JMIR Publications

ABSTRACT

Background:

Remote therapeutic monitoring (RTM) platforms are increasingly deployed in outpatient rehabilitation to support continuous, between-visit communication, adherence to home exercise programs, and earlier identification of clinical setbacks. While patient-facing outcomes have received growing attention, evidence describing the clinician experience of RTM—including its effects on therapeutic alliance, perceived cognitive workload, and capacity for proactive patient management—remains limited. Understanding how providers perceive and integrate RTM technology into their workflows is essential to optimizing implementation, sustaining adoption, and translating digital health investment into measurable clinical value.

Objective:

This pilot study tested the feasibility of evaluating the provider’s experience using a digital RTM platform across three pre-specified domains: (1) therapeutic alliance, (2) work satisfaction and cognitive load, and (3) proactive patient management. A secondary objective examined whether years of clinical experience or self-reported comfort with new technology were associated with provider experience or perceived workload.

Methods:

A cross-sectional, anonymous survey was administered to licensed physical therapists, physical therapist assistants, and occupational therapists at a single hospital-owned outpatient rehabilitation center in Indianapolis, Indiana, between November 1 and December 31, 2025 with a response rate of 43.4% (43/99) for the completed surveys. Eligible clinicians used the SaRA Health RTM platform for at least the previous six months prior to initiation of the study. The survey instrument combined an internally developed 8-item Likert-scale survey (0–5) targeting therapeutic alliance, proactive management, and satisfaction (Cronbach’s α = 0.89) with a modified NASA Task Load Index (NASA-TLX; Cronbach’s α = 0.86) measuring perceived workload across six domains (0–10). Cronbach’s α coefficient demonstrates internal consistency, but not construct validity or test-retest reliability. Descriptive statistical analyses included Spearman rank-order correlations, and Mann–Whitney U tests; effect sizes (ρ, and rank-biserial r) and 95% confidence intervals were reported.

Results:

Of 99 clinicians invited, 46 consented and 43 provided complete data for primary analyses (one of whom did not report years of clinical experience, n = 42 for that variable). Some clinicians completed only 1 of the 2 surveys and all responses were recorded. Confidence in the platform’s early warning detection was significantly correlated with perceived therapeutic alliance (ρ = 0.534, p < .002; 95% CI 0.285–0.715). Connection to the patient journey between visits was strongly correlated with overall positive platform experience (ρ = 0.602, P < .001; 95% CI 0.381–0.758). Lower frustration was associated with lower perceived effort on the NASA-TLX (U=78;P< .001; N1=18, N2=25 r = 0.696). Clinicians who reported the most positive overall platform experience were significantly more likely to report that the platform enabled proactive patient management (U=65.5, P < .001; N3=21, N4=22, r = 0.752). The larger effect sizes (r = 0.696, r = 0.752) are likely to be inflated as a result of the small sample size. Neither years of clinical experience (Mann–Whitney U = 183, P = .85; N1 = 29 [≤10 yrs], N2 = 13 [>10 yrs]; r = 0.03) nor comfort with new technology (Mann–Whitney U = 149, P = .50; N1 = 10 [Uncomfortable/Neutral], N2 = 33 [Comfortable]; r = 0.10) was associated with the positively rated clinical-impact items. Across all six NASA-TLX subscales, clinicians in the Uncomfortable/Neutral group (n = 10) scored numerically higher than the Comfortable group (n = 33) on every dimension. The Performance subscale was the only subscale reaching nominal significance (Mann–Whitney U, P = .02; rank-biserial r = 0.48, medium effect), but did not survive Bonferroni correction for six simultaneous comparisons (adjusted α = .0083).

Conclusions:

In this pilot feasibility study, it was observed that clinician experience with the SaRA Health RTM platform was characterized by enhanced therapeutic alliance when early warning detection performed well, reduced cognitive load was observed when frustration was low, and meaningful facilitation of proactive patient management was observed among engaged users. Frustration emerged as the most actionable lever for design and implementation improvement, and self-reported digital comfort—rather than years of clinical experience—was the strongest clinician-level correlate of cognitive burden. These findings suggest that targeted onboarding, mentorship, and friction-reducing platform refinements may improve RTM adoption and amplify downstream benefits to patient care. Larger, multi-site, longitudinal studies are warranted to validate these signals.