A day in the life: a qualitative study of clinical decision-making and uptake of neurorehabilitation technology.
Courtney Celian, Veronica Swanson, Maahi Shah and 7 others
PMID 34321036WHAT IT FOUND
Therapists at a tech-rich hospital rarely used devices because setup took too long and games did not match functional goals.
They chose familiar tasks instead. Developers must prove devices save time and directly support daily living activities to be adopted.
Key findings
01Complexity and setup time were the most frequent barriers, with all five therapists and all nine vignettes citing difficulty or time burden.
02Therapists perceived technology as having a relative disadvantage because it often focused on impairment or games rather than the functional tasks required for discharge and reimbursement.
03Clinicians were more likely to adopt technology if it was integrated into their academic training or onboarding, rather than requiring self-directed practice after a single session.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted at a single hospital that was specifically built to integrate technology, so the barriers described may be less severe than in typical clinics. The sample was very small (five therapists), and the vignette format may have led therapists to overemphasize certain topics like setup time. The analysis used a pre-existing framework (CFIR) rather than letting new themes emerge inductively, which may have missed unique local factors. Only clinician perspectives were included; patient and administrator views on technology use were not assessed.
Declared interests
Funding was provided by the National Institute on Disability, Independent Living, and Rehabilitation Research, the National Institute on Aging, the U.S. Department of Defense, and the National Center for Advancing Translational Sciences. No conflicts of interest were declared.
The easy way to misread this
Do not assume that therapists avoid technology because they are resistant to change or lack knowledge. The findings suggest that avoidance is often a rational response to workflow constraints, such as setup times that eat into billable treatment minutes, or devices that do not address the functional outcomes required for insurance reimbursement.