Posts Tagged Telehealth

[ARTICLE] Telephysiotherapy: time to get online – Full Text

The science and practice of telehealth have undergone rapid growth in recent years. A search of the Web of Science for the term ‘telehealth’ would have returned only two papers in 1995, compared with 104 papers in 2000, and 5069 papers in June 2017. This exponential growth is also evident in the number of randomised, controlled trials and systematic reviews indexed in the Physiotherapy Evidence Database with ‘telehealth’ in the title, rising from 10 records in 2008 to 70 records in 2017. These papers span the breadth of physiotherapy practice, with particularly strong representation from musculoskeletal and cardiorespiratory physiotherapy (Figure 1). High-quality randomised, controlled trials that support the benefits of telehealth interventions in many physiotherapy subdisciplines have been published over recent years. These have included telephysiotherapy interventions for chronic knee pain,1 non-specific low back pain,2 chronic obstructive pulmonary disease (COPD),3 heart disease,4 breast cancer,5 joint arthroplasty,6 and urinary incontinence.7Many of these studies have demonstrated significantly better clinical outcomes than usual care that did not include physiotherapy, including improved exercise capacity, better physical function, reduced symptoms and enhanced health-related quality of life.

Figure 1 Number of randomised trials and systematic reviews indexed on the Physiotherapy Evidence Database (PEDro) that have a telehealth element, categorised by subdiscipline. Articles were identified using the search terms tele or internet, with screening by title and abstract to confirm a telehealth element. Subdiscipline categorisations are those on the PEDro website, with some articles categorised under more than one subdiscipline.

Telephysiotherapy can take many different forms, with the components driven by the goals of treatment. Videoconferencing provides direct contact between patients and physiotherapists, either one-to-one1 or in a virtual group setting.3 For some telephysiotherapy programs (eg, pulmonary rehabilitation, stroke rehabilitation) it may be necessary to perform a limited number of home visits, in order to perform assessments or provide instruction in the use of equipment.3, 8 However, some telephysiotherapy programs are delivered entirely from a distance, without ever meeting the patient in person, including notable examples of successful treatment of stress urinary incontinence using email support7 and a mobile app.9 Telephysiotherapy programs may include remote monitoring of physiological signals, such as pulse rate, oxygen saturation, electrocardiograms (ECG), and joint range of movement, in specific populations such as cardiorespiratory or orthopaedic disease.4, 10, 11Whilst some telephysiotherapy models require specially designed equipment,6, 11 others have achieved similarly successful outcomes with off-the-shelf consumer devices and software.1, 3 The ubiquitous nature of the smartphone provides new opportunities for telephysiotherapy, including: physical activity monitoring; sound and light cues to set exercise intensity and duration; real-time feedback on exercise performance; and text messaging to provide exercise advice or progression.10, 12 Simple web-based diaries can be used to record exercise and provide feedback.12 Didactic or interactive education programs can also be provided.1 In some populations it may be possible to automate aspects of a telephysiotherapy program to provide efficient and effective care to large patient populations, for instance using internet platforms that provide automated goal setting and feedback in conjunction with a pedometer for patients with non-specific low back pain.2

The increase in our capacity to deliver physiotherapy at a distance using telehealth has occurred at the same time that ‘hands-on’ physiotherapy techniques have become less important for some health conditions. For example, electrotherapy is no longer recommended for routine treatment of low back pain,13 whereas exercise therapy is an important component of care.14 Interventions designed to increase physical activity and physical fitness now have an important role in physiotherapy management for numerous clinical groups and across the lifespan, recognising the critical impact of these factors on long-term health outcomes.15 Many of these interventions, which typically involve goal setting, exercise prescription and self-management training, do not require hands-on therapy and are highly amenable to telephysiotherapy.

