1136/bmj.320.7248.1517

Malagodi, M., Schmeler, M.R., Shapcott, N.G., & Pelleschi, T. (1998). The use of telemedicine in assistive technology service delivery: Results of a pilot study. AOTA Technology Special Interest Section Quarterly, 8.

McCue, M., Fairman, A., & Pramuka, M. (2010). Enhancing quality of life through telerehabilitation. Physical Medicine and Rehabilitation Clinics of North America, 21(1), 195–205. https://doi.org/10.1016/j.pmr.2009.07.005

Nguyen, M., Waller, M., Pandya, A., & Portnoy, J. (2020) A review of patient and provider satisfaction with telemedicine. Current Allergy and Asthma Reports, 20(11), 72. https://doi.org/10.1007/s11882-020-00969-7

Orlando, J.F., Beard, M., & Kumar, S. (2019). Systematic review of patient and caregivers’ satisfaction with telehealth videoconferencing as a mode of service delivery in managing patients’ health. PLOS ONE, 14(8): e0221848. https://doi.org/10.1371/journal.pone.0221848

Ramaswamy, A., Yu, M., Drangsholt, S., Ng, E., Culligan, P.J., Schlegel, P.N., & Hu, J.C. (2020). Patient satisfaction with telemedicine during the COVID-19 pandemic: Retrospective cohort study. Journal of Medical Internet Research, 22(9): e20786. https://doi.org/10.2196/20786

Russo, J.E., McCool, R.R., & Davies, L. (2016). VA telemedicine: An analysis of cost and time savings. Telemedicine Journal and e-health, 22(3), 209–215. https://doi.org/10.1089/tmj.2015.0055

Schein, R.M., Schmeler, M.R., Holm, M.B., Saptono, A., & Brienza, D.M. (2010). Telerehabilitation wheeled mobility and seating assessments compared with in person. Archives of Physical Medicine and Rehabilitation, 91(6), 874–878. https://doi.org/10.1016/j.apmr.2010.01.017

Schein, R. M., Schmeler, M. R., Saptono, A., & Brienza, D. (2010). Patient satisfaction with telerehabilitation assessments for wheeled mobility and seating. Assistive Technology, 22(4), 215–222. https://doi.org/10.1080/10400435.2010.518579

Schmeler, M. R., Schein, R. M., McCue, M., & Betz, K. (2009). Telerehabilitation clinical and vocational applications for assistive technology: Research, opportunities, and challenges. International Journal of Telerehabilitation, 1(1), 59–72. https://doi.org/10.5195/ijt.2009.6014

U.S. Department of Veterans Affairs: 2016 Annual Report. Retrieved from https://www.visn4.va.gov/news/annual-reports/2016/VISN4-annual-report-print.pdf

Whitten, P., & Love, B. (2005). Patient and provider satisfaction with the use of telemedicine: Overview and rationale for cautious enthusiasm. Journal of Postgraduate Medicine, 51(4), 294–300.

Williams, T. L., May, C. R., & Esmail, A. (2001). Limitations of patient satisfaction studies in telehealthcare: A systematic review of the literature. Telemedicine Journal and e-health, 7(4), 293–316. https://doi.org/10.1089/15305620152814700

World Health Organization (2011). World Report on Disability. https://www.who.int/publications/i/item/world-report-on-disability

Published
2020-12-08
How to Cite
Ott, K. K., Schein, R. M., Saptono, A., Dicianno, B. E., & Schmeler, M. R. (2020). Veteran and Provider Satisfaction with a Home-Based Telerehabilitation Assessment for Wheelchair Seating and Mobility. International Journal of Telerehabilitation, 12(2), 3–12. https://doi.org/10.5195/ijt.2020.6341
Section
Original Research