Telerehab resources


Author(s): Dunn, T. (MSc student) & Ogourtsova, T. (PhD OT)

This page provides evidence-based recommendations to inform and support clinicians who are exploring the implementation of telerehab at their practice. The following resources are included:
  • A brief overview of the Telehealth readiness assessment (TRA) tool
  • The Telehealth readiness assessment (TRA) tool complete PDF document
  • A clinician resource form for appointment preparation
  • Clinician information video: What are the "levels of evidence?"
To quickly navigate between sections, click the desired menu title in the Table of Contents.

Overview: Telehealth readiness assessment tool

The Telehealth Readiness Assessment (TRA) tool is a comprehensive resource providing evidence-based strategies to facilitate telehealth implementation. The TRA was initiated by the Maryland Health Care Commission (MHCC) in 2018, where collaborators identified the need for an assessment tool that would help small practices understand the practical barriers, facilitators, and patient/environmental factors associated with telehealth implementation. The TRA is based on an extensive literature review and has been field tested by key stakeholder groups for comprehensibility and applicability. It references over 150 articles, and provides numerous resources and guidelines to support best practices.

The TRA includes:

  1. Telehealth Readiness Assessment Questionnaire evaluates the level of readiness of a practice and patient population. This is scored by the presence of literature-identified telehealth facilitators, using a 3-point scale of degree of preparedness (low score = low readiness). For example:
    "Has your practice determined how to obtain and document the patient’s consent prior to receiving telehealth services?" Check one box: 1=no/unsure, 2=somewhat, 3=definitely.
  2. Supporting Guidance is comprised of 5 domains describing the practical considerations needed for context-specific telehealth implementation. Each domain is split into 2 sections:
    • Why is this important for your practice?
    • Actions to take with specific examples and reminders
The 5 TRA domains

  1. Core Readiness: Is your practice prepared for telehealth?
    How has your practice considered the need for, the costs and benefits of, and the challenges associated with telehealth implementation?
  2. Financial Considerations: Does your practice have realistic expectations for the timely and financial implementation of telehealth?
    Consider initial costs (e.g. devices, secure internet connection), the time needed to adapt services and training, sustainability, liability insurance, and equipment-related reimbursement procedures?
  3. Operations: Has the practice considered how telehealth will impact operations?
    Is your practice prepared to make the necessary changes? For example: staff training, assigning telehealth roles, spatial requirements for private appointments, regional licensing or credentialing processes.
  4. Staff Engagement: Is your team interested and engaged in implementing telehealth?
    Consider the possible need for additional training, and the creation of new guidelines and schedules to suit telehealth services.
  5. Patient Readiness: Are your patients interested in and ready for telehealth?
    Do they have access to the technology necessary to facilitate telehealth, such as a private space with a secure wifi-connection, a video-enabled device (e.g. smart phone, tablet, laptop, etc)

Clinician Appointment Preparation

To optimize families' preparedness and engagement in telerehabilitation sessions, this 1-page form can be filled out by the clinician and sent to families ahead of the scheduled tele-appointment.
To download the PDF, click here.

What are the levels of evidence?

For more information on how the levels of evidence for each article are determined and defined, watch the video below.


Pollak, A. N. et al., (2019). Telehealth Readiness Assessment Tool. Maryland Health Care Commission. Accessed Nov 14, 2022 at