Despite the potential for telehealth to increase the capacity of the health system and deliver better health outcomes, there has been relatively slow uptake in practice. Enthusiasm has been tempered by the lack of clinically relevant benefits seen in some large-scale randomised trials involving people with chronic diseases such as heart failure and COPD;16, 17, 18 however, these trials relied heavily on telemonitoring of physiology and symptoms, rather than on delivery of therapy. Remote monitoring has not delivered consistent benefits over usual care, perhaps because it is difficult to maintain long-term adherence with monitoring, or the difficulty in identifying meaningful changes in monitored variables. Trials in telephysiotherapy, which typically involve delivering a treatment from a remote location, have generally been more successful, producing similar results to interventions that are delivered face to face. For instance, in 205 patients who had undergone knee arthroplasty, in-home rehabilitation delivered by videoconference demonstrated equivalent outcomes for pain, stiffness and function when compared with face-to-face rehabilitation.6 Similarly, in 152 people with heart failure, cardiac rehabilitation with exercise prompts and ECG monitoring transmitted via a mobile phone produced similar benefits to a traditional outpatient cardiac rehabilitation program.10 A key feature of these successful telephysiotherapy interventions is that they delivered treatments of known effectiveness in a different way, using technology to reach patients who are located away from healthcare facilities. […]

CONTINUE —>Telephysiotherapy: time to get online – Journal of Physiotherapy

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[WEB SITE] How It All Works – Brainworks

eRehabilitation™: The future of rehab!


One thing we know for certain is that the future of rehab is inseparable from the Internet. To be client–centred, we have to go where our clients are … and our clients are everywhere, throughout the community and all over the Internet. The growth and complexity of knowledge, research and evidence for best practices in health mirrors the growth of the Internet and its tools to disseminate information, to provide forums for eclectic interactions and informative discussions. Our clients are aptly at this intersection – they are at the centre and we need to meet them there. This intersection is a magical place; it‘s on fire with prolific activity.

We are the benefactors of a modern revolution: the intersection of advances in technology, creative interfaces and evidence-based therapies are taking healthcare to levels only dreamed of. “The motive behind the use of this technology is to maintain the essential qualities of the health-care interaction, while improving access by overcoming barriers such as economics, culture, climate, and geography,” (Rees, 2004).

Telehealth has been touted as the most significant contribution to health-care delivery systems of the future (Bashshur, 1997). eRehabilitation™, a component of telehealth, is a cutting-edge, yet flourishing means of delivering rehabilitation, psychological & mental health services.

At Brainworks, we have developed eRehabilitation™ as a comprehensive treatment platform that uses interactive audio, video, or data communications to provide rehabilitation services at a distance.

 

Does eRehabilitation™ work?

Absolutely – eRehabilitation™ is Evidence-Based: there is a growing literature base that demonstrates the efficacy of these interactive, online modalities.

There are several areas for which online guided therapy based on CBT could be regarded as empirically-supported (Andersson, 2009), including panic disorder, social anxiety disorder, posttraumatic stress disorder (PTSD), and mild to moderate depression. progress. Carlbring et al. (2005) found equivalent outcomes of individual face-to-face CBT and Internet CBT for panic disorder. In a trial on depression (Spek, Nyklıcek, et al., 2007) found no differences between live group treatment and Internet CBT.

A recent study by Matsura et al. (2002) investigated the interrater reliability of videoconferencing compared with face-to-face assessment interviews. Perfect agreement was obtained between both interviewing conditions. Glueckauf et al. (2002) assessed the effects of videoconferencing-based counselling compared with counselling using a speakerphone, and conventional, face-to-face counselling. The counselling was provided to 22 rural teenagers with epilepsy. All treatment conditions were associated with similar outcomes, including significant reductions in problem severity and frequency.

Day and Schneider (2002) conducted a comprehensive and methodologically sound study evaluating the delivery of brief CBT via videoconferencing. A sample of 80 clients with concerns ranging from weight concerns to personality disorders were randomly assigned to one of three treatment groups (face-to-face, two-way audio, or two-way video) or a waiting list control group. No significant differences were found between treatment groups across outcome measures and all three groups were significantly superior to the no-treatment group.

