SPS 2017 Program SPS 2017 Program - Page 36

of telemedicine, four of whom were transferred and three of whom avoided what would have otherwise been an ED transfer. Conclusions: In a short period of time, telemedicine has been shown to reduce the number of ED transfers from senior living communities by providing access to physicians prior to transfers, thereby reducing unnecessary expenditure and improving overall patient well-being. 9. Clinical Simulation-based Usability Testing of a Mobile Telestroke System Sherita Chapman Smith, MD 1 , Kaitlynne Heath 1 , Pamela Brown 2 , Prachi Mehndiratta 3 , Chip Decker, Rob Lawrence 4 , Dempsey Whitt 4 , Dan Fellows 4 , Tamara Broadnax 3 , Vladimir Lavrentyev 3 , Moshe Feldman 1 , Jeneane Henry 3 , Jason Wong 3 , Andres Ruiz 3 , Kevon Hekmatodoost 5 , Muhammad Bhatti 3 , Basit Rahim 3 , Qaiser Toqeer 3 , Jamie Ricks 1 , Theandra Madu 1 , Baaba Blankson 1 , Jamie Heath 3 , Poanna Bennam 1 , Juan Lu 1 , Warren Felton 1,3 , Joseph Ornato 1,3 1 Virginia Commonwealth University, 2 Simmons College, 3 Virginia Commonwealth University Health System, 4 Richmond Ambulance Authority, 5 Emory Healthcare Background: Mobile pre hospital telestroke presents a novel solution to improve stroke diagnosis and reduce treatment times. Methods: An ambulance was equipped with a mobile telemedicine system to perform stroke assessments. Scripted scenarios were performed by actors during transport and evaluated by physicians using the NIH stroke scale (NIHSS). Scores obtained during transport were compared with independent bedside and original scripted NIHSS scores. Participants completed the System Usability Scale (SUS), NASA task load index, audio-video quality scale and a modified Acceptability of Technology survey after completing the NIHSS evaluations. In addition, interviews were conducted to evaluate users’ experience and perceptions. Descriptive analysis was used for all surveys. Weighted kappa was used to compare the agreement in NIHSS scores. A regression model was used to further account for variations. Results: Ten scripted scenarios were simulated twice during the mobile transport and once at bedside. All simulations were completed except for one. NIHSS scores between mobile, bedside and original scripted scenarios revealed good agreement [weighted kappa=0.76 (95% CI: 0.63-0.9, p=0.63)]. There were no statistically significant differences in NIHSS scores between evaluations. The results were independent of stroke scenarios, physicians, and actors. Overall, 92% and 81% of raters deemed video and audio quality as “good” or “excellent” (rating <3) respectively. The overall mean SUS score was 69.1 (13.3). Content analysis identified strengths, usability issues, and safety concerns. Overall users identified similar usability issues with the technology including audibility, connectivity, equipment stability and poor visibility. Conclusion: Our study shows the feasibility and capability of a mobile telestroke system to accurately assess actors simulating stroke patients during transport. 10. Evaluating the Effect of Telerehabilitation on Adherence and Patient Satisfaction Anang Chokshi, PT, DPT, OCS, SCS, Ben Torres, ATC, Stephanie Grier, MS, ATC, CSCS Reflexion Health Background: The primary objective of this study was to evaluate the impact of a novel virtual telerehabilitation platform on adherence, usability, and patient satisfaction in postoperative rehabilitation. Methods: Subjects included 218 (n=218) patients, with an average age of 68, who underwent uncomplicated knee or hip arthroplasty. These patients were prescribed telerehabilitation for physical therapy in lieu of traditional in-person physical therapy. The telerehabilitation system was installed in the patient’s home 2 weeks prior to surgery for prehab. After surgery the system led the patient through their prescribed home exercise program (HEP) using an avatar. Patients also participated in live video conferencing with their treating physical therapist. Variables analyzed included overall HEP adherence, usability, and patient satisfaction. Adherence was automatically captured through the telerehabilitation software platform, and was measured by calculating the repetitions completed compared to repetitions prescribed over the course of the episode of care. The System Usability Scale (SUS) was administered to calculate usability, and a patient satisfaction survey was administered to calculate a Net Promoter Score (NPS). Both surveys were completed upon discharge. Results: Patients enrolled in the program demonstrated a mean