Remote home visits: The future for Occupational Therapists?
By Jennifer Read, Natalie Jones and Dr Becky Field
The COVID-19 pandemic necessitated a rapid shift to delivering remote care and rehabilitation. Pre-COVID-19, delivering health care rehabilitation via remote, online technologies was limited, especially in Occupational Therapy.
However, a research team of UK Occupational Therapists and academics had recognised the potential of this approach in 2016. They investigated how practical and acceptable it was to undertake a key Occupational Therapy assessment remotely: the ‘home visit’. They called this assessment the ‘remote home visit’.
Occupational Therapy ‘home visit’ assessments are fundamental to person centered care and hospital discharges. They provide the Occupational Therapist with an opportunity to visit patients’ homes and determine the care, equipment and adaptations they need to return home safely. For example they may measure the heights of the toilet, note the types of stairs and steps present consider how this physical environment may affect the patient’s ability to safely carry out everyday tasks. This assessment is then used to plan hospital discharges with patients themselves and other health and social care professionals.
Yet, Occupational Therapy ‘home visits’ were being squeezed out of usual practice. They were seen by services as time-consuming and costly. A ‘traditional’ home visit requires Occupational Therapists to physically travel to and look around the patient’s home.
The research team questioned if remote technology could be used by Occupational Therapists to gather the information they required in a more resource efficient, cost-effective way. Software called ‘eyes on the ground’ previously used by Italian emergency services was identified by as a potential software solution to enable Occupational Therapy undertake ‘home visits’ without leaving the hospital. The research team worked with the developers to adapt the software to their needs, trying it in four simulated remote home visits and asked patients, public and Occupational Therapy staff for their thoughts about using it.
This video demonstration shows how the software works. Occupational Therapists send a secure electronic link to a ‘trusted visitor’ (such as a family member or friend) at the patient’s home. Once opened, it allows the Occupational Therapist to look around the patient’s home without being physically there. They can also use the visitor’s phone to take photos and videos of what is seen, operate the torch if needed and make electronic notes as the visit happens.
Results of the study suggested the software had significant potential. The software operated without technical problems and enabled Occupational Therapists to gather the information they required. Patients, public and Occupational Therapists asked for feedback felt the software had the potential to save resources, improve how different health and social care teams worked together and contribute to patient-centered care.
These exciting findings led the research team to undertake two more projects exploring the use and potential of this software in other health and social care settings. One project involved consulting health and social care staff and patient representatives, further developing the software, exploring other settings where this software might be beneficial and what could help or hinder its use in practice. Another project started in March 2020, just before the lockdown and impact of COVID-19 was felt in the UK. That project aimed to try the software in ‘real’ healthcare situations with ‘real’ patients. In this ‘OT’s get digital’ video Occupational Therapist Natalie Jones and I explain these three projects.
Occupational Therapists were at the forefront of exploring the use of remote consultation within health and social care before COVID-19 hit. The pandemic has forced clinicians, the public and patients to rapidly embrace and try delivering remote digital health and social care. Yet, there is much we still do not know about this. Implementing new technologies within health and care settings is challenging, with multiple complexities. Research helps us better understand these challenges of using technology in practice, its impact on the workforce and patients, and the essential ingredients required to maintain its use. Occupational Therapists need to understand the benefits of going digital, how this impacts on different health and social care services, staff and service users. We are sure Occupational Therapists will be at the forefront of this too.
Article details
Remote Home Visit: Exploring the feasibility, acceptability and potential benefits of using digital technology to undertake occupational therapy home assessments
Jennifer Read, Natalie Jones, Colette Fegan, Peter Cudd, Emma Simpson, Suvodeep Mazumdar, Fabio Ciravegna
First Published May 22, 2020 Research Article
DOI: 10.1177/0308022620921111
British Journal of Occupational Therapy
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