Evolution: Telemedicine to digital health
Monday, March 26, 2018
Digital health continues its expansion beyond more traditional telemedicine modalities as health professionals find new ways to apply technologies. In recent years, this expansion has become more of an evolution as the Internet, health information technology and even social media are blended into systems and processes.
Today, digital health might be obtaining a virtual second opinion from specialists or subspecialists, affordable and convenient online eye examinations and even a variety of supportive therapies to aid in recovery.
Rehabilitative services open access to care and increase convenience for patients, especially those with functional limitations and transportation challenges. Healthcare professionals applying digital tools in rehabilitative care processes include:
- occupational therapists
- physical therapists
- speech-language pathologists
- rehabilitation engineers
- assistive/adaptive technologists
- rehabilitation physicians
- rehabilitation nurses
- patient/caregiver educators
- disability specialists
The American Telemedicine Association's Telerehabilitation Workgroup, made up of these professionals, identifies best practices for applying computer-based technologies and telecommunications to improve access to rehabilitation services and support independent living.
Their Principles for Delivering Telerehabilitation Services is a resource for those wanting to provide effective and secure services that are based on client needs, current empirical evidence and available technologies. It includes sections on administrative, clinical, technical and ethical considerations and can be used to develop discipline-specific standards, guidelines and practice requirements.
Consider the potential needs of a patient with Guillain-Barre Syndrome, or other neuromuscular conditions. Due to varying levels of paralysis, this population may not be able to drive safely and are easily fatigued. If they could even arrive for a physical therapy appointment in person, they might be too significantly fatigued to gain much benefit from the exercises.
A digital health option, from the comfort of their own home, would certainly improve access and compliance, but also enhance assessments by revealing environmental risks and barriers.
For example, as a session with a therapist or provider begins, the rehab professional may notice the difficulty the individual has standing from their sofa — or even the step in a sunken living room. When discussing this with the patient, they might find the patient would benefit from grab bars or other assistive devices to fit with the unique conditions of the environment.
In another example, an educator or adaptive technologist supporting a newly discharged patient, might also be able to have multiple family caregivers participate in the session while they are at work or from their own homes. This population also tends to experience "brain fog," or feelings of confusion, forgetfulness and lack of focus and mental clarity. Including all family caregivers virtually and digitally, without adding additional disruption to their lives, would help ensure more effective communication and compliance.
Digital health is here, and it increasingly includes all levels of the healthcare delivery system. As the Silver Tsunami of aging baby boomers continues to grow, so will the demand for digital rehabilitation services. Is your practice prepared?
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