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Goldman JG, Merkitch D, Brewington D, Peirce H, Rho M, Jayabalan P, Curran J, Brennan K. Patient experiences receiving rehabilitation care via telehealth: Identifying opportunities for remote care. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1049554. [PMID: 36817717 PMCID: PMC9932031 DOI: 10.3389/fresc.2023.1049554] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023]
Abstract
Use of telehealth has grown substantially in recent times due to the COVID-19 pandemic. Remote care services may greatly benefit patients with disabilities; chronic conditions; and neurological, musculoskeletal, and pain disorders, thereby allowing continuity of rehabilitation care, reducing barriers such as transportation, and minimizing COVID-19 exposure. In March 2020, our rehabilitation hospital, Shirley Ryan AbilityLab, launched a HIPAA-compliant telemedicine program for outpatient and day rehabilitation clinics and telerehabilitation therapy programs. The objective of this study was to examine patients' experiences and satisfaction with telemedicine in the rehabilitation physician practice, including novel virtual multidisciplinary evaluations. The present study examines survey data collected from 157 patients receiving telemedicine services at Shirley Ryan AbilityLab from December 2020-August 2021. Respondents were 61.8% female, predominantly White (82.2%) with ages ranging across the lifespan (69.4% over age 50 years). Diagnostic categories of the respondents included: musculoskeletal conditions 28%, chronic pain 22.3%, localized pain 10.2%, neurological conditions 26.8%, and Parkinson's and movement disorders 12.7%. Survey responses indicate that the telemedicine experiences were positive and well received. The majority of participants found these services easy to use, effective, and safe, and were overall satisfied with the attention and care they received from the providers-even for those who had not previously used telehealth. Respondents identified a variety of benefits, including alleviating financial and travel-related burdens. There were no significant differences in telehealth experiences or satisfaction across the different clinical diagnostic groups. Respondents viewed the integrated physician and rehabilitation therapist telehealth multidisciplinary model favorably, citing positive feedback regarding receiving multiple perspectives and recommendations, feeling like an integrated member of their healthcare team, and having a comprehensive, holistic team approach along with effective communication. These findings support that telemedicine can provide an effective care model in physiatry (physical medicine and rehabilitation) clinics, across different neurological, musculoskeletal, and pain conditions and in multidisciplinary team care settings. The insights provided by the present study expand our understanding of patient experiences with remote care frameworks for rehabilitation care, while controlling for institutional variation, and ultimately will help provide guidance regarding longer term integration of telemedicine in physiatry and multidisciplinary care models.
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Affiliation(s)
- Jennifer G. Goldman
- Parkinson's Disease and Movement Disorders, Shirley Ryan AbilityLab, Chicago, IL, United States,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States,Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States,Correspondence: Jennifer G. Goldman
| | - Douglas Merkitch
- Parkinson's Disease and Movement Disorders, Shirley Ryan AbilityLab, Chicago, IL, United States
| | - David Brewington
- Information Systems, Enterprise Data Warehouse, Shirley Ryan AbilityLab, Chicago, IL, United States
| | - Hannah Peirce
- Parkinson's Disease and Movement Disorders, Shirley Ryan AbilityLab, Chicago, IL, United States
| | - Monica Rho
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Prakash Jayabalan
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jessica Curran
- Outpatient Physical Therapy, Shirley Ryan AbilityLab, Chicago, IL, United States
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Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer–Related Lymphedema. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Shiner CT, Gardner T, Haskelberg H, Li I, Faux SG, Millard M, Mahoney AEJ. OUP accepted manuscript. PAIN MEDICINE 2022; 23:1621-1630. [PMID: 35312759 PMCID: PMC8996725 DOI: 10.1093/pm/pnac049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/28/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022]
Abstract
Objectives Societal and health system pressures associated with the coronavirus disease 2019 (COVID-19) pandemic exacerbated the burden of chronic pain and limited access to pain management services for many. Online multidisciplinary pain programs offer an effective and scalable treatment option, but have not been evaluated within the context of COVID-19. This study aimed to investigate the uptake and effectiveness of the Reboot Online chronic pain program before and during the first year of the COVID-19 pandemic. Methods Retrospective cohort analyses were conducted on routine service users of the Reboot Online program, comparing those who commenced the program during the COVID-19 pandemic (March 2020–March 2021), to those prior to the pandemic (April 2017–March 2020). Outcomes included the number of course registrations; commencements; completion rates; and measures of pain severity, interference, self-efficacy, pain-related disability, and distress. Results Data from 2,585 course users were included (n = 1138 pre-COVID-19 and n = 1,447 during-COVID-19). There was a 287% increase in monthly course registrations during COVID-19, relative to previously. Users were younger, and more likely to reside in a metropolitan area during COVID-19, but initial symptom severity was comparable. Course adherence and effectiveness were similar before and during COVID-19, with moderate effect size improvements in clinical outcomes post-treatment (g = 0.23–0.55). Discussion Uptake of an online chronic pain management program substantially increased during the COVID-19 pandemic. Program adherence and effectiveness were similar pre- and during-COVID. These findings support the effectiveness and scalability of online chronic pain management programs to meet increasing demand.
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Affiliation(s)
- Christine T Shiner
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital Sydney and the University of New South Wales, Sydney, Australia
- Department of Pain Medicine, St Vincent’s Hospital, Sydney, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
- Correspondence to: Christine Shiner, Department of Rehabilitation and Pain Medicine, St Vincent’s Hospital Sydney, 170 Darlinghurst Rd, Darlinghurst NSW 2010, Australia. Tel: + 61 2 8382 9542; Fax: +61 2 8382 9518; E-mail:
| | - Tania Gardner
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital Sydney and the University of New South Wales, Sydney, Australia
- Department of Pain Medicine, St Vincent’s Hospital, Sydney, Australia
| | - Hila Haskelberg
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital Sydney and the University of New South Wales, Sydney, Australia
| | - Ian Li
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital Sydney and the University of New South Wales, Sydney, Australia
| | - Steven G Faux
- Department of Pain Medicine, St Vincent’s Hospital, Sydney, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital Sydney and the University of New South Wales, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Alison E J Mahoney
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent’s Hospital Sydney and the University of New South Wales, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
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