Table 3.

Themes, Subthemes, and Barriers and Facilitators of Telerehabilitation (TR) Program Implementation

Themes and Subthemes	Theme Description	Representative Barrier(s)	Representative Facilitator(s)
Cultural Factors Influencing Reach and Adoption of TR  Veterans’ acceptance of TR	This theme describes the habits, skills, and practices involved in TR process from both Veterans’ and providers’ perspectives.	Veterans’ discomfort with newness of using technology within rehabilitation interactions Veteran forgoing mileage reimbursement	Caregiver availability to assist with technology and/or logistics Convenience offered by TR Ability to avoid potential exposure to triggering situations for Veterans with PTSD Use of smartphones/technologies that are already embedded in Veterans’ lives TR a benefit when Veterans are challenged in driving
Providers’ cultural acceptance of TR		Therapy practices that traditionally rely on manual procedures	Administrative strategies: Allowing providers autonomy and flexibility in implementing TR into their practice, which enabled them to discover what works Program leaders’ advocating for TR use among providers Mentorship and development of TR training in how to implement
Infrastructural and Logistical Factors for TR Implementation	This theme describes the infrastructure and logistical constraints to telerehabilitation.	Limited space that is quiet, private, ample enough for demonstrations, and flexible enough to meet clinicians’ dynamic scheduling needs Identifying and then procuring needed technology Coordination of services requiring an interdisciplinary approach	Administrative strategies: Program leaders’ championing of TR-related needs (eg, space, equipment) Availability of personnel (ie, technicians) dedicated to providing logistical support for the TR Development of systematic way of sharing TR lessons learned
Rurality as a Factor in TR Implementation	This theme describes the complexity involved in extending TR to rural, low-resource environments.	Complexity of providing health and rehabilitation services to Veterans living in rural, low-resource communities Staffing challenges; difficulty in recruiting rehabilitation professionals to rural clinics	When an urban care center was in close enough proximity to serve rural areas When there are schools and jobs available in rural communities to support families of rural TR technicians

Abbreviation: PTSD, post-traumatic stress disorder.