Chapter 8: Telehealth for Physical and Occupational Therapy 1 Contact Hour
By: Pieter L. de Smidt, PT, DPT, Cert MDT, M TC, FMS-C Learning objectives After completing this course, the learner will be able to: Outline the purpose and benefits of telehealth for physical and occupational therapy. Identify what types of patients are appropriate for telehealth. Outline how to perform a remote telehealth evaluation. Course overview The COVID-19 pandemic demands that health care providers rethink how they deliver care in ways that reduce the risk of further spreading infection. The use of telehealth is one approach that can help keep both patients and providers safe. Telehealth for Physical and Occupational Therapy is administered virtually, through a secure, HIPAA-compliant platform. This platform is usually accessed through a device such as a smartphone, tablet, or computer. Telehealth affords us the unique ability to approach patients from a true biopsychosocial approach, encompassing a systematic consideration of the biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery. Regardless of the payer or policy, PTs/OTs and PTAs/OTAs must ensure that when providing telehealth services or billing for them, they are practicing legally and ethically and are adhering to state and federal practice guidelines and payer contract agreements. Practitioners will need to review and understand their state’s practice act regarding the delivery of physical or occupational therapy services via telehealth. The Health Resources Services Administration defines telehealth as: The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications. Interactive versus asynchronous systems Interactive audio and video telecommunications systems enable providers and patients to communicate in an interactive environment. The provider and patient can see and hear each other, so that two-way communication can take place. In addition, documents, computer-displayed information, and whiteboards can be shared (Majerowicz & Tracy, 2010). The Biopsychosocial (BPS) model and telehealth In the virtual world, sheer practicality dictates the need to spend added time on psychosocial aspects. With the majority, if not all, of patient interaction occurring virtually, much of your approach as a therapist is determined via asking questions and receiving feedback from the patient. The platform demands a focus on communication, especially with the one-on-one nature Pain science education and telehealth Pain science education places the most up-to-date research and information at our fingertips as we attempt to explain our
Describe the importance of pain science education and how it relates to successful patient outcomes when treating via telehealth. Relate the biopsychosocial (BPS) model and how it impacts both evaluation and patient follow-through for telehealth services. Explain when imaging or a referral to a physician is indicated. The American Physical Therapy Association ( APTA) and American Occupational Therapy Association (AOTA) recommend that physical and occupational therapists use their discretion as to the nature and frequency of using telehealth, and do so within their scope of practice while abiding by any state practice act restrictions as well as their obligations to their profession (APTA, n.d.; Estes, 2017). Telehealth provision or use does not alter a covered entity’s obligations under the Health Insurance Portability and Accountability Act (HIPAA), nor does HIPAA contain a section devoted to telehealth (U.S. Department of Health and Human Services, n.d.). Therefore, if a covered entity is utilizing telehealth that involves protected health information (PHI), the entity must meet the same HIPAA requirements that it would if the service were provided in-person. This beginner’s level course will teach practitioners how to set up and complete telehealth sessions for a physical or occupational therapy practice, primarily focusing on how to evaluate, monitor, and treat patients remotely.
TELEHEALTH DEFINED
Telehealth is different from telemedicine because it refers to a broader scope of remote health care services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non- clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. (HealthIT.gov, n.d.)
Asynchronous, or store and forward, applications involve the use of a camera (e.g., audio clips, video clips, still images) to record (store) an image that is transmitted (forwarded) to another site for review at a later time (Majerowicz & Tracy, 2010).
of sessions. In-person visits provide the opportunity for the therapist to observe patient reaction, physical movement, or lack thereof, and insightful body language that may not be available in the telehealth setting. Thus, we are ideally situated to utilize the BPS model with the appropriate shift to psychosocial considerations, creating a truly integrated approach.
patients’ pain. Why are you experiencing pain, what is causing your pain, and what can you personally do about it?
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Book Code: PTNY3622B
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