Maintaining the use of telehealth for delivering rehabilitation services in a regional hospital post-COVID19: Learning from telehealth delivery rates and staff experiences.

Abstract

ObjectiveTo examine what delivery format had been used to facilitate rehabilitation services over recent years and to identify barriers and enablers to using telehealth in the future.DesignMultiple method research approach.Setting:Outpatient rehabilitation service in a large regional hospital in Australia.Participants:Clinicians that deliver rehabilitation interventions including allied health professionals and nurses.Main measuresFirst, a retrospective audit of data examining the rate of telehealth use. Second, semi-structured focus groups with clinical staff to identify barriers and enablers to using telehealth. Data were thematically analysed and mapped to a behaviour change framework.ResultsPre-pandemic, 82% (n = 45,960) of rehabilitation services were delivered in-person; during peak restrictions, in-person delivery was 54% (n = 49,337). Following the ease of restrictions, 71% (n = 49,337) of the rehabilitation services were delivered in-person, 28% (n = 21,624) via phone and 1% (n = 493) via video. Telehealth use increased 11% from pre-pandemic to when restrictions were eased, driven by increased use of phone consultations. Six themes related to barriers and four themes related enablers to using telehealth were identified. Using the behaviour change framework, five interventions functions (education, training, environmental restructure, modelling and enablement) were recommended to facilitate telehealth use.ConclusionsTelehealth-delivered rehabilitation rates increased post-pandemic, primarily via phone consultations. Reported barriers and enablers highlight the need for targeted strategies, with five intervention functions identified that may support increased telehealth adoption in rehabilitation settings. Future efforts should address clinician-raised barriers to optimise telehealth integration into service delivery.