Telehealth is the application of telecommunication technology to provide distant support, assessment and intervention to individuals with disabilities (Ricker et al., 2002). It is not a new idea, but it really wasn’t until the last few years that technology supporting efficient visual and auditory communication between parties on either end of the camera has become widely available.

Thousands of people per year participate in medical telehealth visits currently. In many cases, this method is preferred by the doctor as well as the patient for not only convenience, but also to reduce the risk of patient
exposure to infectious disease while in the doctor waiting room. Of course this is for certain types of visits, which tend to be more straightforward, like a UTI or a sore throat.
 
The potential to apply telehealth in the assessment, treatment and management of rural or underserved populations of people with disabilities, has been of interest to clinicians and researchers for many years. While there is an encouraging body of research to support the use of Telehealth as a tool in the field of Complex Rehab Technology (CRT), specifically seating and mobility, acceptance and integration into practice and public policy has been somewhat limited.
 
The Immediate Need
 
There is a very specific reason to consider telehealth for the CRT population at this time. The onset of the Covid-19 pandemic has accelerated the need and the potential for adoption of a remote service delivery model for CRT in unprecedented ways.

CRT products are, by definition, medically necessary for individuals who require them and are therefore urgent in nature for the client.
 
The prescriptive process requires seamless collaboration between an interdisciplinary team of professionals including a Physician, Physical or Occupational Therapist and a Rehabilitation Technology Professional. Delaying or restricting access to these products or related services could be catastrophic, in terms of physical health, functional and mental health of an individual with a mobility impairment. Disruption of traditional service delivery models has many CRT professionals wondering how to collaborate remotely for the purpose of meeting the needs of the CRT consumer.
 
Telehealth​ for CRT
 
Conceptually, the evaluation and fitting processes should remain consistent with established clinical best practice. Regardless of who is physically present with the client, the clinician maintains the responsibility of guiding and documenting the evaluation process, while the supplier’s role is to assist in the appropriate measurement, selection and fitting of equipment.
 
In speaking to clinical teams around the country who are engaging in remote evaluations, they suggest approaching it “like any other evaluation”. Roles do not change. A thorough screening of the client prior to evaluation, to gauge whether or not the client is appropriate for a remote evaluation is also suggested.
 
Highly complex clients cannot be thoroughly evaluated in this manner, although an evaluation could be initiated and followed up by a hands-on interaction at a later date.
 
The interview portion of the evaluation should largely remain unchanged from what is typical of a live client interaction.

The primary difference occurs in the capturing of objective measures when the clinician is remote and the Rehabilitation Technology Professional is present with client. Typical tests and measures may need to be captured in atypical ways.