Barriers and facilitators for cross-language telerehabilitation services: experiences of occupational and physical therapists.

Abstract

To investigate workflow, or the clinical and administrative tasks that need to be completed, during telerehabilitation visits and to identify factors that support or hinder telerehabilitation services for patients with limited English proficiency (LEP). An exploratory investigation <i>via</i> a qualitative study was conducted with physical and occupational therapists providing outpatient telerehabilitation services. Semi-structured initial and follow-up interviews explored workflow patterns associated with telerehabilitation visits involving patients with LEP. Data was analyzed using Braun and Clarke's six steps for thematic analysis. Eleven providers participated in initial interviews, of whom five also completed follow-up interviews. Three major themes emerged: (1) Ongoing benefits of telehealth; (2) Ongoing challenges with telehealth; and (3) Factors affecting the success of telerehabilitation visits. Five factors affecting telerehabilitation success were identified: (1) Environmental, (2) Communication; (3) Human, (4) Technology, and (5) Organizational. Telerehabilitation visits with patients with LEP involve additional tasks that complicate the workflow. Without adequate language support, complex clinical tasks are especially difficult to perform. Digital determinants of health including technology, environmental, communication, human, and organizational factors play an important role. Policy and practice changes at individual, interpersonal, and community levels are needed to improve telerehabilitation services for this population.