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The ‘wicked problem’ of telerehabilitation: Considerations for planning the way forward

UBC Pulmonary Rehabilitation Research Laboratory, Department of Physical Therapy/Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada

Special Issues: Telerehabilitation for Adults and Older Adults

Telerehabilitation offers great promise to improved access to rehabilitation care. The rising use of technology, the increased expansion of data networks worldwide, and the growing confidence and interest of the general population to incorporate technology into their day-to-day lives via the Internet, smartphones and wearables provide fertile ground for many rehabilitation interventions. Despite this opportunity, telerehabilitation is not integrated into existing health care systems today. Most research is focused on the efficacy of the intervention without addressing the complexity of introducing a system of care that is starkly different from the current health care system in most countries. As such, implementation of telerehabilitation may be considered a ‘wicked problem’ in that it is extremely complex and challenging situation that is intricately linked with the social, economic and political contexts. This paper discusses telerehabilitation implementation while considering the intervention, patient, and health care system contexts in which it occurs.
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