Overview

• Motivation and Aims
• Additional Reading Materials: Chapters from Emerging and Accessible Telecommunications, Information and healthcare Technologies (Winters et al, eds.), RESNA Press, 2002; parts of some journal articles

Universal Access and Telerehab

• Vision of and Perspectives on Universal Access
  • Technology and Changes in Societal Perspectives on Access
  • "Universal Access" Defined
    • US Access Board, Office for Adv. of Telehealth, ITU & FCC, Rehab
  • Federal/State laws Mandating Accessibility
    • Section 255 of Telecom Act of 1996
    • Section 508 of Rehab Act of 1973/1998
  • Perspective on Universal Access
    • Universal Usability plus consideration of the barriers of distance and socioeconomic status
      • example: RERC-AMI Projects D3.1 (telerehab focus) and D3.2 (multimodal accessibility focus)
    • Universal Access and Universal Design Market Potential (15% have functional limitation; aging society; similar prices with front-end design)
  • Telehealth as a Tool for Improving Univeral Access
    • Engineering perspective: maximizing access, with telehealth changing constraints
    • Healthcare systems perspective: maximizing outcomes by adding alternatives to and timely integration within the plan of care
    • So why isn't telerehab flourishing?
• Telecom/Information Technology Access
  • Definitions
  • RERC Telecom Access: distinctions between tele-conversation, tele-messaging, alerting
  • RERC Information Access: Electronic and Information Technology Interface Technology Categories and Emerging Trends
  • RERC Augmentative and Alternative Communciation
    • Components of such systems
• Perspectives on a Tele-Encounter
  • Perspectives
    • illusion of telepresence, remote access to information and services, task-oriented
  • Systems for video teleconferencing:
    • group, rollabout, desktop, mobile
  • Key "...abilities"
    • accessibility/usability, interoperability, reliability, scalability/flexibility
• Practical Aspects in Designing Telerehab Systems
  • Room-based systems (desktop, group)
    • Key implications and considerations (group vs individual, cameras, mics, lighting, background)
  • Mobile systems (wireless, wearable)
    • Key advantages
    • Key challenges

Models for Telerehab

• Process Models for Telehealth
  • List of "Tele-..." terms
  • General process models
    • Community telehealth, telemonitoring, telehomecare, teletherapy
• Conceptual Framework for Scientific Study of Telerehab
  • Science of optimizing rehabilitative bioprocesses
  • Science of optimizing human-technology interface
  • Science of optimizing behavioral modification

Telehealth Technologies

• Historical Perspective on Telecommunications Infrastructure

  • 1980's: POTS phone, broadcast TV, LAN, computer modem
  • 2000's: now cable modem/DSL, cellphone, VoPI, merging!
• Videoconferencing and Multimedia Standards (overview)
  • Terminology
  • H.320 Standard & Technical/User Approaches
  • H.324 Standard & Technical/User Approaches
  • H.323 / SIP Standards & Various IP-Based Technical Approaches
  • Wireless Standards (and Medical Implications)
  • IP Multimedia Standards and Management Approaches
• Glossary of Conferencing Terms

Telehealth Applications

• Telemedicine: Rehab Teleconsults (examples from physiatrist, PT, OT, SLP)
• Telehomecare/telemonitoring: Cardiopulmonary Rehab
• Telehomecare/telemonitoring: Wound care (pressure ulcer) management
• Telemonitoring/teletherapy: Stroke