R1 - Assessment of User Needs in mRehab
Project team
Project PI – John Morris
Mike Jones, Frank DeRuyter, David Reinkensmeyer, Raeda Anderson, Ben Lippincott
Project consumer/advisory team
Consumer Advisory Network (approximately 1,500 people with disabilities nationwide)
Provider Advisory Network
Purpose/aims
Project R1 will engage consumers with disabilities and rehabilitation professionals in identifying their needs, concerns and preferences regarding use of mRehab technologies and strategies. A secondary purpose is to continue to grow our Consumer Advisory Network (CAN) and our more recently established Provider Advisory Network (PAN) of clinical rehabilitation professionals. Members of both networks will offer ongoing input to development efforts to improve usability, accessibility, and acceptability of mRehab tools and strategies. These networks of key stakeholders also provide a robust channel for training and dissemination.
The original plan includes several tasks to be completed in sequence:
Expand/refine membership of the Consumer and Provider Advisory Networks.
Conduct periodic user needs surveys and focus groups.
Engage members in focus groups and usability testing.
Disseminate findings of user needs research.
Status – On target
Consumer Advisory Network (CAN)
The CAN has been maintained by research staff at Shepherd Center for over 20 years across multiple rehabilitation and assistive technology grants.
Currently, through our work for other NIDILRR funded grants (LiveWell RERC and App Factory DRRP) and our industry-sponsored user research, we have built and maintained a national network of over 1150 individuals with all types of disability and broadly diverse backgrounds. The entire CAN has been engaged once over the course of the mRehab RERC grant for national survey research projects related to mHealth and mRehab.
Provider Advisory Network (PAN)
The project team established the PAN in February 2019, in preparation for the application for the mRehab grant. The goal was to understand the knowledge, experience, needs and concerns of rehabilitation clinicians regarding mobile health and mobile rehabilitation technologies. The PAN has been engaged 3 times since the inaugural survey conducted in February 2019.
Key accomplishments
The R1 project team has conducted several surveys of the PAN and CAN to identify user needs and barriers to adoption of mHealth/mRehab solutions. These surveys informed the publication and public comments listed below:
Clinician Perspectives on Remote Therapeutic Monitoring (RTM)
Morris JT, Anderson RK, Sheehan L, Souders L, Jones M, DeRuyter F, Swanson V, Cowart D. Medicare Program; CY 2022 Payment policies under the physician fee schedule and other changes to part b payment policies; Medicare shared savings program requirements; provider enrollment regulation updates; provider and supplier prepayment and post-payment medical review requirements. Agency/Docket Number: CMS-1751-P. Submitted to Centers for Medicare and Medicaid Services, September 13, 2021.
Survey on clinician perspectives on Remote Physiologic Monitoring
Sheehan L, Ruelos P, Anderson R, Morris J, Jones M, DeRuyter F. Comments filed in response to Notice of Proposed Rule Making: Medicare Program; CY 2021 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies Agency/Docket Number: CMS-1734-P. Centers for Medicare and Medicaid Services, October 5, 2020.
Clinician perspectives - Patient needs for health and function mobile apps – Spring 2020
Morris J., Thompson N., Wallace T., Jones M., DeRuyter F. (2020) Survey of Rehabilitation Clinicians in the United States: Barriers and Critical Use-Cases for mRehab Adoption. In: Miesenberger K., Manduchi R., Covarrubias Rodriguez M., Peňáz P. (eds) Computers Helping People with Special Needs. ICCHP 2020. Lecture Notes in Computer Science, vol 12377. Springer, Cham. https://doi.org/10.1007/978-3-030-58805-2_30
Morris, J., Jones, M., Thompson, N., Wallace, T., DeRuyter, F. Clinician perspectives on mRehab interventions and technologies for people with disabilities in the United States: A national survey. Int. J. Environ. Res. Public Health, 2019; 16, 4220; doi:10.3390/ijerph16214220
Mobile Health Apps and Information Resources – Consumer Survey
Lippincott B., Thompson N., Morris J., Jones M., DeRuyter F. (2020) Survey of User Needs: Mobile Apps for mHealth and People with Disabilities. In: Miesenberger K., Manduchi R., Covarrubias Rodriguez M., Peňáz P. (eds) Computers Helping People with Special Needs. ICCHP 2020. Lecture Notes in Computer Science, vol 12377. Springer, Cham. https://doi.org/10.1007/978-3-030-58805-2_32
Challenges and course corrections
Like any network of individuals, the CAN and PAN need regular activation to stay vibrant and engaged.
The CAN is extremely active, but not in the area of mHealth and mRehab user needs research. The CAN is a unique resource that could/should be engaged more robustly for the mRehab RERC.
The PAN has been unevenly and sporadically activated. However, it has been used effectively to gather data to inform comments submitted to CMS. It also could be engaged for data collection to inform journal publications and conference presentations. It needs considerably more effort to maintain and grow.
There will likely be calls for public comment each summer going forward as CMS continues to rollout and refine billing codes and other rules to support technology enabled remote rehabilitation services. So, the R1/R2 team needs to be attentive to the rule-making calendar.
In addition to survey research, it will be useful to engage smaller groups of the PAN in more detailed exploration and discovery of ideal use cases, specific technologies recommended/prescribed, frequency of monitoring or patient data collection, and use of non-clinical staff to manage and review data.