A number of studies have demonstrated the benefits of conducting assessments via the Internet. These include: ease of administration, collecting data, communicating findings to clients, cost efficiency, reaching disabled persons and those that live in the rural areas (EmmelKamp, 2005; Fischer & Freid, 2001; Naus, Phillip, & Samsi 2009;).


References:

References available upon request. Please contact us for more information and literature to support your referral!

Source: How It All Works – Brainworks

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[Abstract] Delivering occupational therapy hand assessment and treatment sessions via telehealth

Telehealth offers a solution to assist delivery of occupational therapy (OT) services for hand therapy in rural and remote locations. However, there is currently no evidence to validate this service model. The aim of this study was to examine the validity of clinical decisions made during hand therapy sessions conducted via telehealth compared to a traditional clinical model (TCM) assessment, and explore patient and clinician satisfaction.

Eighteen patients referred for hand therapy to a rural/remote hospital-based outpatient service were assessed simultaneously via telehealth and a TCM assessment. An allied health assistant supported data collection at the patient end. Hand function was assessed using a range of objective measures, subjective scales and patient reported information. Minimal level of percent exact agreement (PEA) between the telehealth OT (T-OT) and the TCM-OT was set at ≥80%.

Level of agreement for all objective measures (dynamometer and pinch gauge reading, goniometer flexion and extension, circumference in millimetres) ranged between 82% and 100% PEA. High agreement (>80% PEA) was also obtained for judgements of scar and general limb function, exercise compliance, pain severity and sensitivity location, activities of daily living and global ratings of change (GROC) scores. There was 100% PEA for overall recommendations. Minimal technical issues were experienced. Patient and clinician satisfaction was high.

Clinical decisions made via telehealth were comparable to the TCM and consumers were satisfied with telehealth as a service option. Telehealth offers the potential to improve access to hand therapy services for rural and remote patients.

Source: Delivering occupational therapy hand assessment and treatment sessions via telehealth – Feb 13, 2017

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[WEB SITE] Silver Linings: Remote rehab – Telehealth helps seniors recover in rural areas – New Hampshire

Samuel Brown, 86, uses a video game form of telerehabilitation at the New Jewish Home in New York City as Director of Cardiac Rehabiliation Programs Bridgett Zimmermann watches. The home is launching a pilot program that will send these units into patients’ homes. (GRETCHEN GROSKY/Union Leader)

Silver Linings: Remote rehab — Telehealth helps seniors recover in rural areas, By GRETCHEN M. GROSKY, New Hampshire Union Leader

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Melly said the use of Jintronix at the New Jewish Home has resulted in a 60 percent reduction in rehospitalizations of these patients.

“The more engaged the patient is, the better their outcome is,” Melly said.

At the center, Melly said you will see others in the rehabilitation room or patient’s families gather around to cheer on the patient as they go for soccer goals or reach the pinnacle of a rock climb.

“How much fun is that?” she said.

On this day, Brown scored a 6 out of 6 in soccer and 5 out of 6 in skiing. When he leaves the facility, Brown said he plans on buying a Wii videogame console to keep up with his therapy.

“It’s something I can do at home,” he said.

Evin said Jintronix is actually safer than a Wii for people like Brown because the program is tailored to the patient and the patient’s progress is monitored by their health team and tracked.

The future

Bartels said there is “a lot of activity” in the field of telerehabilitation and there are other similar programs in development. He points to the future in sensors.

At Northeastern University, researchers are studying the use of sensors in ceilings to track a person’s movement, their gait, and their level of exercise. He said a person’s gait tells a lot about a person’s health. He said it’s one thing to watch a person walk across the room once for the doctor – it’s another thing to watch a person walk 50 times back and forth a day between the bedroom and the kitchen.

“A slower gait may mean an infection or something with medication and side effects or they’re depressed,” Bartels said.

At the Dartmouth Institute they are using sensors to monitor overweight elders.

Melly said she expects the New Jewish Home to be using more of this type of technology in the future.

