D2- Remote Accessibility Assessment

Task Leaders: Michael Pramuka, Ph.D. and Linda van Roosmalen, Ph.D.

Other participants: All other task leaders

Objectives of task:

1. The overriding objective of this task is to develop a conceptual model for appropriately matching consumers with telerehabilitation technologies through the development of:
2. a web-based tool that provides a searchable database of currently used technologies and the purposes/populations served by that technology
3. a standardized clinical assessment of telerehabilitation needs to guide rehabilitation professionals and agencies in implementing remote rehabilitation services
4. a "best practices" in telerehabilitation model of consumer service delivery
5. health care, documentation, and reimbursement policy related to telerehabilitation implementation

Project update:

This project includes the development of a conceptual clinical service delivery model that is based on telerehabilitation services. Based on this model a consumer-oriented (web based) software tool and knowledge database will be developed that guides clinicians in systematically evaluating a variety of clients that have individual challenges and provide them with remote services using suitable technology. The tool will also function as an infrastructure to collect data that will shape health care policy on the use of telerehabilitation across multiple environments, purposes, and disability types. The use of the model by clinicians will improve the consistency and quality of telerehabilitation services.

To develop the web based telerehabilitation tool, data within the following 5 categories is being gathered and organized within the structure of the model shown in Figure 1. This model depicts the symbolic (triangular) framework of the seamless integration of rehabilitation services, technologies and users.

1. Categorize individual challenges;
2. Collect environmental-related information: typical environmental conditions, technical restrictions (bandwidth, etc), and task demands;
3. Collect expert assessment methods of clinicians for a variety of rehab services and impairments;
4. Search the literature on all potential technology that can be used to remotely assess and service clients in need for rehab services.
5. Keep track of state-of-the-art technology and future innovations for their potential use in remote assessment, treatment or other rehabilitation service, since so many rapid advances are not being published.

Model categories:

• Rehabilitation Service: Education, Employment, Therapy, Assessment, Social Integration, Independent Living, Recreation, Caregiver Support
• Individual challenge: Visual, Hearing, Other sensory, Mobility, Cognitive
• Technology: Phone, Computer, Audio Recording, Video Recording, Wireless, Monitoring

Figure 1: Web based model of Telerehabilitation Service Delivery

Besides clinical research and literature, a range of existing, innovative and prototype technologies was gathered for pairing up with individual challenges as well as matching rehabilitation services. Preliminary connections between subcategories among three primary categories (technologies, individual challenges and rehabilitation services) were established. Next, a draft layout of the web tool was created and populated with the technology and clinical research information and connections between subcategories among the established three primary categories. Figure 2 shows an example of the summary page of the draft web-tool.

To explain the tool in an example: A clinician is searching for available technologies that can be used to remotely reach the educational goals of a client that has cognitive challenges. As a result, the web-tool will provide the clinician with outcome summaries, literature references and several types of technologies that fit the initial search criteria. Additionally, a table comparing the cost, ease of use and installation and reimbursement policy is provided for the resulting technologies.

Figure 2: Example of web tool based on goal selection “education” and challenge selection “cognition”.

The web-tool is still under development and requires evaluation from a pool of expert clinicians and usability specialists about tool usefulness, reliability and ease of use. Upon completion of the tool it will be disseminated on the World Wide Web, or as a stand alone product for use by rehabilitation centers, and for educational purposes to increase knowledge of novice clinicians in the area of telerehabilitation technology and potential telerehabilitation services. An FAQ page on the site will serve as a resource for individuals with disabilities, rehabilitation providers, and institutions having questions or comments.
Link to example of the data base

Last Updated: 4-26-06