Rehabilitation is described as “…integral to all aspects of health and well-being, from health promotion and prevention to end-of-life care and across the lifespan”. Rehabilitation aims to “enhance function for meaningful living” by focusing on the impacts that disease and disability have on function. These studies can inform the evaluation approaches utilized to assess the novel telehealth modalities adopted during the pandemic. Knowledge, awareness of available resources, and confidence to discuss webinar topics increased after attending the webinar. A webinar-focused evaluation found that 90.1% of participants indicated that the webinar content was relevant to their interests and needs. These changes translated into a reduction in system-level health care costs. An evaluation specifically assessing a nurse-led telehealth line concluded that calling the line resulted in a change in the care management of patients. Other studies mentioned similar outcome measures of interest for telehealth evaluations including patient and provider satisfaction cost-effectiveness adherence to, and communication of, care advice and timeliness and responsiveness of the service. A 2017 systematic review (n=137 articles) analyzed the successful evaluation methodologies utilized by telehealth projects and indicated that evaluation studies measured the quality of telehealth services through patient and provider satisfaction, economic benefit, and clinical outcomes. ![]() Many studies have evaluated telehealth and telerehabilitation services. In order to assess whether the telehealth modalities adopted during the pandemic are efficient and effective at meeting the needs of the populations they serve, we need to employ the most relevant and rigorous evaluation modalities. Webinars represent a technology that provides the opportunity to engage with a variety of audiences to provide education, information, and support. ![]() Helplines offer a highly accessible route to determine appropriateness and to promote accessibility of telerehabilitation. Telehealth services provide several conveniences, including lower costs associated with individual visits. Telerehabilitation and telehealth for self-management have been shown to be at least equivalent to in-person care. Telehealth initiatives adopted during the pandemic have included telephone helplines virtual meetings using platforms like Zoom, Google Meets, and Microsoft Teams patient portals chat boxes webinars and wearable devices. The pandemic has catalyzed the rapid adoption of telehealth practices to ensure the continuity of appropriate care during this time. Utilizing and Evaluating Telehealth Modalities In addition to the patients experiencing post-COVID symptoms, there have been, and will continue to be, patients who present with physical and neurological sequelae unrelated to COVID-19, such as spinal cord injuries. Early evidence suggests that patients with COVID-19 undergoing intensive care will likely experience functional decline due to organ dysfunction, deconditioning, cognitive changes, and psychological sequelae (depression and anxiety) for extended periods after hospitalization. ![]() The influx of COVID-19 patients (with actual and expected surges) will introduce more patients requiring rehabilitation care into the system due to the physical, respiratory, and neurological symptoms after acute COVID-19. Extended isolation also exacerbates caregiver demands for people living with disabilities. These challenges have put these patients at high risk for deterioration, possible hospitalization, and unnecessary emergency room visits. As services opened, virtual care and alternative service delivery formats offered opportunities and presented challenges for this population to socially connect and access the care needed. Mandated social distancing seen in the waves of COVID-19 has suspended clinics, homecare, and other support services, which are especially important for Canadians with disabilities. It has been reported that 22% of Canadians have disabilities (eg, spinal cord injury and Parkinson disease). Vulnerable populations, such as individuals living with disabilities in the community, are at risk for negative health outcomes because they are unable to access necessary community resources during the COVID-19 pandemic. The pandemic has triggered inconsistency in health service delivery and variable social distancing mandates, each fluctuating by time, geography, and social mores. The COVID-19 pandemic and concomitant governmental responses have created the need for innovative and collaborative approaches to deliver services, especially for populations that have been inequitably affected.
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