“It’s the case of technology finally catching up with the medical needs,” she said.

Silver Linings is a continuing Union Leader/Sunday news report focusing on the issues of New Hampshire’s aging population and seeking out solutions. Union Leader reporter Gretchen Grosky would like to hear from readers about issues related to aging. She can be reached at ggrosky@unionleader.com or (603) 206-7739. See more at www.unionleader.com/aging.

Source: Silver Linings: Remote rehab — Telehealth helps seniors recover in rural areas | New Hampshire

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[SLIDESHOW/PDF] Successes and Barrier of Implementing Telehealth Models of Rehabilitation with Children and Adults – The Ohio State University

Learning Objectives

  1. Understand the terminology related to telehealth/ telerehabilitation
  2. Describe evidence-based clinical applications of telehealth in OT

  3. Discuss how the use of telehealth technologies may contribute to a world of health and well being

Download PDF Slideshow 

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[Abstract] A Telehealth Approach to Caregiver Self-Management Following Traumatic Brain Injury: A Randomized Controlled Trial

Abstract

Objective: To determine whether a telephone-based, individualized education and mentored problem-solving intervention would improve outcomes for caregivers of persons with traumatic brain injury (TBI).

Design: Parallel group, randomized controlled trial with blinded outcome assessment.

Setting: General community.

Participants: A total of 153 caregivers (mean age = 49.7 years; 82% female; 54% spouses/partners, 35% parents) of persons with moderate to severe TBI who received acute and/or rehabilitation care at a level I trauma center. Eighty-two percent of participants were evaluated at 6-month follow-up.

Intervention: Individualized education and mentored problem-solving intervention focused on caregivers’ primary concerns delivered via up to 10 telephone calls at 2-week intervals.

Main Outcome Measures: Composite of Bakas Caregiving Outcomes Scale (BCOS) and Brief Symptom Inventory (BSI-18) at 6 months post-TBI survivor discharge. Secondary measures included the Brief COPE.

Results: Caregivers in the treatment arm scored higher on the BCOS-BSI composite (P = .032), with more active coping (P = .020) and less emotional venting (P = .028) as measured by the Brief COPE.

Conclusions: An individualized education and mentored problem-solving approach delivered via telephone in the first few months following community discharge of the TBI survivor resulted in better caregiver outcomes than usual care. Consideration should be given to using this approach to augment the limited support typically offered to caregivers.

Source: A Telehealth Approach to Caregiver Self-Management Following… : The Journal of Head Trauma Rehabilitation

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[ARTICLE] Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes – Full Text HTML

Abstract 

This study examined functional outcomes, health-related quality of life (HRQoL), and satisfaction in a group of Veterans who received physical therapy via an in-home video telerehabilitation program, the Rural Veterans TeleRehabilitation Initiative (RVTRI). A retrospective, pre–post study design was used. Measures obtained from 26 Veterans who received physical therapy in the RVTRI program between February 22, 2010, and April 1, 2011, were analyzed. Outcomes were the Functional Independence Measure (FIM); Quick Disabilities of the Arm, Shoulder, and Hand measure; Montreal Cognitive Assessment (MoCA); and the 2-minute walk test (2MWT). HRQoL was assessed using the Veterans RAND 12-Item Health Survey (VR-12), and program satisfaction was evaluated using a telehealth satisfaction scale. Average length of participation was 99.2 +/– 43.3 d and Veterans, on average, received 15.2 +/– 6.0 therapeutic sessions. Significant improvement was shown in the participants’ FIM (p < 0.001, r = 0.63), MoCA (p = 0.01, r= 0.44), 2MWT (p = 0.006, r = 0.73), and VR-12 (p = 0.02, r = 0.42). All Veterans reported satisfaction with their telerehabilitation experiences. Those enrolled in the RVTRI program avoided an average of 2,774.7 +/– 3,197.4 travel miles, 46.3 +/– 53.3 hr of driving time, and $1,151.50 +/– $1,326.90 in travel reimbursement. RVTRI provided an effective real-time, home-based, physical therapy.

