Using Telehealth Modalities to Enhance Vocational Rehabilitation for Rural Veterans

Research Objectives: To investigate the facilitators and barriers to the implementation and impact of video tele-technologies in delivering individualized community-based vocational rehabilitation services to rural veterans with disabilities.

Design: Semi-structured interviews were conducted twice (i.e., one each in October and November 2019 respectively) with providers from two Veterans Health Administration Medical Sites to gain insights into the use of tele-rehabilitation in extending vocational rehabilitation services.

A team of 3 Coders with expertise in clinical interview methods and qualitative research used open-coding strategies to independently identify and label concepts shared by the interviewees.

Thematic analysis was used to identify themes from the detailed interview notes and transcripts.

Setting: Rural community sites (Sites A and B) served by the Veterans Health Administration Medical Hospitals located in both these locations.

Participants: The study involved clinical vocational rehabilitation specialists and/or program managers (n = 3) providing services to rural veterans with disabilities. All participants are college graduates, have at least 3 years working experience with Veterans, and one was also a certified rehabilitation counselor.

Interventions: The study focused on the incorporation of video tele-technologies within existing individualized community-based vocational rehabilitation services. Each site’s VRS’ workload included focused time and duties for incorporating the tele-technologies into the existing face-to-face VR program.

Main Outcome Measures: The study identified themes related to the implementation of tele-rehabilitation, including workflow enhancement, quality of care improvement, practicalities in implementation, interdisciplinary care integration, and the impact of tele-rehabilitation.

Results: Five key themes emerged from the interviews: (1) Enhancing Workflow for Providers, (2)
Improving Quality of Therapeutic Care, (3) Practicalities in Implementing Tele-VR, (4) Embedding Vocational Rehabilitation
into Interdisciplinary Care as a Facilitator to Implementation, and (5) Impact of Tele-VR.

Conclusions: The telerehabilitation delivery of employment service to Veterans with disabilities is a viable means for remotely providing or enhancing face-to-face individualized and community-based VR services that support Veterans ‘competitive employment and job stability within their communities.

Author(s) Disclosures: The authors have no conflicts of interest to report.