This study is paving the way for a new era of clinical services.

For most of us, a visit to the physician or other health care professional is a routine part of our lives. For others, it is a struggle complicated by geography – and disability. A patient’s level of disability or decreased access to transportation services can also reduce the availability of health care, putting them at risk for worsening disability and decreased functional recovery. This is especially true for patients with traumatic brain injury, who because of their cognitive disabilities often have to rely on others to take them to their appointments.

Telemedicine, or more specifically Telerehabilitation, is an innovative solution to this health care dilemma. Services delivered via the Internet have shown promise for improving the health of patients with diabetes and heart disease. Newer studies are showing that these techniques can also be used for patients with traumatic brain injury.

Neuropsychology is a specialty that assesses and treats the cognitive and behavioral changes that occur in patients who have suffered some kind of insult to the brain, including traumatic brain injury (TBI). Individuals with TBI often have a wide variety of physical, cognitive and behavioral changes following injury that limit their ability to return to every day roles and responsibilities.

Neuropsychologists are often consulted to help these individuals understand and cope with these changes. But this highly specialized service is not available in every city or town – patients may have to travel long distances to receive them. Now a study at NRH seeks to broaden access to these services through Telemedicine. A web-based system for assessing cognitive and emotional functioning has been tested on a group of patients with traumatic brain injury who were receiving outpatient rehabilitation services at NRH.

Patients participating in the study took a series of cognitive tests through an Intranet connection. All communication with the examiner was conducted via videoconferencing. The examiner had full view of the participants and was able to monitor patients’ responses. The examiner responded to questions and interacted with the patient in a manner similar to a face-to-face assessment, which was also conducted for comparison purposes.

All study participants were able to complete testing without the need for the examiner to be present in the room, demonstrating that it is feasible to conduct this type of an assessment over the Internet. Such studies, along with others at NRH, are paving the way for a new area of clinical care that will expand services to greater numbers of people and ultimately improve quality of life for individuals with traumatic brain injury.