1.INTRODUCTION:
Physiotherapy is evolving along with telehealth technology, and telemedicine for Physiotherapy is changing the way that patients receive services that at one time were only available during in-office visits. Telemedicine software and other tools make it possible for Physiotherapy professionals to provide flexible care for their patients from remote locations, improving appointment turnover and promoting successful completion of Physiotherapy treatment plans. While a patient meets with the clinician comfortably from his own home, the therapist can check his progress, address issues, and aid with exercises and other treatments, making the most efficient use of both the therapist’s time and his patient’s time.
WHAT IS TELEHEALTH:
Telehealth, the use of electronic communication to remotely provide health care information and services, is gaining more and more attention as providers, patients, and payers all seek more effective and cost-efficient ways to deliver care. Telehealth is the delivery of health-related services and information via telecommunications technologies. Telehealth is an expansion of telemedicine, and unlike telemedicine (which more narrowly focuses on the curative aspect) it encompasses preventive, promotive and curative aspects.
HOW TELEHEALTH WORKS IN PHYSIOTHERAPY:
Physiotherapy is no exception, and while those services have developed mostly in rural areas to accommodate the long distances between patients and providers, telehealth in Physiotherapy is being considered in other geographic and clinical settings. In Physiotherapy, our patients are asking for more time-efficient and less costly care models. Their busy lifestyles also can make it difficult for them to attend traditional appointments. Applications of telehealth in Physiotherapy already have its roots that expand throughout patient care and consultation, as it allows Physiotherapists to better communicate with patients and provide more flexible care. Telehealth will not replace traditional clinical
care for sure. However, it will give Physiotherapists and Physiotherapy Assistants the flexibility to provide services in a greater capacity. With the revolutionary telemedicine program in place in one’s practice, the therapist can meet with his patients in real-time while maintaining patient privacy & discretion, rendering services over high-resolution video and audio inputs. The patient consults with the clinician from his location, so he does not need to make a trip to one’s clinic or waste time waiting in the reception area. The therapist also can monitor the patient’s vitals, share images, scans, and studies on his screen, and more, all during a video-conference from one’s home or office.
2. USES OF TELEHEALTH TECHNOLOGIES: CLINICAL:-
CLINICAL:-
Transmission of medical images for diagnosis (often referred to as store and forward telehealth).
Groups or individuals exchanging health services or education live via videoconference in real time (real-time telehealth).
Transmission of medical data for diagnosis or disease management to monitor prognosis (sometimes referred to as remote monitoring).
Advice on prevention of diseases and promotion of good health by patient monitoring and follow-up (tele-patient education).
Health advice by telephone in emergency cases (referred to as teletriage)
NON CLINICAL:-
Distance education including continuing medical education, grand rounds, and patient education
Administrative Uses Including Meetings Among Telehealth Networks, Supervision, And Presentations
Research On Telehealth
Online Information And Health Data Management
Healthcare System Integration
Asset Identification, Listing, And Patient To Asset Matching, And Movement
Overall Healthcare System Management
Patient Movement And Remote Admission
3. BENEFITS OF USING TELEHEALTH FOR PHYSIOTHERAPY PATIENTS:-
Access – saves travel time, cost and difficulty for the patient. The ease of telemedicine also allows the patient living in a rural or far-away location to get quality care right at home.
Telemedicine gives patients greater freedom to schedule appointments that meet their own specific schedules.
Can see patients in their own environment – usually more comfortable with this, less anxiety regarding specialist appointment.
Improved adherence to treatment by reducing barriers for patients thereby improving patient compliance.
Patients who normally come in to see one two, three, or even more times per week will appreciate the ability to meet their treatment goals without the commute to one’s office, getting the care they need on demand thereby creating greater patient satisfaction.
Multi disciplinary team consults saves time for the therapy team – no repetitive questioning, and reduced need for handover
Education - Increase exposure of primary health care providers to our service and the core business we do.
4. BENEFITS OF USING TELEHEALTH FOR PHYSIOTHERAPISTS:-
While telehealth is not intended to completely replace patient care in a clinical setting, it is useful with many physiotherapy patients and makes one’s practice more flexible to meet the demand for this type of service. Telemedicine is becoming a service that more and more patients are expected to be available them – so getting on board is part of staying on the cutting edge in one’s niche.
