Platform functional specifications (Telerehabilitation requirements)

This part of the CLEAR project is aimed at defining the user requirements, expressed as the functional specifications, of the CLEAR platform from the perspectives of the clinical centres and of the chosen group of patients. These specifications are fundamental to guide the technical work related to the upgrade of the existing platform and the ‘real’ implementation in daily rehabilitation care.
The description and preliminary results of CLEAR actions, methodologies and tools for platform clinical specifications have been reported since they represent useful information to be added to the service guidelines and taken into account whenever it is necessary to define further TR service clinical specifications (Habilis TR service within new contexts; treatment of new pathologies).
The methodology applied to retrieve clinical user needs relied on a stepwise approach in order to be able to list the functional specifications including questionnaires, interviews and workshops. A crucial step of this approach was the composition of scenarios together with the clinical centres. The scenario storylines were used as ‘representations for communication and joint understanding’ between developers and clinicians. By means of the scenario CLEAR partners were able to:

1. to better understand how a specific team can deliver the (tele-) rehabilitation service to a particular patient group;
2. to define home therapies based on different sets of rehabilitation exercises which are relevant to the concerned pathology.

The functional specifications obtained are related to equipment, access control, user identification, content of the telerehabilitation via the platform, authorization, data storage processing and management, feedback to the patient, user friendliness, registration of user activities on the platform (e.g. to monitor compliance), interaction patient-system, interaction patient-clinician, and interaction clinician-system. Accordingly, the functional specifications to be implemented on the current platform will be translated into technical specifications.
The expected outcome and results of this part of the project will be:

1. to understand how a specific team can deliver the service to that particular patients’ group;
2. to define home therapies based on different sets of rehabilitation exercises which are relevant to the concerned pathology.

The functional specifications obtained from the study were split up in need to have and nice to have requirements: the need to have aspects, both for therapists and patients, are critical factors in the design of the system, necessary for a successful implementation of the system; the nice to have aspects are “wishes” (e.g. for the future).
Thirty need to have functional specifications were identified which deal with the following issues: equipment, access control, user identification, content of the CLEAR website , telerehabilitation exercises, registration of training activities (e.g. compliance), authorization, data storage & processing & management, visual representation, interaction patient – system / professional – system, feedback from system to patient, and user friendliness.
List of need to have functional specifications:

1. PC and Internet access;
2. Webcam availability/installation;
3. Additional technological features (digital writing tablet, adapted mouse or keyboard, headphones or tactile screens);
4. User identification & Registration;
5. Establishment of a simple password recovery system;
6. Access control;
7. Registration of login activities (to measure compliance);
8. Registration of treatment activities;
9. Manuals & Instructions to patients (written instructions, text, figures and explanations, pictures, videoclips, animations);
10. Manuals & Instructions for professionals (not visible for patients);
11. ‘Online’ content of the telerehabilitation programme;
12. ‘Online’ availability of Clinical assessment instruments;
13. Automatic back-ups;
14. Data-storage and privacy (data stored on local service provider level);
15. Patient list/overview;
16. Monitoring quality and quantity of execution / progress of patients;
17. Patient record/data base (retrieval security);
18. Availability of research data;
19. Suitability of the professional user interface;
20. Prevention of information overload;
21. Printing documents / information from the CLEAR website;
22. Availability of videos for documentation and assessment;
23. Video and mail patient-therapist interaction;
24. Availability of predefined settings (e.g. training schedule, exercises);
25. Possibility to adjust/change settings (e.g. training schedule);
26. Feedback by the system to the patient;
27. Importance of a user friendly CLEAR system/platform;
28. Availability of helpdesk in case of technical difficulties/ problems for both patients and professionals;
29. PC general maintenance;
30. Overview of restrictions in compatibility of the CLEAR platform with applications already in place at the clinical centres.

Importantly, since one of the essential requirements for each and every tool, system, procedure and service dealing with health care is the safety of the user, it is mandatory that each functional specification derived from this study is carefully validated and its conformity assessed with the regulations and standards in the field of health before being implemented into the system and before being included in best practice service guidelines.