Patient and health care professional perspectives on using telehealth to deliver pulmonary rehabilitation

Abstract

The objective of this study was to identify the necessary features of pulmonary telerehabilitation (P-TR) from the perspectives of individuals living with chronic lung disease and health care professionals (HCPs) who deliver pulmonary rehabilitation (PR). Focus groups were carried out with patients (n = 26) and HCPs (n = 26) to elicit and explore their opinions about the critical elements of in-person PR and ideas for how these elements could be supported using technology. A questionnaire was used to assess technology use, PR experience, and general health status. Four key elements of PR were identified as critical to P-TR: the social aspect of PR; communicating with HCPs for education and support; using biosensors for monitoring and promoting self-knowledge; and the evolution of support with progress over time. A range of technology-enabled devices and programs were suggested as means to recreate aspects of these integral elements. Consultations with patients and HCPs suggest that users are interested in technology and want to ensure it recreates the important aspects of PR. Patients and HCPs identified similar key elements for P-TR. The opinions and suggestions of patients and HCPs should be the driving force of innovation if P-TR is to succeed in improving health outcomes.

Barriers and enablers of COPD telerehabilitation – a frontline staff perspective

“…First, several studies found that health professionals reported technical tasks as a great barrier to their job and professional role. 20 , 26 , 44 – 47 Similarly, the participants in this study experienced that technical tasks increased their preexisting work burden and undermined their professional identity. Second, more studies emphasized that telecare would not be able to replace the physical meeting because important communication would be missed.…”

“…Similarly, a study by Inskip et al found that health professionals reported that being able to support patients who otherwise would not participate in rehabilitation was satisfying and made their job meaningful. 47 Likewise, we found that making a difference to the patients was an often mentioned motivator to perform TR.…”

“…Therefore, when implementing new teleinterventions, it is crucial that health professionals get a sufficient introduction to the tele devices and are assured that IT support is available when needed. 39 , 47 …”

Disparities in Geographic Access to Hospital Outpatient Pulmonary Rehabilitation Programs in the United States

“…Another potential strategy for increasing access to PR in rural areas is to explore the use of telehealth technologies, which have been successfully used in other countries, including Scotland and Canada, for remote delivery of PR services. [24][25][26] Expansion of PR services to underserved areas is an important first step in improving access. However, the availability of a PR program in a geographic area does not guarantee that all patients in need of the service will be able to obtain it or that the services provided are high quality.…”

Wearable Sensing and Telehealth Technology with Potential Applications in the Coronavirus Pandemic

“…It is noteworthy that the educational videos and instruction manuals in an e-consultation platform should be elaborately prepared and the real-time supervision is recommended to support patient conduct of tele-PR in an effective and safe way [202]. To promote physical exercise as an example, patients with mild to moderate symptoms can, for example, use posture and movement monitoring technologies, such as depth-cameras or wearable systems [203][204][205]. With remote feedback on the monitored information from the patients, training effectiveness can be ensured with improved motivation, which can potentially relieve stress and anxiety.…”