title: Benefits and Challenges of Delivering Tele-rehabilitation Services to Rural Veterans.
abstract: Veterans residing in underserved rural areas face many barriers to accessing high-quality rehabilitation services. This article describes the benefits and challenges of using technology for delivery of rehabilitation services to rural Veterans using TeleHOME, an innovative tele-rehabilitation program. TeleHOME enables rehabilitation providers to remotely assess the Veteran's functional abilities and needs in his or her own home where these tasks must be performed. This technology increases the ability of all team members to contribute to interdisciplinary care, but also requires greater levels of team integration. One month after the completion of the TeleHOME project, we met with clinicians to discuss their perceptions of whether and how use of the technology affected interdisciplinary care processes, and what approaches were used to meet team-based goals. TeleHOME can improve access to rehabilitation services for rural Veterans, but will also bring about novel integrative care processes that may improve the effectiveness of such services. Recommendations to overcome challenges to optimize the implementation and delivery of TeleHOME services as well as to better inform clinicians working with rural Veterans are discussed.
authors: Michael P. Cary, Jr., PhD, RN, is an Assistant Professor, Duke University School of Nursing, Durham, North Carolina. Michelle Spencer, DPT, PT, is a Physical Therapist, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina. Ansuya Carroll, MBS, LPN, is a Licensed Practical Nurse and Telehealth Care Technician, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina. Deborah H. Hand, MS, OTR, is an Occupational Therapy Supervisor, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina. Kristopher Amis, MS, OTR, is an Occupational Therapist, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina. Elizabeth Karan, MS, OTR, is Chief, Occupational Therapy Section, Durham VA Medical Center, Durham, North Carolina. Rebecca F. Cannon, LPN, is a Licensed Practical Nurse and Telehealth Care Technician, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina. Michelle S. Morgan, BS, is a Project Coordinator, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina. Helen M. Hoenig, MD, MPH, is a Professor of Medicine/Geriatrics, Physical Medicine and Rehabilitation Services, Duke University School of Medicine, Rehabilitation Services, Durham VA Medical Center, Durham, North Carolina.
authors: Michael P
authors: MP
authors: Cary
authors: Michelle
authors: M
authors: Spencer
authors: Ansuya
authors: A
authors: Carroll
authors: Deborah H
authors: DH
authors: Hand
authors: Kristopher
authors: K
authors: Amis
authors: Elizabeth
authors: E
authors: Karan
authors: Rebecca F
authors: RF
authors: Cannon
authors: Michelle S
authors: MS
authors: Morgan
authors: Helen M
authors: HM
authors: Hoenig
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D010348:Patient Care Team; D015397:Program Evaluation; D019035:Rural Health Services; D012424:Rural Population; D000069350:Telerehabilitation / Q000379:methods; D014481:United States; D014728:Veterans