In the last three years, the delivery of rehabilitation services at a distance by means of electronic information and communication technologies has come to be known as telerehabilitation. It is part of both the larger spectrum of telemedicine activities that have waxed, waned and waxed again since the early seventies; and the growing array of non-medical applications of consumer electronics and communication technology that can provide “tele-enhancement of independent living” for individuals with neurological and other disabilities. While telerehabilitation is still largely hypothetical, activities are underway at several clinical rehabilitation centers. Most commonly, inexpensive video phone connections are used to provide face-to-face two-way image and voice contact between patient and provider, but transmission of data from sensors that monitor health and rehabilitation is technically feasible and promising. Telerehabilitation provides access to quality services for patients who are immobile or geographically remote from direct service. Some view it as a means of compensating for shortened lengths of stay in acute rehabilitation hospitals, while others emphasize the cost reductions it offers. Telerehabilitation methods, both current and in-the-works, are promising but it remains to be seen whether and how the reimbursement policy-makers at HCFA and private payers will respond to its potential.
