Online Ward: Innovative, digital-era, home-based rehabilitation services
By Wang Haoyu, President, and Liu Xiaohuan, Director of the Community Guidance Office, Ningbo Rehabilitation Hospital
In 2020, Ningbo Rehabilitation Hospital in Ningbo, China, launched the Online Ward, an innovative, home-based rehabilitation program to address the rehabilitation needs of patients during the pandemic due to the challenges of maintaining continuity in rehabilitation after patients transitioned from institutions to communities or homes, as well as the insufficient capacity of grassroots rehabilitation services.
The achievement of seamless patient transition from institutions to home environments has pioneered a new “Internet+” model for home rehabilitation. The program has been honored with China national awards, including the National Model Case of Technology-Assisted Disability Support and the National Key Contact Area for Disability Prevention Scientific Innovation Project.
Precision targeting for selection of service recipients
By establishing admission criteria and conducting household assessments, the program precisely identifies eligible beneficiaries. Key eligibility requirements include: physical functional impairment with strong rehabilitation commitment; stable medical condition; basic self-care training capabilities; independent living space; stable internet access; and must reside within the Ningbo metropolitan area. This mechanism ensures service feasibility and safety from the outset.
Collaboration across disciplines to provide customized solutions
A multidisciplinary service team comprised of doctors, nurses, therapists, assistive technology engineers, psychologists, and nutritionists was created to implement the “one patient, one plan, one team” model. Customized rehabilitation plans are developed based on patients’ functional impairments and executed by a dedicated team to ensure professional expertise and continuity. The team provides flexible remote consultations as needed, facilitating cross-disciplinary resource integration.
Standardized service procedures
The Ningbo City “Internet+” Online Ward Home Rehabilitation Operation Manual provides standardized service system procedures for admission/discharge management, remote ward rounds, rehabilitation guidance, regular assessments, and medical record maintenance.
The service cycle spans 3–6 months per year, with rehabilitation physicians conducting two weekly remote rounds. Rehabilitation therapists provide monthly online training guidance of at least 15 working days and daily guidance of no less than 30 minutes. Pre-, mid-, and post-rehabilitation home assessments are scheduled. The medical records provided through online services are in accordance with the standards of offline services. Quality control officers and rehabilitation quality management personnel conduct regular monitoring to ensure home services meet the same quality standards as in-hospital care.
Empowerment by technology
The Ningbo Rehabilitation Hospital has a remote visual control center (currently serving about 103 accounts) and an online ward within the Hospital Information System (HIS). High-definition video equipment is installed at home locations and connected to the control center to facilitate visual and interactive communication between medical staff and patients.
Through a hybrid service model combining online rounds, remote guidance, and home assessments, it is ensured home-based rehabilitation matches institutional care standards. The rehabilitation team utilizes an Internet of Things (IoT) platform for remote parameter settings, real-time data monitoring, and seamless adjustments. We achieve efficient rehabilitation and optimized resource allocation by quantifying the data for precise evaluation and personalized plans to enhance compliance for optimal outcomes.
Significant results for all age groups
Since its launch in 2020, the rehabilitation program has provided high-quality, home-based rehabilitation services to over 490 individuals with physical disabilities. The service population spans all age groups, with 61% aged 19–60, 33% over age 60, and 6% under age 18. The program achieved a 70% effectiveness rate (measured by a 5-point or greater improvement in Activities of Daily Living scores), significantly enhancing patients’ functional abilities and self-care capabilities while playing a positive role in preventing new cases of severe disability. Notably, 45 individuals aged 18–60 with employment aspirations received vocational training and access to job information channels. Four of which successfully secured employment. The program achieved an overall service satisfaction rate of 98%.
The Online Ward home-based rehabilitation model successfully integrates public health response with solutions to industry pain points. By implementing precise screening, personalized plans, standardized processes, and cloud-based technology, it has established as a replicable and scalable “Internet + Home Rehabilitation” framework. This innovative approach effectively expands the reach of professional rehabilitation services and provides valuable insights for further enhancement of rehabilitation service systems in the digital era.
Ningbo Rehabilitation Hospital in Ningbo, China, received exemplary recognition in a recent CARF Medical Rehabilitation accreditation report due to the organization’s incredibly unique and effective program for extending its services into the community and providing virtual services and follow-up support to discharged patients.
For questions about this unique program, contact Wang Lijun, CARF Coordinator, Ningbo Rehabilitation Hospital, at nbdprc@126.com.