JMIR Publications

ABSTRACT

Background:

Despite a surge in health information and communication technology (ICT), there is little evidence of lowered cost or increased quality of care. ICT may support stakeholders through a rehabilitation trajectory by offering safe storage of data and information exchange, still leaving the complex intersection between producers and users of ICT a challenge.

Objective:

This scoping review synthesizes existing literature and key characteristics of ICT solutions that address the collaboration between patients, providers, and/or other stakeholders through a rehabilitation process.

Methods:

This scoping review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping review guidelines. Studies were identified by searching MEDLINE (OVID), Embase (OVID), CINAHL (EBSCOhost), AMED (EBSCOhost), and Scopus. Unpublished studies are extracted from OAIster, Bielefeld Academic Search Engine, ProQuest Dissertations and Theses, NARIC, and Google Scholar. Eligible articles addressed or described a remote dialogue between stakeholders utilizing ICT to address goals and means, give decision support, and/or evaluate certain treatment modalities within a rehabilitation context. Due to ICT’s surging development, the date cut is set to 2018.

Results:

3,206 articles (excluding duplicates) were screened. Three articles met all inclusion criteria. The articles varied in design, key findings, and key challenges: i) A pragmatic exploratory partial RCT pilot design with 16 patients, using synchronous video communication to assess adults with acquired brain injury to discover performance problems and enable goal attainment; ii) A qualitative descriptive design, where eight health professionals and eight rehabilitation inpatients described experiences with an iPad application for decision-making; iii) A multi-center randomized trial on the effects of telephone support and a digital platform for patients with chronic obstructive pulmonary disease and/or chronic heart failure. All studies reported improvements in activity performance, participation, frequency of leaving the house, improved self-efficacy, change in patients’ perspective on possibilities, and change in professionals’ understanding of patients’ priorities. However, a misfit between the participants’ needs and the technology offered, complexity and lack of availability of the technology, difficulties with implementation and uptake, and lack of flexibility in setup and maintenance, reduced the value of ICT for those involved in the studies.

Conclusions:

ICT holds the potential to facilitate communication between stakeholders in the complex and collaborative context of rehabilitation trajectories. This scoping review indicates that there is a paucity of research on the complexity of ICT in health care and rehabilitation trajectories. Furthermore, ICT builds on e-health literacy, which may differ between stakeholders, and the lack of sufficient e-health literacy and ICT knowledge creates barriers for access to healthcare and rehabilitation.