An evaluation framework for a rural home-based telerehabilitation network

This study was a needs assessment to inform the design and evaluation of a home-based telerehabilitation network for rural elderly patients. We conducted a literature review of telerehabilitation studies and a needs-assessment by interviewing 43 professionals, including homecare nursing staff, members of volunteer organizations and service agencies, social workers, discharge planners, researchers, and rehabilitation therapists. The survey addressed perceived needs, advantages, and disadvantages with the use of telemedicine technologies for rehabilitation services. All respondents agreed that there are unmet needs among elderly people who are discharged from hospital settings, and identified several problems including: medication noncompliance, isolation, limited access to specialists and community-based services. Our findings defined a framework for the development of a client-oriented rural telehealth network that will be used to guide patients discharged to homecare following stroke, through a complex array of health, mental health, and social services, spanning all levels of care.