Telerehabilitation

In the last three years, the delivery of rehabilitation services at a dista nce by means of electronic information and communication technologies has c ome to be known as telerehabilitation. It is part of both the larger spectr um of telemedicine activities that have waxed, waned and waxed again since the early seventies; and the growing array of non-medical applications of c onsumer electronics and communication technology that can provide "tele-enh ancement of independent living" for individuals with neurological and other disabilities. While telerehabilitation is still largely hypothetical, acti vities are underway at several clinical rehabilitation centers. Most common ly, inexpensive video phone connections are used to provide face-to-face tw o-way image and voice contact between patient and provider, but transmissio n of data from sensors that monitor health and rehabilitation is technicall y feasible and promising. Telerehabilitation provides access to quality ser vices for patients who are immobile or geographically remote from direct se rvice. Some view it as a means of compensating for shortened lengths of sta y in acute rehabilitation hospitals, while others emphasize the cost reduct ions it offers. Telerehabilitation methods, both current and in-the-works, are promising but it remains to be seen whether and how the reimbursement p olicy-makers at HCFA and private payers will respond to its potential.