Integrating Wearable Sensor Technology into Outpatient Rehabilitation Care: A Proof-of-Concept Study

Background: The disconnect between episodic in-clinic assessments and patients goals to improve activity in daily life presents a challenge in rehabilitation. Wearable sensors are promising for addressing this disconnect but are not part of routine practice. The purpose of this study was to develop and test a digital health solution that integrated wearable sensor technology into outpatient rehabilitation. Methods: Using an iterative user-centered design approach, a digital solution was built that integrated data from a wrist sensor into the electronic health record (EHR). The feasibility, usability, and resources required of the solution were evaluated in a 9-month proof-of-concept study in outpatient rehabilitation. Results: 17 clinicians and 38 patients (median monitoring duration: 42 days) participated. Patient adherence to daily data syncing was a median of 68.6% and was not significantly correlated with digital technology self-efficacy (r = 0.03, p = 0.86). Recent sensor data (≤ 3 days old) were available in the EHR for 90.2% (193/214) of clinic visits, and clinicians viewed these data in 81.9% (158/193) of these visits. Overall user-friendliness on the System Usability Scale received a median rating of "good" from both patients and clinicians. Resources included costs to build the data transfer pipeline, a 24-month build timeline, and ongoing technical support. Conclusions: By combining user-centered design principles with dedicated resources, we built a feasible and usable digital health solution to bridge the gap between brief clinic visits and daily life in outpatient rehabilitation. These results and future refinements will facilitate broader-scale implementation of sensor technology in rehabilitation.