JMIR Publications

ABSTRACT

Background:

Patients with occupational injuries often receive multidisciplinary rehabilitation for a rapid return to work. Rehabilitation aftercare programs give patients the opportunity to transfer the success of rehabilitation programs into their daily lives. Telerehabilitation aftercare programs can help reduce barriers to rehabilitation, such as lack of time due to commitments to other priorities, because they can be used regardless of time or location. Careful identification of barriers, facilitators, and design requirements with key stakeholders is a critical step in developing a telerehabilitation aftercare program. Key stakeholders are those who will be most affected by the eHealth program.

Objective:

The overall objective of this study was to identify barriers, facilitators and design requirements for a telerehabilitation aftercare program for patients with occupational injuries from the perspective of the key stakeholders.

Methods:

We used a literature review and expert recommendations to identify stakeholders and key stakeholders. We conducted semi-structured interviews in-person and via real-time video call with 28 key stakeholders to collect data. Interviews were transcribed verbatim and thematic analysis was applied. We selected key stakeholder statements about facilitators and barriers of the telerehabilitation aftercare program and categorized them as individual, technical, environmental, and organizational facilitators and barriers. We identified expressions that captured aspects that the telerehabilitation aftercare program should fulfill and clustered them into attributes and overarching values. We translated the attributes into one or more requirements and grouped them into content, functional, service, user experience, and work context requirements.

Results:

The identified key stakeholders can be grouped into patients, healthcare professionals, administrative personnel, and members of the telerehabilitation program design and development team. The most frequently reported facilitators of a telerehabilitation aftercare program for patients with occupational injuries were time savings for patients, high motivation of patients to participate in telerehabilitation aftercare, high usability of the program and regular in-person therapy meetings during telerehabilitation aftercare. The most frequently reported barriers were low digital affinity and skills of patients and personnel, lack of trust and acceptance of patients in the telerehabilitation aftercare program, slow internet speed, lack of reliability of the telerehabilitation program, and inability of telerehabilitation to perform certain elements of in-person rehabilitation aftercare such as monitoring exercise performance. In our study, the most common design requirements were reducing barriers and implementing facilitators. The two most frequently discussed overarching values were tailoring of telerehabilitation, such as a tailored exercise plan, and tailored injury-related information and social interaction, such as real-time psychotherapy and digital and in-person rehabilitation aftercare in a blended care approach.

Conclusions:

Key stakeholders reported on facilitators, barriers and design requirements that should be considered throughout the development process. Tailoring telerehabilitation content was the key value for stakeholders to ensure the program could meet the needs of patients with different types of occupational injuries. An important decision that remains to be made after further focus groups with key stakeholders is the selection of an approach to exercise monitoring.