A telehomecare model for optimizing rehabilitation outcomes

For telehealth to become an accepted component of rehabilitation, a scientific base verifying that telehealth improves outcomes must be developed. A conceptual framework based on theory and empirical findings is necessary for this area of inquiry to flourish. Most academic curricula possess such an educational pillar, which serves to help prepare professionals to practice in the new arena, and scholars to perform quality research. Currently, the authors are involved in developing areas of the biomedical engineering and nursing curricula at Marquette University to address key areas of telerehabilitation. This paper outlines the conceptual framework for these curricular areas. The conceptual framework is derived from three areas that modulate each other, and ultimately impact the outcomes of telerehabilitation. These areas are rehabilitative biosystems, human-technology interfaces, and behavioral compliance. Each can be viewed from the context of an optimization process, and the model can be applied to help identify the weak link for a given telerehabilitative approach under study. Examples of how the model can be used to frame telerehabilitation research are presented, with a special focus on designing home-based solutions for two societal challenges of large scope and great need-stroke and cardiac rehabilitation. The authors conclude that the proposed framework can be used to conceptualize, understand, and optimize the key components of a telerehabilitative process and to analyze alternative approaches for optimizing outcomes.