As a provider of Physiotherapy, one knows how much of a productivity killer missed and cancelled appointments can be. With telemedicine services, one’s patients are less likely to cancel their appointments, and the clinician sees a decrease in the number of “no shows” on his schedule. This improves the flow of patients in one’s practice, allowing one to optimize scheduling, seeing patients as quickly as possible while still providing the best possible care. This maximizes the revenue the therapy clinic generates while keeping in-person patient flow on point and on time – so one’s traditional patients are happier too.
Offering Physiotherapy services via telemedicine also improves one’s practice’s reputation among patients who are looking to reduce the hassle that Physiotherapy often causes. Patients desire quick appointments that are convenient for them. By merely offering these services and marketing them locally, one can anticipate an upsurge in the number of new patients coming in.
By seeing patients remotely, the therapist can also take advantage of the normally unpaid phone calls one fields each day from hiss patients by scheduling a quick visit to address their concerns. This lets him maximize his incoming revenue, so that his practice sees even greater success.
Quicker screening, assessment, and referrals can improve care coordination within collaborative delivery models such as accountable care organizations or patient-centered medical homes
Telehealth can facilitate consultation between providers or in clinical education
5. WHAT WORKS WELL IN PHYSIOTHERAPY TELEHEALTH ASSESMENT:-
Subjective Assessment
Observational analysis of function
Posture
Gait
Quality of movement
Range of motion
Tolerance and irritability
Education – huge component of treatment in chronic pain management
Identify needs for investigation prior to attending face to face appointments
Exercise review and program upgrades
6. DISADVANTAGES IN PHYSIOTHERAPY TELEHEALTH ASSSMENT:-
Manual tests
Neuro exam – Strength, Reflexes, sensation
Special tests for diagnostic purposes
Motor control assessment
7. RECOMMENDED SOLUTIONS FOR OVERCOMING THE DISADVANTAGES:-
Telehealth to the GP practice
Trained health professional from the Nursing background or Physiotherapy assistant with the patient can complete the exam components that one cannot do
Referral to local physiotherapy clinic to complete further physical exam that is not possible on telehealth
Added benefit that they need to develop a relationship with this therapist in the long term so involving them in the specialist assessment process can be helpful
Organize a face to face appointment for a one off physical assessment and program set up and then take follow ups via telehealth.
Patients are generally very happy to do this and assessment is generally more productive than a usual initial consult as all the history taking is already done.
Modify documentation, questionnaire and assessment sheets to suit what can be done by telehealth easily and appropriately.
Set up appropriate and definitive procedures around telehealth responsibilities -
i.e. admin phones the patient to remind them of appointment and ensure they know how to connect, test call if it is the patients first attempts.
Set up functional telehealth spaces that are easily accessible
Standard room bookings, dedicated webcam with fast internet connections for service etc.
8. CAN TELEHEALTH MAKE PHYSIOTHERAPY MORE EFFECTIVE? RECENT CASE STUDIES:-
Telehealth-based therapy programs for stroke survivors have helped increase cognitive and language skills and enabled patients to receive therapy five times more often, according to one company. The survey of more than 20 million therapy sessions by Boston-based Constant Therapy is in line with reports from mHealth advocates who say home-based physical and cognitive therapy programs can improve outcomes and frequency. The platform is now being considered for everything from post-discharge to remote patient monitoring and physiotherapy programs. Duke University’s Clinical Research Institute has launched a new study to determine whether telehealth-based Physiotherapy works better than traditional therapy. Called VERITAS (Virtual Exercise Rehabilitation In-home Therapy: A Research Study), the program will evaluate patients undergoing total knee replacement (TKR) surgery who use the VERA virtual exercise rehabilitation platform developed by San Diego-based Reflexion Health, both before and after surgery. They’ll be compared to a control group who receive traditional home- and clinic-based physiotherapy. The American Telemedicine Association has long supported tele-rehabilitation – including Physiotherapy delivered via telehealth – as a means of reducing expensive follow-up care, including painkiller prescriptions and additional doctor appointments, reducing re-hospitalizations and improving a patient’s overall health and wellness.
SOURCES:-
VSEE WEBSITE
APHYSIOTHERAPY ASSISTANTS
STUDY ON PHYSIO VIA TELEHEALTH- REBECCA MOORE
PHYSIOPEDIA
M HEALTH INTELLIGENCE