INTRODUCTION

The mission of the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) is to deliver uniform high-quality care to all Veterans, regardless of geography, distance, or economic circumstances. To meet this mission, the VHA must reach Veterans regardless of barriers to care provision, including long travel times and distances and expense. These barriers are magnified for rural Veterans with disabilities who require rehabilitation services. These individuals must invest additional time, thought, and resources in order to reach distant medical centers. Many rehabilitation protocols involve repeated therapy sessions, often two to five times weekly over weeks or months, resulting in additional physical, financial, and logistical hardships. In order to fulfill its promise, the VHA is actively attempting to address the gap in services for Veterans with limited access to traditional modes of treatment.

The VHA presently serves 3.3 million Veterans residing in rural localities. These individuals represent 41 percent of all Veterans enrolled in the VHA. Nearly 43 percent (2.27 million) of Veterans served by the VHA with a service-­connected disability live in rural or highly rural areas [1]. Therefore, the VHA is looking to new technologies to facilitate access to healthcare for these individuals. As stated by W. Scott Gould, the former U.S. Deputy Secretary of Veterans Affairs, “We are investing more in telehealth technologies to make VA healthcare available to Veterans wherever they live. In FY [fiscal year] 2010, we invested $121 million in telehealth. In FY2011, those investments will grow to $163 million. By the end of FY2012, we expect to have doubled our present use of telehealth” [2]. Robert A. Petzel, the former Under Secretary for Health of the VA, has explicitly endorsed home telehealth technologies. In testimony before the House Committee on Veterans’ Health on February 23, 2010, he stated, “Our increasing reliance on noninstitutional long-term care includes an investment in 2011 of $163 million in home telehealth. Taking greater advantage of the latest technological advancements in healthcare delivery will allow us to more closely monitor the health status of Veterans and will greatly improve access to care. Telehealth will place specialized healthcare professionals in direct contact with patients using modern IT [information technology] tools” [3].

Telerehabilitation refers to the clinical application of consultative, preventative, diagnostic, and therapeutic services via two-way interactive telecommunication technologies [4–5]. Telerehabilitation is an alternative to usual-care outpatient rehabilitation services. It can also serve as an alternative to “homecare” rehabilitation, which requires the treating therapist or clinician to travel to the patient’s home. By reducing or eliminating barriers relating to travel time and travel-related costs, telerehabilitation has the potential to improve access to rehabilitative care for stroke survivors [6–7]. Improving access to rehabilitative care may reduce disparities for stroke survivors and caregivers facing financial or transportation-related challenges. While research on telerehabilitation is limited, there is increasing evidence supporting the need for telerehabilitation services, the development of telerehabilitation interventions, and support for people with disabling conditions that potentially limit access to rehabilitation services [6–14].

The emerging field of video-based telerehabilitation allows therapists to deliver rehabilitative care to Veterans with physical, financial, and logistical barriers to healthcare providers and facilities [5]. Telerehabilitation has expanded dramatically in recent years as a result of advances in technology, increases in speed of telecommunication, and decreases in costs of computer hardware and software [6]. The scope of telerehabilitation includes direct therapeutic interventions, disease monitoring, coordination of care, patient and caregiver training and education, patient networking, and multidisciplinary professional consultation [15–16].

Veteran access to healthcare services is a topic of high interest and concern to both providers and researchers [6,17–20]. Numerous factors may interfere with patient access to healthcare, including distance, high travel-related expenses, reduced numbers of healthcare providers within rural areas, transportation barriers, caregiver burden, attitude toward and perception of medical care providers, consumer knowledge, informal caregiver and/or familial supports, and ethnic and cultural differences. Reduced access to healthcare contributes to increased morbidity and mortality, increased cost of treatment, and inappropriate use of emergency services [21–24]. Available technologies allow for rehabilitative services to be provided in real-time from providers’ clinics to various recipients’ locations such as home, community, health facilities, and/or work settings. While popular enthusiasm and capital investment in telerehabilitation continue to grow, very little is known regarding the efficacy of telerehabilitation or patients’ overall evaluation and acceptance of telerehabilitation services [25]. A recent Cochran review concerning telerehabilitation services provided to patients during recovery from stroke concluded that sufficient data do not exist to support the effectiveness of telerehabilitation as a stand-alone replacement for traditional rehabilitative services for the restoration of activities of daily living, mobility, upper-limb function, health-related quality of life (HRQoL), patient satisfaction, or cost savings for patients receiving rehabilitative care following stroke [5]. The purpose of this study was to assess the functional outcomes, HRQoL, and satisfaction of a group of patients who participated in a VA telerehabilitation program.

