Southwest Educational Development Laboratory
Roxanne Pickett Hauber, Ph. D., R.N., Manager and Nurse Researcher of the Telerehabilitation to Support Assistive Technology program at the Shepherd Center in Atlanta, talks about the use of telerehabilitation applications to provide follow-up support to recently-discharged patients, their families and their health providers. Implications and benefits of telerehabilitation applications for individuals from rural communities are discussed.
NIDRR has provided leadership in redefining disability as "the product of an interaction between characteristics of the individual and characteristics of the natural, built, cultural and social environments" (Seelman, 2000). Within this new paradigm of disability one must consider:
The new cyber-environment lends itself to being modified, even customized to the user so that resources and services are readily accessible. For that reason, cyber-environments have tremendous potential for changing the world for people with disabilities (Vesmarovich, Hauber and Jones, 2000). The use of these advances in telecommunications technology to inform and educate has resulted in the emerging field of interactive health communication (IHC) (Hauber, Vesmarovich and Testani-Dufour, in press).
In 1999, Shepherd Center in conjunction with Georgia Institute of Technology and corporate partners, Bell South, Cyber-care, and Siemens, Inc. were awarded a matching funds grant from the U. S. Department of Commerce National Telecommunications and Information Administration to develop a Next Generation Internet (NGI) network in the metro-Atlanta area linking patients' homes and rehabilitation service providers. Georgia, in general, is a rural state with a few major areas of urban concentration. Primary care clinicians cover the state reasonably well, but rehabilitation expertise for people with brain and spinal cord injury is limited to the major urban areas (Stachura, 2001). Therefore, mechanisms that can empower individuals with related disabilities and their families living in rural areas are crucial to optimize long-term outcomes.
Part of this project included the development of a server database that included disability-specific health and wellness information addressing patients' specialized care needs. This information is used to deliver, over the network, "just-in-time" interactive, multi-media instruction and support to patients and caregivers. The materials provide easy access to essential information about specific health care routines, community resources, and topics related to moving beyond disability such as travel, healthy life styles, recreation, and return to work and school. These instructional and resource materials can be accessed in the home, at work, at public libraries, in small clinics and anywhere people have access to the Internet.
Prior to beginning this endeavor, a three-year retrospective survey of Shepherd patients was conducted to find out what percentage of our clients has access to computers and the Internet. Findings indicated that 73% of individuals surveyed had access to and used computers and 68% had access to the Internet (Hauber et al., in press). The survey also asked participants what types of health-related information they had found on the Internet that was useful, and what kinds of things they had not been able to find, but would like to have access to on the Internet. In addition, a consumer group made up of former Shepherd patients was initially brought together to discuss the kinds of information, resources, etc. they would find useful. Guidelines from the Science Panel on Interactive Communication and Health (1999) were used as the materials were developed.
All patients who receive rehabilitation services at Shepherd and their families are instructed on how to access and use the materials while they are in in-patient rehabilitation. To access this material go to Shepherd's website http://www.shepherd.org/ ; Select My Vital Connections, choose Patient Pages, and then click on Preview Page.
Roxanne Pickett Hauber,
Ph.D., RN, CNRN
Manager and Nurse Researcher
Telerehabilitation to Support
2020 Peachtree Road NW
Atlanta, Georgia 30309-1402
Hauber, R. P., Vesmarovich, S., & Testani-Dufour, L. (in press). The use of computers and the Internet as a source of health information for people with disabilities. Rehabilitation Nursing.
Science Panel on Interactive Communication and Health. (1999). Wired for health and well-being-the emergence of interactive health communication. Washington D.C.: U.S. Department of Health and Human Services, Office of Public Health and Science.
Seelman, K. D. (2000). Science and technology: Is disability a missing factor? Colin McLaurin Distinguished Lecture sponsored by Sunrise Medical, RESNA, Orland, FL. July 1, 2000.
Stachura, M. E. (2001). The Georgia state-wide telemedicine network: some lessons learned. Journal of Telemedicine and Telecare. 7(suppl.2) 62.
Vesmarovich, S. H., Hauber, R. P., & Jones, M. L. (2000). Using telecommunication technologies to change the world for people with disabilities related to catastrophic neurological impairment. Cyberpsychology and Behavior. 3(6) 925.
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