Investigating the Acceptance and Implementation Conditions of Telerehabilitation in Germany Among Patients and Health Care Professionals: Qualitative Interview Study

Abstract

Background: Telerehabilitation has become increasingly important worldwide, as the COVID-19 pandemic forced many rehabilitation centers to change their daily care routine and find new ways to provide medical rehabilitation and aftercare. Objective: This study aims to investigate the acceptance and implementation conditions of telerehabilitation in Germany, particularly following the COVID-19 pandemic. Methods: We conducted qualitative semistructured interviews with patients (n=9) and health care professionals (n=8) between September 2023 and January 2024. To explore individual and structural barriers to and facilitators of telerehabilitation adoption, we used the extended unified theory of acceptance and use of technology and the Consolidated Framework for Implementation Research. Results: Patients and health care professionals perceived telerehabilitation as positive, mainly due to its flexibility and accessibility. Patients expressed high acceptance levels, anticipating health benefits, although they found it challenging to familiarize themselves with the technology and establish routines. Health care professionals highlighted the need for adequate resources (financial, time, and personnel) and management support to implement telerehabilitation successfully. Both groups saw higher acceptance and cost coverage of telerehabilitation services as essential for successful implementation and use in Germany. Conclusions: This study identified institutional barriers, such as concerns about resource availability, team communication, and initial resistance among health care staff to the introduction of new technologies. At an individual level, we found that patients struggled with routine establishment and that digital and in-person support from institutions and peers could mitigate this challenge. Implementing a hybrid approach and improving funding and approval processes would enhance telerehabilitation integration in the German health care sector.