adherence of 77.9 percent. Patients who partake in traditional in-person physical therapy demonstrate an average adherence of 42.7 percent (Chan, 2010, p.132). Patients spent, on average 26 minutes per day engaged in their exercise program. The mean System Usability Scale (SUS) for Vera was 93 with a Net Promoter Score of 87. Conclusion: A virtual telerehabilitation platform, when implemented with lower-extremity joint replacement, points to increased adherence and high patient satisfaction. Furthermore, an increase in adherence may lead to a decrease in total episode length, which would demonstrate that telerehabilitation is not only a tool for care redesign, but also an effective solution when participating in an episode based payment model. 36 | Page of telemedicine, four of whom were transferred and three of whom avoided what would have otherwise been an ED transfer. Conclusions: In a short period of time, telemedicine has been shown to reduce the number of ED transfers from sen- ior living communities by providing access to physicians prior to transfers, thereby reducing unnecessary expenditure and improving overall patient well-being. 9. Clinical Simulation-based Usability Testing of a Mobile Telestroke System Sherita Chapman Smith, MD 1 , Kaitlynne Heath 1 , Pamela Brown 2 , Prachi Mehndiratta 3 , Chip Decker, Rob Lawrence 4 , Dempsey Whitt 4 , Dan Fellows 4 , Tamara Broadnax 3 , Vladimir Lavrentyev 3 , Moshe Feldman 1 , Jeneane Henry 3 , Jason Wong 3 , Andres Ruiz 3 , Kevon Hekmatodoost 5 , Muhammad Bhatti 3 , Basit Rahim 3 , Qaiser Toqeer 3 , Jamie Ricks 1 , Theandra Madu 1 , Baaba Blankson 1 , Jamie Heath 3 , Poanna Bennam 1 , Juan Lu 1 , Warren Felton 1,3 , Joseph Ornato 1,3 1 Virginia Commonwealth University, 2 Simmons College, 3 Virginia Commonwealth University Health System, 4 Richmond Ambulance Authority, 5 Emory Healthcare Background: Mobile pre hospital telestroke presents a novel solution to improve stroke diagnosis and reduce treatment times. Methods: An ambulance was equipped with a mobile tele- medicine system to perform stroke assessments. Scripted scenarios were performed by actors during transport and evaluated by physicians using the NIH stroke scale (NIHSS). Scores obtained during transport were compared with inde- pendent bedside and original scripted NIHSS scores. Partici- pants completed the System Usability Scale (SUS), NASA task load index, audio-video quality scale and a modified Accepta- bility of Technology survey after completing the NIHSS evalua- tions. In addition, interviews were conducted to evaluate us- ers’ experience and perceptions. Descriptive analysis was used for all surveys. Weighted kappa was used to compare the agreement in NIHSS scores. A regression model was used to further account for variations. Results: Ten scripted scenarios were simulated twice during the mobile transport and once at bedside. All simulations were completed except for one. NIHSS scores between mo- bile, bedside and original scripted scenarios revealed good agreement [weighted kappa=0.76 (95% CI: 0.63-0.9, p=0.63)]. There were no statistically significant differences in NIHSS scores between evaluations. The results were independent of stroke scenarios, physicians, and actors. Overall, 92% and 81% of raters deemed video and audio quality as “good” or “excellent” (rating <3) respectively. The overall mean SUS score was 69.1 (13.3). Content analysis identified strengths, usability issues, and safety concerns. Overall users identified similar usability issues with the technology including audibil- ity, connectivity, equipment stability and poor visibility. Conclusion: Our study shows the feasibility and capability of a mobile telestroke system to accurately assess actors simu- lating stroke patients during transport. 10. Evaluating the Effect of Telerehabilita- tion on Adherence and Patient Satisfaction Anang Chokshi, PT, DPT, OCS, SCS, Ben Torres, ATC, Stephanie Grier, MS, ATC, CSCS Reflexion Health Background: The primary objective of this study was to eval- uate the impact of a novel virtual telerehabilitation platform on adherence, usability, and patient s ѥ͙ѥд)Ʌѥٔɕхѥ)5ѡMՉ́Ցँѥ̰ݥѠ)ٕɅఁݡչݕЁչѕȁ)ѡɽ丁Q͔ѥ́ݕɔɕ͍ɥѕɕф)ѥȁͥѡɅ䁥ԁɅѥͽͤ)ѡɅ丁Qѕɕхѥѕ݅́хѡ)ѥӊéȁݕ́ɥȁѼɝ䁙ȁɕѕ)ɝѡѕѡѥЁѡɽ՝ѡȁɕ͍ɥ)ɍ͔ɽɅ!@ͥمхȸAѥ́ͼ)ѥѕٔ٥ɕݥѠѡȁɕѥ)ͥѡɅиYɥ́镐ՑٕɅ!@)ɕͅ䰁ѥЁͅѥ͙ѥɕ݅)ѽѥ䁍ɕѡɽ՝ѡѕɕхѥͽд)݅ɔљɴ݅́ɕ䁍ձѥѡɕѤ)ѥ́ѕɕѼɕѥѥ́ɕ͍ɥٕȁѡ)͔ѡͽɔQMѕUͅM(MUL݅́ѕɕѼձєͅ䰁ѥ)ͅѥ͙ѥٕ݅́ѕɕѼձє9ЁAɼ)ѕȁMɔ9AL Ѡٕ́ݕɔѕ̴)ɝ)IձAѥ́ɽѡɽɅɅѕ)ɕܸɍиAѥ́ݡх)ɅѥͽͥѡɅ䁑Ʌєٕȴ)ɕȸ܁ɍЀ ȤAѥ)аٕɅ؁ѕ́ȁ䁕ѡȁȴ)͔ɽɅQMѕUͅMMULȁYɄ)݅̀́ݥѠ9ЁAɽѕȁMɔܸ) ͥ٥Յѕɕхѥљɴݡ)ѕݥѠݕȵɕ䁩Ёɕа́Ѽ)ɕ͕ɕѥЁͅѥ͙ѥѡȴ)ɔɕ͔ɕ䁱Ѽɕ͔)ѽхͽѠݡݽձɅєѡЁѕɕ)хѥ́Ё䁄ѽȁɔɕͥЁͼ)ѥٔͽѥݡѥѥͽ͕嵕)(؁A