Hill Annie J, Breslin Hugh M
Centre of Research Excellence in Telehealth, School of Health and Rehabilitation Sciences, The University of Queensland Brisbane, QLD, Australia.
BreezeSoft Brisbane, QLD, Australia.
Front Hum Neurosci. 2016 Dec 20;10:640. doi: 10.3389/fnhum.2016.00640. eCollection 2016.
Asynchronous telerehabilitation in which computer-based interventions are remotely monitored and adapted offline is an emerging service delivery model in the rehabilitation of communication disorders. The asynchronous nature of this model may hold a benefit over its synchronous counterpart by eliminating scheduling issues and thus improving efficiency in a healthcare landscape of constrained resource allocation. The design of asynchronous telerehabilitation platforms should therefore ensure efficiency and flexibility. The authors have been engaged in a program of research to develop and evaluate an asynchronous telerehabilitation platform for use in speech-language pathology. eSALT is a novel asynchronous telerehabilitation platform in which clinicians design and individualize therapy tasks for transfer to a client's mobile device. An inbuilt telerehabilitation module allows for remote monitoring and updating of tasks. This paper introduces eSALT and reports outcomes from an usability study that considered the needs of two end-user groups, people with aphasia and clinicians, in the on-going refinement of eSALT. In the study participants with aphasia were paired with clinicians who used eSALT to design and customize therapy tasks. After training on the mobile device the participants engaged in therapy at home for a period of 3 weeks, while clinicians remotely monitored and updated tasks. Following the home trial, participants, and clinicians engaged in semi-structured interviews and completed surveys on the usability of eSALT and their satisfaction with the platform. Content analysis of data involving five participants and three clinicians revealed a number of usability themes including ease of use, user support, satisfaction, limitations, and potential improvements. These findings were translated into a number of refinements of the eSALT platform including the development of a client interface for use on the Apple iPad®, greater variety in feedback options to both the participant and clinician, automatic transfer of results to the clinician, and expansion of the task template list. This research highlights the importance of including end-users in the process of technology refinement, in order to ensure effective and efficient use of the technology. Future directions for research are discussed including clinical trials in which the effectiveness of and adherence to intervention protocols using asynchronous telerehabilitation are examined.
异步远程康复是一种新兴的服务提供模式，在沟通障碍康复中，基于计算机的干预措施会被远程监控并进行离线调整。与同步远程康复相比，这种模式的异步特性可能具有优势，因为它消除了日程安排问题，从而在资源分配受限的医疗环境中提高了效率。因此，异步远程康复平台的设计应确保效率和灵活性。作者参与了一项研究计划，旨在开发和评估一个用于言语病理学的异步远程康复平台。eSALT是一个新颖的异步远程康复平台，临床医生可以在该平台上设计并个性化治疗任务，然后将其传输到客户的移动设备上。内置的远程康复模块允许对任务进行远程监控和更新。本文介绍了eSALT，并报告了一项可用性研究的结果，该研究在eSALT的持续改进过程中考虑了失语症患者和临床医生这两个最终用户群体的需求。在该研究中，失语症患者与使用eSALT设计和定制治疗任务的临床医生配对。在移动设备上接受培训后，参与者在家中进行了为期3周的治疗，临床医生则远程监控并更新任务。在家中试用之后，参与者和临床医生进行了半结构化访谈，并完成了关于eSALT可用性及其对该平台满意度的调查。对涉及5名参与者和3名临床医生的数据进行的内容分析揭示了许多可用性主题，包括易用性、用户支持、满意度、局限性和潜在改进。这些发现被转化为对eSALT平台的一些改进，包括开发用于苹果iPad®的客户端界面、为参与者和临床医生提供更多样化的反馈选项、将结果自动传输给临床医生以及扩展任务模板列表。这项研究强调了在技术改进过程中纳入最终用户的重要性，以确保有效且高效地使用该技术。文中还讨论了未来的研究方向，包括对使用异步远程康复的干预方案的有效性和依从性进行检验的临床试验。
