Boissy Patrick, Tousignant Michel, Moffet Helene, Nadeau Sylvie, Brière Simon, Mérette Chantal, Corriveau Hélène, Marquis François, Cabana François, Ranger Pierre, Belzile Étienne L, Dimentberg Ronald
1 Université de Sherbrooke and Research Centre on Aging , Sherbrooke, QC, Canada .
2 Université Laval , Quebec, QC, Canada .
Telemed J E Health. 2016 Aug;22(8):637-49. doi: 10.1089/tmj.2015.0157. Epub 2016 Mar 9.
Audio/video-mediated communication between patients and clinicians using videoconferencing over telecommunication networks is a key component of providing teletreatments in rehabilitation.
The objectives of this study were to (1) document the conditions of use, performance, and reliability of videoconferencing-based communication in the context of in-home teletreatment (TELE) following total knee arthroplasty (TKA) and (2) assess from the perspective of the providers, the quality attributes of the technology used and its impact on clinical objectives.
Descriptive embedded study in a randomized controlled trial using a sample of 97 post-TKA patients, who received a total of 1,431 TELE sessions. Technical support use, service delivery reliability, performance, and use of network connection were assessed using self-report data from a costing grid and automated logs captured from videoconferencing systems. Physical therapists assessed the quality and impact of video-mediated communications after each TELE session on seven attributes.
Installation of a new Internet connection was required in 75% of the participants and average technician's time to install test and uninstall technology (including travel time) was 308.4 min. The reliability of service delivery was 96.5% of planned sessions with 21% of TELE session requiring a reconnection during the session. Remote technical support was solicited in 43% of the sessions (interventions were less than 3-min duration). Perceived technological impacts on video-mediated communications were minimal with quality of the overall technical environment evaluated as good or acceptable in 96% of the sessions and clinical objectives reached almost completely or completely in 99% of the sessions.
In-home rehabilitation teletreatments can be delivered reliably but requires access to technical support for the initial setup and maintenance. Optimization of the processes of reliably connecting patients to the Internet, getting the telerehabilitation platform in the patient's home, installing, configuring, and testing will be needed to generalize this approach of service delivery.
患者与临床医生通过电信网络使用视频会议进行音频/视频介导的沟通是提供康复远程治疗的关键组成部分。
本研究的目的是：（1）记录全膝关节置换术（TKA）后家庭远程治疗（TELE）背景下基于视频会议的沟通的使用条件、性能和可靠性；（2）从提供者的角度评估所使用技术的质量属性及其对临床目标的影响。
在一项随机对照试验中进行描述性嵌入式研究，样本为97例TKA术后患者，共接受1431次TELE治疗。使用成本核算网格的自我报告数据和从视频会议系统捕获的自动日志评估技术支持的使用、服务提供的可靠性、性能和网络连接的使用情况。物理治疗师在每次TELE治疗后评估视频介导沟通在七个属性方面的质量和影响。
75%的参与者需要安装新的互联网连接，技术人员安装、测试和卸载技术的平均时间（包括行程时间）为308.4分钟。服务提供的可靠性为计划疗程的96.5%，21%的TELE疗程在治疗期间需要重新连接。43%的疗程寻求远程技术支持（干预持续时间少于3分钟）。技术对视频介导沟通的感知影响极小，96%的疗程评估整体技术环境质量良好或可接受，99%的疗程几乎完全或完全实现了临床目标。
家庭康复远程治疗可以可靠地提供，但初始设置和维护需要技术支持。需要优化将患者可靠连接到互联网、在患者家中安装远程康复平台、安装、配置和测试的流程，以推广这种服务提供方式。
