2018 Lee et al. – Telehealth Physical Therapy in Musculoskeletal Practice
With improvements in video, audio, and other communication technologies, telehealth has become a viable method of interacting with patients. Physical therapists can also make use of this technology in the form of telerehabilitation. Preliminary research suggests that telehealth can improve patient satisfaction, overcome barriers to access to physical therapy services, and reduce costs of care for musculoskeletal injuries.
Currently, the foremost users of telehealth technology in the United States are the Department of Veterans Affairs, the Indian Health Service, and Kaiser Permanente. Worldwide, healthcare organizations in the United Kingdom, Australia, Canada, Italy, the Netherlands, Spain, and Poland use telerehabilitation to triage musculoskeletal conditions and provide coverage in areas lacking physical therapy providers.
As with other aspects of technology, regulation lags behind implementation. The FSBPT and APTA have released policy suggestions, summarized below.
- Identity verification for the patient should involve some form of photo ID, while state license databases should be used to verify a therapist’s identity.
- Therapists should be licensed in the state where the client is located and receiving telehealth services. This may involve multiple independent licensures, the use of the interstate compact, and legislature allowing for cross-border physical therapy.
- Clients should give informed consent to being photographed/recorded/videotaped, to that data being stored (with disclosures about how long they’ll be stored), a hold harmless clause for information lost because of technology failures, and acknowledgement of the limitations of telehealth services as compared to in-person ones.
- Standards of care do not and should not change with regards to licensure, professional discipline, best available evidence, and existing clinical practice guidelines.
- Physical therapy providers must comply with federal and state legal requirements including HIPAA, the HITECH Act, and GDPR.
- Remote physical therapists should have procedures to address technical, medical, or clinical emergencies that take into account a client’s emergency contact, local physician, and local first responders.
Relevance to Gaming:
Guess what PTs – telehealth is a viable method to interact with patients in the gaming community. This is especially true as we are living in a more virtual world with IOT. With an appropriate evaluation and treatment system along with video movement analysis we can provide the right care for our patients in gaming. While I agree there is absolutely no replacement for an in-person evaluation (as we can better assess emotional state around the injury and have a more accurate physical assessment of the injury) – we have been able to help many in our community fully address their injuries with telehealth.