 

Continue —> Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes

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[Abstract] Home-based telesurveillance and rehabilitation after stroke: a real-life study

 

Abstract

Home-based telesurveillance and rehabilitation after stroke: a real-life studyBackground: After discharge from in-hospital rehabilitation, post-stroke patients should have the opportunity to continue the rehabilitation through structured programs to maintain the benefits acquired during intensive rehabilitation treatment.

Objective: The primary objective was to evaluate the feasibility of implementing an home-based telesurveillance and rehabilitation (HBTR) program to optimize the patient’s recovery by reducing dependency degree.

Method: Post-stroke patients were consecutively screened. Data were expressed as mean ±  standard deviation (SD). 26 patients enrolled: 15 were sub-acute (time since stroke: 112 ± 39 days) and 11 were chronic (time since stroke: 470 ± 145 days). For 3 months patients were followed at home by a nurse-tutor, who provided structured phone support and vital signs telemonitoring, and by a physiotherapist (PT) who monitored rehabilitation sessions by videoconferencing.

Results: 23 patients completed the program; 16.7 ± 5.2 phone contacts/patient were initiated by the nurse and 0.9 ± 1.8 by the patients. Eight episodes of atrial fibrillation that required a change in therapy were recorded in two patients. Physiotherapists performed 1.2 ± 0.4 home visits, 1.6 ± 0.9 phone calls and 4.5 ± 2.8 videoconference-sessions per patient. At least three sessions/week of home exercises were performed by 31% of patients, two sessions by 54%. At the end of the program, global functional capacity improved significantly (P < 0.001), in particular, static (P < 0.001) and dynamic (P = 0.0004) postural balance, upper limb dexterity of the paretic side (P = 0.01), and physical performance (P = 0.002). Symptoms of depression and caregiver strain also improved.

Conclusion: The home-based program was feasible and effective in both sub-acute and chronic post-stroke patients, improving their recovery, and maintaining the benefits reached during inpatient rehabilitation

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Source: Taylor & Francis Online

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 [WEB SITE] eRehabilitation: Emerging Tool in Rehab services – Brainworks

Advances in internet technology, creative interfaces and evidence-based therapies are combining to propel healthcare to levels only dreamed of. “The motive behind the use of this technology is to maintain the essential qualities of the health-care interaction, while improving access by overcoming barriers such as economics, culture, climate, and geography,” (Rees, 2004). The dominant theme of therapy is so often to examine and collaboratively develop solutions rather than allowing any one barrier to prohibit progress.

“The landscape of mental health is shifting dramatically; online therapy is becoming mainstream.”

On September 23, 2011 The New York Times featured an article entitled, ‘When Your Therapist is Only a Click Away’. Based on the buzz this article caused, it was placed on the homepage of the New York Times website, on September 25, 2011. The piece beautifully illustrates how online therapy is used by real people in the real world. The landscape of mental health is shifting dramatically. Online therapy is becoming mainstream and the evidence-base for such therapy services is growing in Canada and around the globe. Technology is exciting and it allows us to provide services to people that would not otherwise get help.

Many vocational rehab professionals use their cell phone to talk to or text their clients. Some professionals use regular Skype sessions to communicate with clients, employers or other professionals. But it’s not just as simple as jumping online with a client. Professionals must be aware of and heed their legal and ethical obligations before practicing online.

