1.6 Prerequisites to apply
Overall, Digital Rehabilitation can be used for all clients in rehabilitation. However, as the examples above show, some aspects can hinder the implementation of Digital Rehabilitation. In this section we would like to point out the aspects that should be considered and serve as prerequisites for the implementation of Digital Rehabilitation.
Before we discuss the prerequisites that are influencing clients, rehabilitation professionals and societies, we would like to present some general aspects that are important when digital technologies are integrated in rehabilitation.
1.6.1 General Prerequisites
- One of the prerequisites for a successful rehabilitation process is tailoring services to meet the client’s individual needs. This means that the implementation of Digital Rehabilitation must always be linked to the client's goal and the client's perspective must be included.
- In addition, face-to-face interventions are rarely replaced by purely digital components. This means that there is usually a blended therapy, which means face-to-face intervention mixed with digital components.
- The prerequisites that should be considered depends also on the different technologies that are used. We are not presenting the prerequisites per technology, but we will give you a general overview.
- The prerequisites below should not be considered alone but in combination with each other. They can rarely be separated from each other and should therefore be considered as a whole.
1.6.2 Prerequisites for clients
The following prerequisites should be discussed with the client before Digital Rehabilitation can be implemented. These aspects are intended to support the rehabilitation professional in setting up a personalized Digital Rehabilitation where face-to-face contact with a rehabilitation professional is integrated into a digital application that enables rehabilitation sessions digitally. Discussion of the items facilitates the determination of whether Digital Rehabilitation is appropriate for the individual client and promotes the achievement of their goals and if so, the determination of the appropriate level of therapeutic guidance alongside a digital application. All items are illustrated with examples. The following aspects are adapted from [34].
Motivation and consent of client
Example: Is the client open-minded to use Digital Rehabilitation? Consider client’s attitude towards digital technologies, prior experiences with Digital Rehabilitation, beliefs about the benefits of digital technology.
Technology
Example: Does the client have access to the required technology to perform Digital Rehabilitation? Think of the access to the internet, a smartphone, tablet, or PC etc.
Space
Example: Does the client have enough space to perform Digital Rehabilitation? Consider whether a client has a quiet, private, calm place for rehabilitation, and consider that some digital technologies require some room.
Safety
Example: Is the safety of the client ensured when performing a part of the rehabilitation without the presence of the therapist? Consider physical and mental conditions or possible contraindications.
Computer skills
Example: Is it possible for the client to learn how to use the required digital technology? Consider the operation of the digital technology.
Digital Health Literacy
Example: Is the patient able to interpret text, video, and/or audio files as presented in the digital technology? Consider the level of client's digital health literacy, language, and cognition.
1.6.3 Prerequisites for rehabilitation professionals
The following aspects should be reflected by the rehabilitation professional and then decided whether they are suitable to offer Digital Rehabilitation. Each requirement is explained with an example. The following aspects are based on [34,35].
Technology
Example: Does the rehabilitation professional have access to the required technology to perform Digital Rehabilitation? Consider access to the internet, a smartphone, tablet, or PC, and all software/programmes needed to deliver the service. Separate cameras and conference phone/headphones might be also needed to increase the quality of the video/audio transferred to the client.
Space
Example: Does the healthcare professional have appropriate space to deliver Digital Rehabilitation services? Consider that rehabilitation professionals need a quiet, private space for rehabilitation, and bear in mind that some digital technologies require a certain amount of space.
Computer skills
Example: Does the rehabilitation professional have the ability to operate with digital technologies? Consider the operation of the digital technology.
Organizational aspects
Example: Does Digital Rehabilitation fit into the rehabilitation professional's schedule? Consider time needed to prepare the Digital Rehabilitation intervention.
1.6.4. Prerequisites on system level
Apart from the prerequisites that must be met by the client and the rehabilitation professional, the use of Digital Rehabilitation also depends on political and societal infrastructure or/and legislation. The following aspects are based on [34,35]
Reimbursement for Digital Rehabilitation
Example: How could Digital Rehabilitation be reimbursed? Consider costs occurring for the client to purchase internet or the technology and of the legislation that are relevant in your country to perform Digital Rehabilitation.
Accessibility to Technologies/Internet
Example: Do the client and rehabilitation professional have access to the technology or internet connectivity required to use Digital Rehabilitation?
Usability of Technologies
Example: Is the technology designed to be user-friendly to facilitate the use of the technology?
Effectiveness of Digital Rehabilitation
Example: Does proof of effectiveness for the digital intervention exist?