Why Stroke Rehabilitation Teams Are Struggling to Actually Use Digital Health Tools—Even When They Work

Digital technologies can improve stroke recovery outcomes, but most rehabilitation teams aren't actually using them in their daily practice—even when research proves they work. A new qualitative study of 12 experienced multidisciplinary health care professionals at two Norwegian rehabilitation settings reveals a surprising gap: while digital tools show promise for monitoring progress and supporting home exercises, organizational barriers, skepticism about remote care, and the challenge of replacing human connection are keeping these technologies on the sidelines.

What's Actually Stopping Rehabilitation Teams From Using Digital Health Tools?

The research identified several organizational processes, roles, standards, and rules that act as barriers or drivers to implementing digital technologies in stroke rehabilitation practice. The study found that health care professionals—including physiotherapists, occupational therapists, speech therapists, nurses, physicians, and social workers—view digital technologies primarily as supplements to existing practices rather than replacements for in-person care. However, this cautious approach has created a disconnect: despite guidelines and research recommending technology use in stroke rehabilitation, actual implementation and clinical validation remain inconsistent.

One of the most striking findings involves the tension between efficiency and human connection. Rehabilitation professionals expressed significant ambivalence about digitalizing multidisciplinary psychological support and exercise programs. They worry that moving sensitive conversations and complex motor rehabilitation assessments online could undermine the relational depth needed to address patients' emotional and physical needs effectively.

Where Digital Tools Actually Show Promise in Stroke Care

Despite the implementation challenges, the study identified three specific areas where digital technologies are making a real difference in stroke rehabilitation:

• Coordination and Continuity of Care: Systems for sharing medical records and goal-setting apps help coordinate care between hospital settings and community services, allowing stroke survivors to remain involved in their own recovery planning and follow-up.
• Progress Monitoring: Digital tools for tracking motor rehabilitation progress give both patients and clinicians objective data about recovery, helping motivate patients and inform treatment adjustments.
• Home Exercise Engagement: Technologies like gaming, videoconferencing, and online exercise platforms enhance motivation and accessibility for patients doing rehabilitation exercises at home, making recovery more portable and cost-effective.

The World Health Organization has promoted digital health to enhance the quality and accessibility of health care services, and studies have shown that digital technologies improve activity and function, social participation, and medical adherence among individuals with stroke. Yet the gap between what research recommends and what clinicians actually use remains wide.

Why Implementation Lags Behind the Research

A key insight from the research is that rehabilitation specialists have introduced many digital solutions for home-based rehabilitation, but significant challenges remain in adapting these technologies in practice. One major issue: physical and occupational therapists often continue prescribing written, paper-based, and nontechnological home exercises instead of digital alternatives, even when digital options are available.

The study also found that while individuals with stroke generally hold positive attitudes toward digital technologies—appreciating increased accessibility and convenience—they still advocate strongly for personal contact, shared responsibility, and collaboration with health care professionals. This preference reflects a real clinical need: rehabilitation is inherently relational, and the professionals in this study recognized that some aspects of stroke recovery simply cannot be fully digitalized without losing critical elements of care.

Limited resources have led to earlier hospital discharge and outsourced rehabilitation services aided by digital technologies, creating both opportunity and pressure to implement these tools. However, despite the rapid adoption of digital technologies after the COVID-19 pandemic, scaling up remains slow in specialized neurological rehabilitation settings.

What Needs to Change for Digital Tools to Actually Work in Stroke Rehabilitation?

The research suggests that viewing familiar digital technology as a supplement to existing practices, rather than as a singular solution for all areas of specialized stroke rehabilitation, offers significant potential for quality improvement. The professionals interviewed emphasized that future digital technologies should focus on specific, high-impact areas: systems for sharing medical records across care settings and goal-setting apps that actively involve stroke survivors in their own recovery planning.

The findings provide valuable insights for technology developers, health care personnel, and user groups in specialized neurological rehabilitation settings. Rather than pushing for wholesale digitalization of stroke care, the evidence suggests a more nuanced approach: identify the specific clinical tasks where digital tools genuinely improve outcomes or efficiency, implement them thoughtfully with staff buy-in, and preserve the human elements of care that patients and professionals both recognize as essential.

For stroke survivors and their families, this research offers an important takeaway: digital health tools are increasingly part of recovery, but they work best when they enhance—not replace—the relationship with your rehabilitation team. The future of stroke rehabilitation likely involves a thoughtful blend of technology and human expertise, tailored to what actually works in practice.