Tele-Rehab 2.0

 

Tele-Rehabilitation 2.0

Tele-Rehab 2.0 is changing the landscape of virtual care by redefining assessment and breaking accessibility barriers, because everyone deserves equitable, accessible healthcare.

Tele-Rehab 2.0 came from humble beginnings, starting as an idea in 2015 when Dr. Martin Ferguson-Pell, our Principal Investigator, was inspired by Microsoft’s holoportation technologies. Years later, Tele-Rehab 2.0 has grown from a pilot project with a 2-year grant to a project which has secured continued funding from Alberta Innovates, operates in 13 rural communities, including 3 supported living facilities, and has engaged an enormous network of collaborators and clinicians as we work to have our technology and processes integrated into Alberta Health Services and beyond.

At the outset of the project we launched four modules: shoulder pain, hip and knee replacement follow-up, vertigo and balance, and wheelchair special seating assessment, and had four rural sites. Since then we have been working to expand our reach. Currently, we are working to validate a shoulder surgery follow-up module and we will soon roll out long COVID and falls risk modules.

As we move forward we are always considering what other areas Tele-Rehab 2.0 could be applied in, and the possibilities are seemingly endless! Some other areas we may tackle in the future include stroke rehabilitation and conservative management for osteoarthritis.

The Impact

The COVID-19 pandemic resulted in a whirlwind, rapid uptake of virtual health in various forms, paving the way for Tele-Rehab 2.0. Now that the general public has seen how virtual health can work for them, there are many reasons patients want it to stick around. Virtual care means that patients can get the care they need and deserve, without the stress, personal costs, and organizational efforts an in-person appointment can entail. Tele-Rehab 2.0 has all of those benefits, and more.

The feedback we have received from patients and clinicians alike has been very positive and encouraging. Patients benefit from having the support of a local (spoke) clinician in-person and the expertise of a specialist (hub) clinician via videoconference. Tele-Rehab 2.0 also means reduced wait times, and less risk for developing chronic pain or loss of function. Lastly, Tele-Rehab 2.0 makes rehabilitation appointments safer for rural patients as they can avoid traveling on busy highways in poor road conditions.

Tele-Rehab 2.0 also provides many benefits to clinicians. Hub clinicians are able to expand their reach to see more patients more effectively and can utilize tools with more objective measurements than they normally would in-person. Spoke clinicians gain the support and mentorship of the hub clinician. All these aspects of Tele-Rehab 2.0 lead to a better patient experience.

The Technology

Tele-Rehab 2.0 includes a tool kit of different technologies which allow clinicians to make precise and accurate measurements and feel like they are in the room with the patient, even from hundreds of kilometers away. Some of the main players are the Double Robot, the Temi Robot, Kinetisense Markerless Motion capture software, and the Vestibular First Infrared Goggles.

The Double Robot
The Double is a self-driving video conferencing system which allows our hub clinicians to have a presence at our rural sites. The hub clinician is able to control the position, height, and angle so they simply click to where they want to go and safely maneuver around any obstacles without having to interrupt the spoke clinician. Patients have remarked that it feels like the hub clinician is really there!
Temi Robot
Temi is a personal robot which, like the Double, provides a way for our hub clinicians to safely navigate the assessment space without having to interrupt or be moved around by the spoke clinician. Temi is also voice controlled and can be directed by either the hub or spoke clinician to move around, or to follow the patient out of the room for specific tests. Unlike the Double, Temi includes a platform on the back of the robot which allows us to place a laptop onto Temi, streamlining Tele-Rehab 2.0 into one integrated system instead of a separate cart and robot.
Kinetisense Markerless Motion Capture Software
Using Kinestisense’s markerless motion capture software has been a game changer for remote assessments. This tool allows clinicians to easily track and measure movements and angles, such as the patient’s range of motion or sway during a balance assessment. The precise and objective measurements mean that smaller changes can be seen over time than with in-person assessments, and all clinicians have the same information. With improved measurements there are improved outcomes for patients.
Vestibular First Infrared Goggles
The Vestibular First Goggles allow for a clinician to get a closer look at eye movements which could indicate a vestibular disorder. These important eye movements can often be suppressed if the patient has somethign visual to focus on. With the Vestivular First Goggles, all incoming light is blocked, but the infrared camera enables the clinician to view the eye movements.

The Potential

In just 3 years, Tele Rehab 2.0 has grown and expanded into more rural communities, more focus areas, and into supported living facilities, but we are not stopping there! Tele-Rehab 2.0 is changing the face of rehabilitation. Tele-Rehab 2.0 is redefining assessment. Tele-Rehab 2.0 is creating a new standard for virtual care.

Currently we have been working on expanding our connections beyond Alberta’s borders and are especially excited to learn more about virtual care in Indigenous communities from our colleagues in Saskatchewan and Manitoba.

By working to integrate Tele-Rehab 2.0 into our healthcare system, we provide patients with a virtual option and make rehabilitation services more equitable for all. Everyone can benefit from virtual care.

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