The challenge of collaborative telerehabilitation: conception and evaluation of a telehealth system enhancement for home-therapy follow-up

Telerehabilitation aims to solve problems like equitable access to the rehabilitation and cost reduction by providing rehabilitation services at a distance. The largest part of telerehabilitation systems implement a real-time one-to-one process involving patient and therapist. Even though they can be successfully exploited in conditions such as post-traumatic recovery, in complex scenarios, this simple model should be replaced by a more structured collaborative one envisioning a multidisciplinary team. This paper presents the design and evaluation of a patient-centric collaborative telerehabilitation framework aimed at supporting a multidisciplinary team in the follow-up of domiciliary patients. The proposed framework follows the experience of a clinical trial that exploited a novel telerehabilitation device not conceived to support collaborative scenarios. Compared with the original system, the proposed extension allows the hierarchical division of the responsibility within the medical team, promoting a collaborative management of the rehabilitation. Proactive and decisional behaviors, as well as consulting practices on shared data within the medical team, are fostered by the system. Semi-structured interviews have been administered to a panel of experts to evaluate the proposed approach. The collected feedback can be exploited to finely tune the system in view of a new clinical trial including new functionalities.