Thursday, October 16, 2025
Integrating proven technological innovations into existing rehabilitation plans: in “blended” or hybrid rehabilitation care, technology supports both the patient and the healthcare provider, rather than requiring extra work and attention. This opens up new possibilities.
Technological innovations make it possible to work on your recovery independently and in your own environment. In blended rehabilitation care, this is done with professional guidance and advice, for example, through remote monitoring and training, video care, and rehabilitation apps.
The Medical Delta Living Lab ‘Blended rehabilitation’ explores ways to integrate technological innovations into existing care pathways, together with healthcare providers, informal caregivers, and patients.
We spoke with special lecturer Dr. Marije Holstege (Inholland, Omring) and PhD candidate and physiotherapist Aurelie Oosterlynck (Tranzo, Tilburg University, and special lecturership in geriatric rehabilitation Omring/Inholland), both involved in the living lab. “People can do a lot themselves, and they want to: they appreciate being in control and rehabilitating in their own environment.”
This interview is the fourth in a series with practice partners of the transdisciplinary Medical Delta programs and living labs.
What need does the Medical Delta Living Lab ‘Blended Rehabilitation’ address?
Marije: “The goal is to explore how we can optimize rehabilitation trajectories or organize them more intelligently using technology. Healthcare providers play an important role in this, as it requires a different way of working. In our living lab, we combine research, practical knowledge, and education with daily work. Co-creation is the guiding principle: developing, researching, and gathering needs together with patients, informal caregivers, and healthcare providers from the multidisciplinary team, such as physiotherapists, nurses, and occupational therapists. At Omring, the focus is primarily on geriatric rehabilitation.
There are many technological possibilities. At the same time, research shows that only about 10% of healthcare professionals use this technology in a ‘blended’ way. That’s understandable: they have trained in a specific profession, and the blended way of working is really different. Their role shifts to a more coaching approach. This requires different skills, and that is where the living lab provides guidance.”
"Good information provision is also appreciated by informal caregivers. There is also a group that needs more support, and we are exploring how best to provide that. Think, for example, of a digital practice group.
People rehabilitate at home up to 2.5 times faster than when staying in a rehabilitation center. So far, this has meant that once patients are home, they can become somewhat “out of sight” for their therapists. With blended rehabilitation, that transition is smoother. Remote monitoring provides patients with extra motivation to work on their recovery at home. Healthcare providers can give feedback and coaching not only based on what patients tell them, but also based on the generated data."
A common problem reported in the field is that healthcare technology creates extra work: it comes 'on top of' rather than 'in place of'.
Aurelie: “That does happen. For example, during a field test of new technology, colleagues said: ‘Now this is on top of everything else, and we already have so little time.’”
It requires time before it leads to time savings
“The idea of blended rehabilitation is that technology becomes part of existing rehabilitation care. In this way, it can take work off your hands. For example, someone who receives physiotherapy twice a week could do one session on-site and one remotely. Or a patient could receive fifteen minutes of guidance on-site and then spend fifteen minutes working independently, using exercise equipment that engages them through a game.”
Marije: “Aurelie is developing a blended care pathway through her PhD research. She does this using practice- and action-based research and by examining what it means for the process to work with rehabilitation apps and video care. For healthcare providers, blended working is certainly a time investment at first, because you need to make it your own. It takes time before it leads to time savings.”
Can you tell us a bit more about this PhD research?
Aurelie: “The goal is to develop a general care pathway that can be used with m-health (‘mobile health,’ i.e., mobile digital applications for healthcare, such as wearables). We are studying rehabilitation care broadly by implementing three types of technological innovations: a movement app, video care, and activity monitoring. Ultimately, this should become a blueprint for creating a blended care pathway. We do this with input from rehabilitation-focused healthcare organizations, healthcare providers, patients, and informal caregivers.
Marije: “These will become building blocks you can use to assemble a blended care pathway. It provides insight into what you need if you want to work in a blended way.”
Aurelie: “Healthcare professionals have been involved from the start of the research, for example by providing input in working groups. All relevant disciplines were included, such as physiotherapists, occupational therapists, information managers, the care manager, an e-nurse, movement specialists, and not least, patients and informal caregivers. We asked them, among other things, about the barriers and facilitators to working with m-health. We incorporate this into the research.”
Marije: “We want to conduct the research in co-creation with them, and feasibility testing in the healthcare practice will also be an iterative process. Aurelie conducts the research as a practicing physiotherapist with her team and colleagues, which works well. We carry out the research in short cycles so that those directly involved can quickly see the results. This helps integrate technology quickly while evaluating it at the same time.”
How is healthcare practice involved in this?
Aurelie: “Because I still work two days a week as a physiotherapist, I know the team, the other involved disciplines, and the patients. This makes it easy for me to brainstorm and lowers the barrier for my research group to participate in the study. Being present on the ward helps advance the research.”
Marije: “Omring is leading the way here: research and daily practice flow into each other. Students are also involved. At the same time, through the living lab, we conduct research at other healthcare organizations, allowing us to incorporate different perspectives to provide a general overview. At Pieter van Foreest, researcher Loes Oostrik specifically studies the treatment module, which is closely linked to Aurelie’s process research.
