Telerehabilitation: Policy Issues and Research Tools

Abstract

A number of experts recognize the importance of public policy as a complementary framework for telehealth, telemedicine, and by association, telerehabilitation. The purpose of this paper is to report on the current state-of-the-science on telerehabilitation (TR) policy and research methodology and make recommendations about future research needs. We conducted an extensive search of the literature via search terms grouped into the main topics of telerehabilitation, policy, population of users, and policy specific issues such as cost and reimbursement.The availability of rigorous and valid evidence-based cost studies emerged as a major challenge to the field. Existing cost studies provide evidence that tele-homecare may be a promising application area for TR. Cost studies also indicate that tele-psychiatry is a promising telepractice area. Notably, the literature did not reference the International Classification on Functioning, Disability and Health (ICF).We concluded that outcome studies characterized by rigorous and comprehensive TR assessment and evaluation are required to generate confidence among providers, payers, clinicians, and end users. Study criteria must comprehensively assess consumer satisfaction and participation via medical, functional, and quality of life items such as assistive technology and environmental factors.