Leveraging Technology - Telerehabilitation

Good Afternoon.

One of my goals has been to look at ways to leverage technology to improve our profession.  Most of what I have focused on is imaging tools that assess our ability to assess movement dysfunctions.  Well, this weekend I heard two great presentations by Donald Shaw and Beverly Newman regarding their work based out of Texas State University in San Marcos, TX on telerehabilitation. 

They have found a way to leverage technology to allow for home health PTs to improve their quality of care by having telerehabilitation technology in place.  In a nutshell, individuals with high risk that are being seen by home health PTs can now have electrocardiogram (ECG) monitoring during the exercise regimen.  Additionally, they have found a way to convince an home health agency to train these PTs in ACLS, have AEDs in their vehicles, and CPR masks on-hand at all times to help safely manage these individuals.

Think about this:

1.  Patients are going home sooner and sicker from the hospital

2.  Rehabilitation that would be traditionally done in the hospital under supervision (telemetry) with assets to handle a code is now being done at home with a PT present.

3.  There are numerous guidelines: American Heart Association, American College of Sports Medicine, and American Association of Cardiovascular and Pulmonary Rehabilitation that have set guidelines on how individuals with different risk stratification are suppose to be monitored.

4.  Although these guidelines exist, there is a LARGE gap between what is suggested and what is actually being done based on resources, individuals being treated in their own home instead of in a medical facility, training, and reimbursement issues.

5.  Most home healthcare providers recognize that their patients are "sicker" and that they don't have the right technology to progress them through an exercise program safely...So, what are the options?  To be more conservative?  Does that hamper our ability to progress them to the highest level of independence?

Their success in finding a way to leverage technology to monitor the patients vital signs, ECG, and oxygen status is a perfect fit!  This allowed the treating therapist to have real-time information about their patient.  This real-time input from someone > 450 miles away allowed for on-the-spot changes in the therapy regimen in order to ensure a safe rehabilitative environment.  Further, the patients felt safer exercising knowing that they were being monitored (does this mean they were willing to do more exercise?  test their limits better?). 

I really believe Don Shaw and his colleagues have developed the next big telerehabilitation tool that will (at some point) be required for all of these at-risk individuals being cared for in their homes. 

Congratulations Don, Beverly and colleagues for thinking outside of the box and pushing our profession to another level of excellence.  Your ability to find a way to shrink the gap between evidence and practice is wonderful for our profession.

This is huge for our profession- Congratulations!

Deydre