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The purpose of this paper is to provide the current position of the American Occupational Therapy Association (AOTA) regarding the use of telerehabilitation technologies by occupational therapists and occupational therapy assistants1 to provide occupational therapy services, based on the existing research. This document examines the research and issues related to telerehabilitation for evaluation and intervention, telemonitoring, practitioner qualifications, ethics, and regulatory issues and reimbursement. Occupational therapy practitioners2 are the intended audience for this document, although others involved in supervising, planning, delivering, and paying for occupational therapy services also may find it helpful.
Telecommunication has prompted the development of an emerging model of health care delivery called telehealth, which involves "providing health care, health information, and health education across a distance, using telecommunications technology....It allows physicians, nurses, and health care specialists to assess, diagnose, and [provide interventions to clients] without requiring both individuals to be physically located in the same place" (Center for Telehealth and E-Health Law, 2010, para. 1).
Telerehabilitation within the larger realm of telehealth is the application of communication technology for supporting rehabilitation services (Russell, 2007). On the basis of this definition, telerehabilitation includes the application of evaluation, preventative, diagnostic, and therapeutic services via two-way or multipoint interactive telecommunication technology. Occupational therapy practitioners can use telerehabilitation as a mechanism to provide services at a location that is physically distant from the client, thus allowing for services to occur where the client lives, works, and plays, if that is needed or desired. Telerehabilitation also allows occupational therapy practitioners to use new technologies to provide interventions through alternative methods such as through virtual reality. Key terms related to telerehabilitation and telehealth are defined in Appendix A.
As in other health care fields, the use of telehealth and telerehabilitation is expanding. Research to measure its effectiveness and utility by professionals in a variety of health care fields is ongoing. This paper includes an overview of some of the research that is relevant to the use of telerehabilitation for providing occupational therapy services. This paper also highlights some of the current topics being discussed regarding the use of telerehabilitation for providing occupational therapy services.
Telerehabilitation in Evaluation and Intervention
In general, the use of telerehabilitation to conduct evaluations depends on real-time two-way or multipoint observation, communication, and...