Implementation and use of video tele-technologies in delivery of individualized community-based vocational rehabilitation services to rural veterans

BACKGROUND: Telerehabilitation is an effective health delivery method for patients with a variety of health conditions. There is insufficient knowledge about use of telerehabilitation to support patients with disabilities and chronic illness in obtaining or sustaining competitive employment. Employment rates of Veterans are lower than civilian rates, and the employment gap is higher for Veterans living in rural areas. OBJECTIVE: To investigate factors that enabled and constrained routine use of video tele-technologies in delivering individualized community-based vocational rehabilitation (referred to as Tele-VR) services and to identify impacts and promising practices in implementation. METHODS: Semi-structured interviews with providers from two Veterans Health Administration Medical Sites that use telerehabilitation to supplement their existing face-to-face individualized community-based VR services. Interviews were analyzed using thematic analysis. RESULTS: Five themes in the implementation of Tele-VR were identified (1) Enhancing Workflow for Providers, (2) Improving Quality of Therapeutic Care, (3) Practicalities in Implementing Tele-VR, (4) Embedding Vocational Rehabilitation into Interdisciplinary Care as a Facilitator to Implementation, and (5) Impact of Tele-VR. CONCLUSIONS: The telerehabilitation delivery of employment service to Veterans with disabilities is a viable means for remotely providing or enhancing face-to-face individualized and community-based VR services that support Veterans’ competitive employment and job stability within their communities.