Date Presented 03/23/24
This retrospective cohort analysis describes the characteristics of persons who utilized a telehealth versus in-person evaluation for a new wheelchair. These individuals tended to be older with mostly progressive disabilities.
Primary Author and Speaker: Chelsea M. McClammer
Contributing Authors: Elizabeth A. Choma, Richard Schein, Corey Morrow
PURPOSE: The COVID-19 pandemic created unique telehealth opportunities for medically essential services such as new wheelchair evaluations. The purpose of this pilot study was to answer: do clinical variables vary for patients utilizing telehealth versus in-person evaluations for wheelchairs? These findings will help provide evidence for larger studies aimed at improving reimbursement for OT telehealth services.
DESIGN: This descriptive pilot study statistically compared the age and diagnoses of persons with disabilities (PwD) seeking a new wheelchair evaluation via telehealth versus in-person appointments.
METHOD: This retrospective cohort analysis used the Functional Mobility Assessment and Uniform Dataset, which is a nationwide registry with ongoing enrollment at 31 clinical sites of PwD seeking a new wheelchair evaluation. Patients were stratified into either a Telehealth Group or In-Person Group and their diagnosis was categorized as either Acutely Acquired (i.e., stroke, spinal cord injury), Progressively Acquired (i.e., osteoarthritis, Parkinson’s disease), or Congenital Disability (i.e., spina bifida).
RESULTS: The full cohort included 11,084 PwD, including 227 in the Telehealth Group. The mean age of participants in the Telehealth Group was older than the In-Person Group (67.7+12.9 versus 62.6+17.1). Additionally, there were higher percentages of Progressively Acquired Disability (60.1%) in the Telehealth Group versus the In-Person Group (44.4%).
CONCLUSION: Older adults with Progressively Acquired Disability may benefit from the convenience of telehealth wheelchair evaluations. This project is impactful as it will support larger comparative effectiveness studies contrasting the telehealth versus in-person wheelchair evaluations for different patient populations. These larger studies will be invaluable to steer research, influence reimbursement policy, and facilitate translational research directly impacting OT practice for wheelchair services.
References
Schmeler, M. R., Schein, R. M., Saptono, A., & Schiappa, V. J. (2019). Development and Implementation of a Wheelchair Outcomes Registry. Archives of Physical Medicine and Rehabilitation, 100(9), 1779–1781. https://doi.org/10.1016/j.apmr.2019.03.007
Ott, K. K., Schein, R. M., Saptono, A., Dicianno, B. E., & Schmeler, M. R. (2020). Veteran and Provider Satisfaction with a Home-Based Telerehabilitation Assessment for Wheelchair Seating and Mobility. International Journal of Telerehabilitation, 12(2), 3–12. https://doi.org/10.5195/ijt.2020.6341
