title: Implementing telerehabilitation research for stroke rehabilitation with community dwelling veterans: lessons learned.
abstract: Telerehabilitation (TR) is the use of telehealth technologies to provide distant support, rehabilitation services, and information exchange between people with disabilities and their clinical providers. This article discusses the barriers experienced when implementing a TR multi-site randomized controlled trial for stroke patients in their homes, and the lessons learned. The barriers are divided into two sections: those specific to TR and those pertinent to the conduct of tele-research. The TR specific barriers included the rapidly changing telecommunications and health care environment and inconsistent equipment functionality. The barriers applicable to tele-research included the need to meet regulations in diverse departments and rapidly changing research regulations. Lessons learned included the need for: telehealth equipment options to allow for functionality within a diverse telecommunications infrastructure; rigorous pilot testing of all equipment in authentic situations; and on-call and on-site biomedical engineering and/or IT staff.
authors.affiliation: VA HSR&D Center of Excellence on Implementing Evidence Based Practice (CIEBP), Richard L. Roudebush VAMC, Indianapolis, IN ; Department of Sociology, Indiana University School of Liberal Arts, Indiana University Purdue University Indianapolis, Indianapolis, IN ; VA HSR&D Stroke Quality Enhancement Research Initiative (QUERI) Program, Richard L. Roudebush VAMC, Indianapolis, IN ; Regenstrief Institute, Indianapolis, IN.
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.affiliation: VISN 8 Patient Safety Center, James A. Haley VAMC, Tampa, FL.
authors.forename: Patricia
authors.initials: P
authors.lastname: Quigley
authors.affiliation: Atlanta VA Rehab R&D Center, Atlanta VAMC, Atlanta GA.
authors.forename: Jon
authors.initials: J
authors.lastname: Sanford
authors.affiliation: Atlanta VA Rehab R&D Center, Atlanta VAMC, Atlanta GA ; Emory University School of Medicine, Div. of Geriatrics and Gerontology, Atlanta, GA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Griffiths
authors.affiliation: University of Florida, College of Public Health and Health Professions, Gainesville, FL.
authors.forename: Dorian
authors.initials: D
authors.lastname: Rose
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC ; Geriatric Research Education and Clinical Center, Durham VAMC, Durham, NC.
authors.forename: Miriam
authors.initials: M
authors.lastname: Morey
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN ; Tennessee Valley Healthcare System, VA Geriatric Research Education and Clinical Center, Nashville, TN.
authors.forename: E Wesley
authors.initials: EW
authors.lastname: Ely
authors.affiliation: Physical Medicine & Rehabilitation Service, Durham VAMC, Durham, NC ; Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig