Exploring the perspectives of outpatient rehabilitation clinicians on the challenges with monitoring patient health, function and activity in the community

Abstract

Purpose

Rehabilitation clinicians need information about patient activities in the home/community to inform care. Despite active efforts to develop technologies that can meet this need, clinicians’ perspectives regarding how information is collected and used in outpatient rehabilitation have not been comprehensively described. Therefore, we aimed to describe: (1) what data pertaining to a patient’s health, function and activity in their home/community are currently collected in outpatient rehabilitation, (2) how these data can impact clinical decisions, and (3) what challenges clinicians encounter when they manage the care of outpatients based on this information.

Materials and methods

Eight clinicians working in outpatient rehabilitation programs completed qualitative interviews that were analyzed using an inductive thematic analysis.

Results

Four themes were identified: “Nature of data about a patient’s health, function and activity in the home/community and how it is collected by clinicians,” “Value of data from the home/community,” “Perceived drawbacks of current data collection methods,” and “Improving data collection to understand patient trajectory.”

Conclusions

Clinicians described the importance of understanding patient activities in the home/community, but perspectives varied regarding the suitability of current methods. These perceptions may inform the design of solutions to bridge the gap between the clinic and the community in outpatient rehabilitation.

Implications for rehabilitation

• Clinical decision-making in outpatient rehabilitation is guided by verbal and written reports about a patient’s health and function in the community and adherence to treatment plans.

• Differing perceptions on the suitability of current data collection methods indicate that the development of new solutions, such as rehabilitation technologies, needs to carefully consider clinician workflows and what data are perceived as meaningful.

• Potentially impactful directions for new solutions include providing well validated data on adherence, movement quality, or longitudinal progression, presented in formats that match clinical decision criteria.

Keywords:

• Occupational Therapists
• Physical Therapists
• Qualitative Research
• Data Collection
• Rehabilitation Research
• Rehabilitation Centers

Acknowledgements

We would like to thank all of the participants for participating in this study.

Author contributions

HS collected and analyzed the data and wrote the first draft of the manuscript. KEM participated in the study design, analysis and manuscript writing/edits. TJFC participated in manuscript writing/editing. KSM participated in manuscript writing. AI participated in manuscript writing/editing. MB participated in manuscript writing/editing. JZ is the guarantor/corresponding author. JZ conceived the study and participated in the study design, data collection, analysis and manuscript writing/editing. All authors read and approved the final manuscript.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Canadian Institutes of Health Research Fellowship to HS and the Craig H. Neilsen Foundation Psychosocial Research Grant to KEM. The funders did not have any influence over the analysis, interpretation and reporting of data.