Basalt, which provides specialized medical rehabilitation care, is also involved. They already had valuable experience with home rehabilitation and blended working, which we are now applying further in geriatric rehabilitation.”
We recently received a major RAAK grant for the research project ‘BARBAPAPA,’ which builds on this work. In this project, we are looking at what healthcare providers need to be able to work in a blended way. This includes training or support to adopt a different way of working, or help to understand and use the technology.”
What are the barriers and facilitators? Do you have examples?
Aurelie: “It’s important that blended working is widely supported and that a healthcare organization has a clear vision on it.
In addition, the implementation of innovations can be a barrier. How should I work with it, and how should I handle it? These are questions that arise for both healthcare professionals and patients.”
Marije: “Research shows that healthcare providers are sometimes hesitant because they think their patients won’t be able to use it. If you reverse this and introduce ‘digital first’ for everyone, you quickly see who it really isn’t suitable for and end up with a larger group who can and wants to work with it.”
If you replace some of those visits with online guidance, it saves a lot of time in healthcare providers’ busy schedules.
Aurelie: “What works as a facilitator are the extra possibilities that blended working offers. For example, in outpatient rehabilitation, many people find it difficult to come to the location every time. They need to arrange transportation and rely on informal caregivers or taxi services. For these people, it’s helpful if they can do part of their rehabilitation at home.
On the other hand, as professionals, we also often do home visits. If you replace some of those visits with online guidance, it saves a lot of time in healthcare providers’ busy schedules. This way, we can support more people in the same amount of time.”
Does this make the work more enjoyable?
Aurelie: “That’s something we want to include in the feasibility study, because it is indeed an important aspect. Physiotherapists and occupational therapists choose this profession because they like working with people and with their hands. If that shifts to spending more time in front of a screen, how does that affect job satisfaction?
Blended working means that we always continue to treat patients physically as well—that comes first. At the same time, it can actually make the work more attractive, for example by giving you more insight into patients’ progress, which allows you to tailor the treatment accordingly.
An advantage is that insights gained from monitoring can improve collaboration among all disciplines. Based on monitoring data, the entire treatment and care team—and always in collaboration with the patient—can coordinate what a good daily schedule looks like, for both daily tasks, therapy sessions, and independent exercises.”
And how do patients experience this change?
Marije: “Other studies show that patients appreciate being able to rehabilitate partly at home, and they are also more motivated to practice through technological applications, such as an activity monitor. They feel more confident knowing they are being monitored remotely and receiving feedback.”
Aurelie: “It also gives patients and informal caregivers more insight, allowing them to better plan their day—for example, knowing that after a strenuous session it’s better to take it easier in the afternoon.”
How is vocational education (mbo) involved in this?
Marije: “Vocational education is an important part of the living lab. A large portion of healthcare providers at Omring have mbo-level training, so it’s important to include this perspective. Mbo students can think along like no one else about what healthcare providers need practically. Their input is closely connected to the experience of practitioners. For example, we asked mbo students to create manuals. We collaborate on this with the Practoraat Zorgtechnologie at Vonk, partly established by Omring.”
Mbo students are uniquely able to think along about what healthcare providers need in practice.
For a successful implementation, it is also important to involve practice from the start of innovation projects. Successful implementation is, after all, highly dependent on the setting and context. We bring together the full range of university (wo), higher professional (hbo), and vocational (mbo) education. A solid infrastructure helps.”
Which practical questions have been incorporated into the research?
Marije: “The transition back home is quite intense for patients. They need to motivate themselves to practice, and a lot happens at once. That is a topic we include. Self-management is also considered important, and technology can support this. From the healthcare professionals’ perspective, there is primarily a need for support in integrating technology into existing processes.”
Aurelie: “Patients express a need for clarity about what to expect in a blended rehabilitation pathway.”
Marije: “Patients appreciate being able to practice on-site with the technology they will later use at home. That was also a clear practical question that we included.”
Marije, you are a special lecturer with a dual appointment at healthcare organization Omring and Inholland. What are the advantages of this?
Marije: “My lecturership is truly embedded in healthcare practice. In my view, this happens too little in elderly care. Omring has its own research department, which offers significant benefits. Through my dual appointment, I act as a linking pin between many different parties, from scientific research to hands-on healthcare practice. This fosters a learning culture. It does, however, require a certain vision and infrastructure within the organization to make it work this way.”
How do you notice that this is a Medical Delta living lab? How does it help you?
Aurelie: “I can easily brainstorm with others. We share insights, experiences, and methodologies. For example, I regularly have contact with fellow PhD candidate Loes Oostrik.”
Marije: “Even within the core team of the living lab, we combine each other’s insights and previous research. That is extremely valuable. During one of the consortium meetings, we presented what we know so far about blended rehabilitation and shared our experiences. You realize that quite a lot of knowledge has already been collected. The risk is that everyone in the Netherlands does the same thing without knowing about each other’s work. By combining this knowledge, we strengthen each other. We remain open to insights from others, including from other fields where blended approaches are used.”
Photos: Guido Benschop