Telehealth has been touted as the most significant contribution to health-care delivery systems of the future (Bashshur, 1997). eRehabilitation, a component of telehealth, is a cutting-edge and flourishing means of delivering rehabilitation services. At Brainworks, we have further developed and defined eRehabilitation as a comprehensive treatment platform that uses interactive audio, video, or data communications to provide rehabilitation services at a distance.

eRehabilitation embraces both mainstream and emergent technologies to deliver evidenced-based therapies. Some examples of how eRehabilitation can be used include:

  • rehabilitation counseling via a secure web interface
  • videos demonstrating job skills available on demand
  • executive skills coaching (planning, scheduling, prioritizing, troubleshooting) assisted by video conferencing & the use of apps
  • email and text messaging to access job supportinter active web based learning modules for skill development

There are several advantages to providing therapy services online. By taking advantage of the power of the internet, services can be provided in context, with no commute for client or therapist, resulting in an overall cost savings. Moreover, shorter, more frequent sessions make good sense from a learning theory perspective, but until now have not been practical. Therapists can now provide more frequent mini sessions to spread out their involvement and contain costs while boosting efficacy. Clinical experience, confirmed by the literature, indicates that e-based sessions result in fewer cancellations.

Continue —> Brainworks – Emerging Tool in Rehab

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[WEB SITE] Emerging Tool in Rehab – Brainworks

Advances in internet technology, creative interfaces and evidence-based therapies are combining to propel healthcare to levels only dreamed of. “The motive behind the use of this technology is to maintain the essential qualities of the health-care interaction, while improving access by overcoming barriers such as economics, culture, climate, and geography,” (Rees, 2004). The dominant theme of therapy is so often to examine and collaboratively develop solutions rather than allowing any one barrier to prohibit progress.

“The landscape of mental health is shifting dramatically; online therapy is becoming mainstream.”

On September 23, 2011 The New York Times featured an article entitled, ‘When Your Therapist is Only a Click Away’.  Based on the buzz this article caused, it was placed on the homepage of the New York Times website, on September 25, 2011.   The piece beautifully illustrates how online therapy is used by real people in the real world. The landscape of mental health is shifting dramatically. Online therapy is becoming mainstream and the evidence-base for such therapy services is growing in Canada and around the globe. Technology is exciting and it allows us to provide services to people that would not otherwise get help.

Many vocational rehab professionals use their cell phone to talk to or text their clients.  Some professionals use regular Skype sessions to communicate with clients, employers or other professionals.  But it’s not just as simple as jumping online with a client. Professionals must be aware of and heed their legal and ethical obligations before practicing online.

Telehealth has been touted as the most significant contribution to health-care delivery systems of the future (Bashshur, 1997). eRehabilitation, a component of telehealth, is a cutting-edge and flourishing means of delivering rehabilitation services. At Brainworks, we have further developed and defined eRehabilitation as a comprehensive treatment platform that uses interactive audio, video, or data communications to provide rehabilitation services at a distance.

eRehabilitation embraces both mainstream and emergent technologies to deliver evidenced-based therapies.  Some examples of how eRehabilitation can be used include:

  • rehabilitation counseling via a secure web interface
  • videos demonstrating job skills available on demand
  • executive skills coaching (planning, scheduling, prioritizing, troubleshooting) assisted by video conferencing & the use of apps
  • email and text messaging  to  access job support
  • interactive web based learning modules for skill development

There are several advantages to providing therapy services online. By taking advantage of the power of the internet, services can be provided in context, with no commute for client or therapist, resulting in an overall cost savings.  Moreover, shorter, more frequent sessions make good sense from a learning theory perspective, but until now have not been practical.  Therapists can now provide more frequent mini sessions to spread out their involvement and contain costs while boosting efficacy.  Clinical experience, confirmed by the literature, indicates that e-based sessions result in fewer cancellations.

more –> Brainworks Client-Centred Rehabilitation – Emerging Tool in Rehab.

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