: Remote therapeutic monitoring (RTM) platforms were increasingly deployed in Outpatient Rehabilitation to support continuous, between-visit communication, adherence to home exercise programs, and earlier identification of clinical setbacks. While patient-facing outcomes have received growing attention, evidence describing the clinician experience of RTM; including its effects on therapeutic alliance, perceived cognitive workload, and capacity for proactive patient management remains limited. Understanding how providers perceive and integrate RTM technology into their workflows is essential to optimizing implementation, sustaining adoption, and translating digital health investment into measurable clinical value. This cross-sectional survey study tested the feasibility of evaluating the provider's experience using a digital RTM platform across three pre-specified domains: 1) therapeutic alliance, 2) work satisfaction, plus cognitive loading, and 3) proactive patient management. A secondary objective examined whether years of clinical experience or self-reported comfort with new technology were associated with provider experience or perceived workload.A cross-sectional, anonymous survey was administered to licensed physical therapists at the Outpatient Clinics, Shebin El-Kom, Menofyia governate, Egypt between 1st March, and 31th July, 2026 with a response rate of 43.4% (43/99) for the completed surveys. Eligible clinicians used the SaRA Health RTM platform for at least the previous six months prior to initiation of current study. The survey instrument combined an internally developed 8-item Likert-scale survey (0-5) targeting therapeutic alliance, proactive management, and satisfaction (Cronbach's α = 0.89) with a modified NASA Task Load Index (NASA-TLX; Cronbach's α = 0.86) measured the perceived workload across six domains (0-10). Cronbach's α coefficient demonstrates internal consistency, unless not construct validity or test-retest reliability. Statistical analyses included Spearman rank-order correlations and Mann-Whitney-U tests. For Mann-Whitney comparisons, results were reported as: U, p-value, group sample sizes (N1, N2), and rank-biserial r-effect size. For multiple comparisons across NASA-TLX subscales (k = 6), a Bonferroni-corrected threshold of α = .0083 was applied. Spearman correlations were reported with ρ and 95% confidence intervals.In this cross-sectional survey feasibility study, it was observed that clinician experience with the SaRA Health RTM platform was characterized by enhanced therapeutic alliance when early warning detection performed well, reduced cognitive load was observed when frustration was low, and meaningful facilitation of proactive patient management was observed among engaged users. Frustration emerged as the most actionable lever for design and implementation improvement, and self-reported digital comfort rather than years of clinical experience was the strongest clinician-level correlate of cognitive burden. These findings suggest that targeted onboarding, mentorship, and friction-reducing platform refinements may improve RTM adoption and amplify downstream benefits to patient care. Larger, multi-site, longitudinal studies are warranted to validate these signals.
Remote Therapeutic Monitoring (RTM) has emerged as an increasingly important component of contemporary rehabilitation delivery, particularly within outpatient musculoskeletal care. The introduction of RTM-specific CPT codes beginning in 2022 to include patient-reported subjective data, has created reimbursement pathways that support integration of RTM into physical therapy practice by enabling clinicians to monitor patient progress, adherence, symptoms, and treatment response between in-person visits. Digital-health technologies may strengthen this alliance by providing easy access to communication with clinicians in between visits, enhancing continuity, and supporting personalized feedback between visits. Recent evidence suggests that digital-health interventions can positively influence patient-provider relationships when technologies are perceived as supportive rather than intrusive or burdensome. A feasibility, cross-sectional, quantitative survey was conducted at the Outpatient Clinics, Shebin El-Kom, Menofyia governate, Egypt between 1st March, and 31th July, 2026. The Outpatient Clinics provide care to adult patients with musculoskeletal, and neuromuscular conditions. Participating clinicians were defined as licensed physical therapists (PTs). All participants were recruited voluntarily and checked an informed consent box through an emailed request. Across three pre-specified objectives for this cross-sectional, quantitative survey study, the SaRA Health RTM platform demonstrated observational signals consistent with improved therapeutic alliance when early warning detection performed well, reduced cognitive load when frustration with the platform was minimized, and meaningful facilitation of proactive patient management among clinicians who experienced the RTM process as positive. Frustration emerged as the single most actionable target for improvement, and lower self-reported digital comfort was the clinician characteristic most associated with elevated cognitive load and reduced performance on the modified NASA task index. Together these findings suggest clinician experience design, education, and training as important determinants of whether this specific RTM platform translates into the proactive, alliance-strengthening care it is intended to enable.
Study Type
OBSERVATIONAL
Enrollment
45
The survey was administered anonymously and consisted of two principal instruments: 1) an internally developed 8-item Likert-scale survey examining clinician experiences with the SaRA Health RTM platform and its perceived contribution to patient care plans, and 2) a modified, non-validated NASA Task Load Index (NASA-TLX) that captured perceived cognitive and physical workload, time pressure, performance (defined as the ability to complete work), effort, and frustration associated with platform use. The validated tool is generally used without modification using a 0-100 scale. We modified the scale to 0-10 with '0' representing the lowest end of each domain. The internally developed survey, designed by the SaRA Health research team, comprised 8 items rated on a Likert scale from 1 (strongly disagree) to 5 (strongly agree). Items targeted clinician perceptions of therapeutic alliance, proactive patient management, and work satisfaction associated with use of the RTM system.
Shebin ElKom Teaching Hospital
Shibīn al Kawm, Menofyia, Egypt
A modified, non-validated NASA Task Load Index (NASA-TLX)
A modified, non-validated NASA Task Load Index (NASA-TLX) measures perceived workload of human-machine systems across six domains and has been used extensively in the healthcare field to exam workload for providers using digital health technologies. The validated tool is generally used without modification using a 0-100 scale. We modified the scale to 0-10 with '0' representing the lowest end of each domain. For example, a score of 0 on the mental demand item indicates no additional mental load attributable to the system, whereas a score of '10' indicates extremely high additional mental load. The original instrument served as a template; item wording was lightly modified to reflect the RTM use case more specifically.
Time frame: 1. At base-line of the study.
An internally developed 8-item Likert-scale survey
An internally developed 8-item Likert-scale survey designed by the SaRA Health research team, comprised 8 items rated on a Likert scale from 1 (strongly disagree) to 5 (strongly agree). Items targeted clinician perceptions of therapeutic alliance, proactive patient management, and work satisfaction associated with use of the RTM system.
Time frame: 1. At base-line of the study.
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