Rural post-acute stroke care using multidisciplinary telerehabilitation

Stroke is the third leading cause of death in the USA and is the leading cause of long-term adult disability. Comprehensive coordinated rehabilitation services can reduce mortality and improve functional outcomes following stroke. In rural communities, however, the specialized services and supports needed by patients after stroke are often not available. An innovative alternative to deliver rehabilitation services is telerehabilitation. The INTEGRIS Rural Facilities and the INTEGRIS Jim Thorpe Rehabilitation Network collaboratively conducted case studies utilizing physical therapy, occupational therapy, neuropsychology and vocational rehabilitation for stroke survivors in rural communities 70 to 170 miles away from the specialists. Consultations were conducted using H320 videoconferencing equipment over dedicated T-1 lines. The telerehabilitation applications, patient outcomes, service coordination, cost-effectiveness and lessons learned are discussed.