Perspectives of key stakeholders on integrating wearable sensor technology into rehabilitation care: a mixed-methods analysis.

Introduction: Rehabilitation is facing a critical practice gap: Patients seek out rehabilitation services to improve their activity in daily life, yet recent work demonstrates that rehabilitation may be having a limited impact on improving this outcome due to lack of objective data on patients' activity in daily life. Remote monitoring using wearable sensor technology is a promising solution to this address this gap. The purpose of this study was to understand patient and clinician awareness of the practice gap and preferences for integrating wearable sensor technology into rehabilitation care. Methods: This study used a mixed-methods approach consisting of surveys and 1:1 interviews with clinicians (physical and occupational therapists or assistants) employed at an outpatient rehabilitation clinic within an academic medical center and patients seeking care at this clinic. Data were analyzed using descriptive statistics and thematic analysis. Results: Data saturation was reached from nineteen clinicians and ten patients. Both clinicians and patients recognized the importance of measuring activity outside the clinic and viewed wearable sensor technology as an objective measurement tool. Most clinicians (63%) preferred continuous (vs. intermittent) monitoring within a care episode and most patients (60%) were willing to sync their sensor data as often as instructed by their provider. To maximize integration into clinical workflows, clinicians voiced a preference for availability of sensor data in the electronic health record. Conclusions: Clinicians and patients value the use of wearable sensor technology to improve measurement of activity outside the clinic environment and expressed preferences for how this technology could best be integrated into routine rehabilitation care.