May 29, 2009
A Quick Overview of Telerehabilitation
Telerehabilitation is an emerging field of telemedicine. The concept is simple: supervise and deliver rehabilitation services over a telecommunications platform, such as the Internet. This includes all kinds of rehabiltiation ranging from speech to physical rehab.
Lots of examples of non-physical telerehabilitation systems exist. Here’s a sample:
- Queensland telerehabilitation project (speech, see below)
- Easterseals telerehabilitation project (observation, training)
- Alberta telerehab center (observation, training)
Several scientific journals have also recently emerged discussing the state of telerehabilitation including the International Journal of Telerehabilitation.
Hometelemed.com’s ReJoyce workstation is an example of a physical rehabilitation device.
Whereas many types of telemedicine don’t require a patient to have any equipment beyond a computer and camera, physical telerehabilitation usually requires exercise or rehabilitation equipment in a patients’ home. Rehab devices are conventionally bulky and expensive, which prohibit hospitals and clinics from sending them home with patients.
The ReJoyce telerehabilitation workstation is an example of one of the first devices designed to be used in the clinic and at home, and is inexpensive enough to make telerehabilitation profitable. Many more telerehabilitation devices are in various stages of experimental development around the world including the following:
- At-home constraint-induced therapy from CABRR
- Queensland telerehabilitation project (physical assessments, etc.)
- Chicago University Project (upper extremity)
Many articles have discussed the potential of telerehab. Here are some interesting ones from the last few years:
- Journal of Rehabilitative Research & Development
- Therapy Times (an interesting article, although a little out of date)
- A French telerehab study for wheelchair usage
May 15, 2009
Telemedicine and Stroke Care
Here’s the latest from the American Heart Association.
A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care
- Few patients receive treatment benefit with evidence-based and FDA-approved tissue plasminogen activator, partly due to lack of access to this treatment.
- Stroke Telemedicine (Telestroke, Teleconsultation) provides an opportunity to increase access to specialist expertise (neurological) in areas where disparities exist for stroke care (urban and rural).
- Telemedicine is an important care modality in the stroke systems of care model.
Recommendations for the Implementation of Telemedicine Within Stroke Systems of Care
- Telemedicine technology provides specialists with the data necessary to assist clinicians at the bedside in stroke-related decision making for patients presenting at distant or under-equipped facilities.
- The reported numbers of telestroke consultations overall and those that lead to thrombolysis show that the use of telemedicine is feasible and has already impacted local stroke care.
- Barriers to effective telestroke implementation include licensure and liability laws, technology assessment and deployment, community outreach/education, assuring confidentiality of information shared, and processes of requesting and delivering telemedicine consultations.
May 1, 2009
New Hampshire Senate passes Telecare Bill
The N.H Senate has passed a bill requiring insurance companies to reimburse certain medical appointments whether they happen face-to-face or not.
“…This is vastly going to reduce the costs of health care and help with early detection,” said Sen. Debbie Reynolds, D-Plymouth. Telemedicine would help with early detection and “access to specialty care that would reduce the severity of diseases…”
Read the full article here.
Proposal for More Telemedicine Coverage
California Congressman Mike Thompson has introduced legislation to screen returning soldiers for PTSD and to expand access to telemedicine. This bill is a companion to one introduced in the Senate by Montana Senator Max Baucus. Here’s an excerpt from the article:
“…The telemedicine legislation would provide $30 million in grants to help health facilities pay for telehealth equipment and expand telehealth support services… The Medicare Telehealth Enhancement Act would expand Medicare reimbursement to urban and suburban areas and include more families…”
You can read the rest of the article here.
