Humanity & Inclusion’s Telerehabilitation Project Manager, Martin Jacobs, answers common questions about a new telerehabilitation software developed by the organization and being launched in Vietnam.
Q: What inspired Humanity & Inclusion to develop OpenTeleRehab?
OpenTeleRehab was inspired by the need to improve access to rehabilitation services in communities and strengthen discharge procedures. Many people have the mindset that there are rehabilitation professionals just around the corner at any given time, and that these services are easy to access. We need to realize that the context is different in different countries. People often need to travel to receive care. It’s costly for them to spend the money to travel, to pay for their consultation, and they miss out on earning income while they’re away from work.
The software aims to avoid multiple trips back and forth, increase our capacity to provide services over a distance, and increase the ability to follow-up with patients. We have seen how useful telerehabilitation can be in situations like the Covid-19 pandemic, where physical services are closed, or in emergency settings where rehabilitation needs surge and hospitals must quickly discharge patients without a way to follow-up afterward. With OpenTeleRehab, access can be improved because it reduces some of the current barriers to rehabilitation services.
Q: How is telerehabilitation software different from simply watching online videos or using internet resources?
It is important to rely on the expertise of rehabilitation professionals, who are trained to design individual treatment plans for optimal functioning. This helps prevent the possibility of further damage, which could be caused by following inappropriate practices or advice we may find online. Following a treatment plan remotely does not mean you are on your own. With OpenTeleRehab, even while you are remote, you are getting individualized care that is designed and adapted for you by a professional. Plus, users receive regular follow-up from their providers. Humanity & Inclusion’s approach is not only to facilitate service delivery, but to provide quality services. Our ‘Do No Harm’ mandate would not be fully respected if we allowed people to self-provide rehabilitation services.
Q: How will people use the software?
In upper-low and middle-income countries, actually a large portion of the population has access to smartphones. For example, I was surprised to see how many people in rural parts of Vietnam actually have smartphones and how common internet connection is. In some countries, this may be less true, but we can rely on hybrid approaches where we have tablets in local health community centers or schools, for example. This means people will not need to have a device at home, and rehabilitation professionals will not have to travel all the way to the community.
OpenTeleRehab is specifically designed to use very little data and allow access to content even when offline, so it is ideal for low-connectivity settings or contexts where internet may come and go. Reports show that internet access is increasing every year, so it will become even more relevant for more regions over time.
Q: What inclusive considerations were taken in designing the software?
OpenTeleRehab is patient-centered and has been designed for a wide range of users. The patient mobile app is really simple to use. Users will land on a homepage and it will immediately tell them what to do. There is also a child-friendly version, made specifically for younger users. We followed web content accessibility guidelines to ensure that the software is accessible to users of differing abilities, and we selected what we believed were the most relevant accessibility features for users. One of these is the ability to read the exercises aloud, for users with low vision.
We have also designed OpenTeleRehab to be culturally appropriate. After monitoring other software in various countries, we found that the illustrations were rarely appropriate or representative of the users. Our illustrations are gender-balanced, mostly age-neutral (with the exception of infants), and wearing loose-fitted, full coverage clothing.
Humanity & Inclusion has launched OpenTeleRehab, a new innovative software specifically designed by its experts to provide quality rehabilitation services for isolated populations. The software opens first in Vietnam, with plans to expand to other countries.
In Vietnam, more than 64% of the population live in rural areas, significantly limiting access to rehabilitation care. This is particularly true for people with disabilities for whom traveling long distances can be challenging. There are fewer than one physical therapist per 10,000 people in Vietnam, and only 2% of Vietnamese children receive rehabilitation care when needed.
By contrast, 80% of the population uses a smartphone and 4G coverage is at 95%. Even families with low incomes typically have access to a mobile device. With its background in innovative humanitarian response and rehabilitation expertise, Humanity & Inclusion designed the OpenTeleRehab software as an adaptive solution to ensure both access to and quality of care for patients who need rehabilitation.
The software with developed in partnership with hospitals in Vietnam and JAMK University. Its development was funded by USAID and the Botnar Foundation.
Custom care, accessible to all
“The application will provide remote rehabilitation services, increasing access to care in contexts where the rehabilitation workforce is limited,” says Martin Jacobs, Humanity & Inclusion rehabilitation technical advisor and OpenTeleRehab project manager. “Patients are taught in service by their therapist how to use the patient mobile application, then, once they are home, they can access their custom treatment plan by smartphone. The treatment plan can include exercises, information, educational material and questionnaires. Therapists can organize regular follow-up audio or video calls and track patient progress and adherence to the plan.” Read a full Q&A with Jacobs about this software launch.
OpenTeleRehab aims to increase access to rehabilitation services by strengthening hospital discharge, transition of care and community-based follow-up. It should help prevent repeat hospital stays for people with long-term needs, lower patient costs, optimize functioning and reduce obstacles for individuals with disabilities in central Vietnam. Its offline features ensure that it can easily be used in contexts with limited internet access, and a child-friendly version of the patient mobile app increases engagement among young users.
Implementation and next steps
The initial OpenTeleRehab launch will be piloted in two provinces of Vietnam, serving 550 direct patients and their families. Tablets will be distributed to families if they are unable to access a mobile device. After its initial release, Humanity & Inclusion plans to further develop its services and eventually expand its use.
“The next steps will be to increase the number of exercises in the library, and to translate it to different languages,” Jacobs explains. “We will then be able to deploy the software in different countries and different contexts.”
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