Tanner Kelly, Bican Rachel, Boster Jamie, Christensen Catie, Coffman Candace, Fallieras Kristin, Long Rene, Mansfield Christine, O'Rourke Sara, Pauline Lindsey, Sagester Grace, Marrie James
Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio, USA.
Int J Telerehabil. 2020 Dec 8;12(2):43-52. doi: 10.5195/ijt.2020.6336.
Telerehabilitation has long been recognized as a promising means of providing pediatric services; however, significant barriers such as cost, payor reimbursement, and access prevented widespread use. The advent of the COVID-19 pandemic necessitated rapid adoption of telerehabilitation into clinical practice to provide access to care while maintaining social distancing. The purpose of this study is to present clinical data on the feasibility and acceptability of speech-language pathology, developmental occupational and physical therapies, and sports and orthopedic therapies telerehabilitation delivered in a pediatric hospital setting.
Telerehabilitation services were rapidly implemented in three stages: building the foundation, implementing, and refining this service delivery model. Paper patient satisfaction surveys were administered as part of ongoing quality improvement efforts throughout 2019 and were adapted for online administration in 2020 for telerehabilitation patients. Outpatient visit counts by type (in-person, phone, and video) were extracted from the electronic medical record using data warehousing techniques.
Historical patient satisfaction rates from 2019 indicated high patient satisfaction (98.97% positive responses); these results were maintained for telerehabilitation visits (97.73%), indicating that families found telerehabilitation services acceptable. Patient volume returned to 73.5% of pre-pandemic volume after the implementation of telerehabilitation services.
Pediatric telerehabilitation is feasible to provide in clinical settings, and the services are acceptable to patient families. Future work is needed to evaluate the impact of telerehabilitation services on patient care and applications for ongoing use of this delivery model.
远程康复长期以来一直被认为是提供儿科服务的一种有前景的方式;然而,成本、支付方报销和获取途径等重大障碍阻碍了其广泛应用。新冠疫情的出现使得远程康复迅速被应用于临床实践,以便在保持社交距离的同时提供医疗服务。本研究的目的是展示在儿科医院环境中提供的言语病理学、发育性职业和物理治疗以及运动和骨科治疗远程康复的可行性和可接受性的临床数据。
远程康复服务分三个阶段迅速实施:奠定基础、实施和完善这种服务提供模式。纸质患者满意度调查作为2019年持续质量改进工作的一部分进行,2020年针对远程康复患者进行了调整以便在线管理。使用数据仓库技术从电子病历中提取按类型(面对面、电话和视频)划分的门诊就诊次数。
2019年的历史患者满意度表明患者满意度较高(积极回应率为98.97%);远程康复就诊的满意度保持在这一水平(97.73%),这表明家庭认为远程康复服务是可以接受的。实施远程康复服务后,患者数量恢复到疫情前数量的73.5%。
在临床环境中提供儿科远程康复是可行的,并且该服务为患者家庭所接受。未来需要开展工作来评估远程康复服务对患者护理的影响以及这种服务提供模式持续使用的应用情况。