Telehealth Evaluation

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Original Editor - User Name

Top Contributors - Simisola Ajeyalemi and Kim Jackson  

Introduction

Telehealth is the delivery of health-related services and information via electronic communication. As with any process or intervention, it is essential to continually evaluate the efficacy of digital solutions for healthcare delivery. Healthcare professional can assess telehealth visits based on service user's satisfaction, experience, technical quality, usefulness, effect on interaction and effectiveness.

Satisfaction

The focus here should be on service user's expectation; if the expectation were met. Overall satisfaction and willingness to reuse telehealth to receive healthcare services should be measured.Satisfaction questionnaire typically show ceiling effects e.g.most report 80‐100% satisfaction however they are not designed to be sensitive to variations in quality of services.

Experience

The focus here is on service user's experience. The following dimensions should be evaluated- comfort, safety, values, equity, needs and preferences, participation

in decisions, treated with compassion and respect.

Technical Quality

Technology is a key aspect of telehealth service delivery and the focus here is technical quality of the platform used for telehealth. The visual and audio quality, reliability, ease of use and security should be evaluated.

Usefulness

The focus here is on evaluating if the service user found the service useful and/or benefits. Convenience, time & cost, accessibility, efficiency, acceptability, intent to use

again and appropriateness are all measured in this domain.

Effect on Interaction

The focus here is to evaluate the effect of telehealth as a mode of healthcare delivery on the clinician-patient interaction. Effect on communication, ability to do assessment; effect of visual & non‐verbal cues has to be evaluated.

Effectiveness

The focus here is to assess the effect on the service user's health service and/or well being. Change in knowledge, quality of life, health status, wellbeing,

function etc. In addition, clinician confidence in diagnosis should be measured.

Evaluating Telehealth Visits

The following outcome measures can be used in evaluating the effectiveness of telehealth visits

• General patient reported measure
  1. SF-12
  2. EuroQol

• Specific Patient‐Reported Measures
  1. Lower extremity Functional Scale
  2. Upper extremity functional scale
  3. Disability of the Arm and Hand
  4. Rating of Perceived Exertion
  5. Fatigue Severity Scale
  6. Falls Efficacy Scale
  7. Activities-Specific Balance Confidence Scale
  8. Oswestry Disability Index
  9. Oxford Hip/Oxford Knee Score

• Performance Measures
  1. Timed Up and Go
  2. 5 times Sit to Stand
  3. 30 secs Sit to Stand
  4. Functional Reach Test
  5. Modified Berg- Single leg stance
  6. 10 Metre walk test/ Gait Speed

• Special Test
  1. Empty Can
  2. FABER

• Individualised Measures
  1. Patient Specific Functional Scale
  2. Goal Attainment Scale

• Functional Observation
  1. Bed mobility
  2. Transfers
  3. Gait
  4. Functional ROM

• Impairment Measures
  1. Range of motion
  2. Pain- Numerical Pain Scale
  3. Strength

• Activity – independence, time, frequency
  1. Walking distance, duration, frequency
  2. Duration to complete a task e.g. dress

Resources

Physiotherapy Specific Evaluation Tools	Non-Physiotherapy Specific Evaluation Tools
MedRisk: Patient Satisfaction with Physical Therapy Care	Telemedicine Satisfaction Questionnaire
Physical Therapy Outpatient Satisfaction Survey	Telemedicine Satisfaction and Usefulness Questionnaire
Physical Therapy Patient Satisfaction Survey	Telemedicine Perception Questionnaire
Patient Satisfaction with Physical Therapy	Patient Assessment of Communication during Telemedicine
Patient Satisfaction with Outpatient Physiotherapy	Telehealth Usability Questionnaire
Treatment Outcome Satisfaction Questionnaire