User requirements of physiotherapists of a telehealth service for patiens with movement disorders: an exploratory study

Telehealth, the use of communication technologies within the context of clinical health care has the possibility to substantially transform health care to match the demands of a demographically changing society. Although the positive effects of telehealth have been supported by numerous studies, few telehealth applications have been implemented so far. This is partially due to the technically focused approach when developing these applications. To maximize the effectiveness of telehealth services a user-centered approach is needed to tailor them to the specific demands of the end-user. Aim: This qualitative study was conducted to acquire insight on the user requirement of physiotherapists regarding a web-based remote monitoring and feedback service, consisting of three modules closely connected with the rehabilitation of patients with movement disorders. Method: A total of seven research questions serve two purposes. Five research questions were posed to capture the preferences of physiotherapists regarding the parameters needed to be monitored, the time when they shall be monitored and which technologies they would want to use for this purpose. Further the participants were asked how, and how frequent they would want to provide feedback to their patients. Two of the research questions were formulated according to constructs derived from the technology acceptance model (Davis, 1989), examining how intention to use is influenced. To answer these research questions a total of sixteen semi-structured interviews were conducted, transcribed and analyzed. Five participants were recruited at rehabilitation centre in Groot Klimmendaal. The other eleven were recruited at primary care offices in Venendaal (five participants) and Rheine (six participants). Results: Results showed that none of the participants believed that the service could actually replace personal meetings, but that the application of videoconferencing as a medium for feedback could be an valuable asset. Physiological variables, information on daily activities and patient´s experiences were regarded valuable information to be used for enhancing and adjusting the treatment. Activity monitors and self-report questionnaires as well as diaries were the preferred methods to acquire these information. For the provision of feedback, most respondents preferred a fixed weekly evaluation moment. The majority of the respondents reported that they perceive a web-based remote monitoring and feedback service useful, but that its actual application is heavily dependent on the patient´s condition. Regardless of that, most respondents found the possibility to create and share electronic patient dossiers to coordinate the treatment with other healthcare professionals very promising. Conclusion: Most physiotherapists participating in this study perceived a telehealth service as a useful addition to traditional therapy. Especially for the current generation which is proficient in the use of computer technologies, telehealth services could be an valuable addition. However, most of the respondents lack confidence in current information technologies and cooperation from the patients´ side is mandatory to make telehealth systems work. Also, in order to implement these systems on a societal level, their benefits, such as cost effectiveness, need to be recognized by the authorities and insurance companies.