Development of a Service Delivery Protocol Used for Remote Wheelchair Consultation via Telerehabilitation

Prescription of wheelchairs requires considerable examination and follow-up. In a carefully considered approach, these investigators have developed a system connecting two distant sites with a central rehabilitation facility to assess, prescribe, and deliver wheelchair needs. The system entails high-quality video and considerable thoughtful logistics with the intent of accurate prescription and timely delivery with minimal travel for those needing the consultation. This system is now being tested. The purpose of this paper is to explain the development, methodology, and implementation of an assistive technology (AT) service delivery protocol using a telerehabilitation consultation model for evaluation of remote wheelchair prescriptions. The provision of wheeled mobility and seating interventions can be complex when considering people with intricate seating and positioning needs, environmental factors, and wide array of product interventions. The availability of qualified practitioners with specialty expertise in this area is limited, especially outside of urban areas. Therefore, people are potentially isolated from rehabilitation services due to geography or physical limitations. A repeated measure study design is used to evaluate the service delivery protocol measured by the effectiveness of wheeled mobility and seating interventions provided in a remote location by a generalist occupational and/or physical therapy practitioner with consultation from an expert therapist via interactive teleconferencing. Effectiveness is measured by magnitude of change and scored by pre and post scores of the Functioning Everyday with a Wheelchair (FEW) outcome measure tool. Two model programs have been specified and are currently implementing the service delivery protocol. The live interaction has enabled remote therapists the ability to exchange personal and health information to experts in the field from an urban facility. The impact of this service delivery protocol will be augmented as it is to be launched and replicated in three additional sites. Telerehabilitation is a new field that can only be measured by its long-term impact; however, its success can be looked at by its development and implementation into everyday clinical service delivery.