Practical Considerations in Telehealth: Difference between revisions

No edit summary
No edit summary
Line 2: Line 2:


== Introduction to Telehealth ==
== Introduction to Telehealth ==
The ubiquitous nature of technology in our daily lives has paved the way for the development of alternative methods of healthcare delivery. Telehealth is an effective "next-gen" solution that helps clients receive equivalent if not better care than traditional practices.<ref>Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clinical rehabilitation. 2017 May;31(5):625-38.</ref><ref>Van Egmond MA, van der Schaaf M, Vredeveld T, Vollenbroek-Hutten MM, van Berge Henegouwen MI, Klinkenbijl JH, et al. Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy. 2018 Sep 1;104(3):277-98.</ref><ref>Chumbler NR, Quigley P, Li X, Morey M, Rose D, Sanford J, et al. Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial. Stroke. 2012 Aug;43(8):2168-74.</ref> In order to ensure the most effective, safe, and responsible delivery of physiotherapy services through the means of telehealth, some prerequisites need to be met.
The ubiquitous nature of technology in our daily lives has paved the way for the development of alternative methods of healthcare delivery. Telehealth is an effective "next-gen" solution that helps clients receive equivalent if not better care than traditional practices.<ref>Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clinical rehabilitation. 2017 May;31(5):625-38.</ref><ref>Van Egmond MA, van der Schaaf M, Vredeveld T, Vollenbroek-Hutten MM, van Berge Henegouwen MI, Klinkenbijl JH, et al. Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy. 2018 Sep 1;104(3):277-98.</ref><ref>Chumbler NR, Quigley P, Li X, Morey M, Rose D, Sanford J, et al. Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial. Stroke. 2012 Aug;43(8):2168-74.</ref> To ensure the most effective, safe, and responsible delivery of physiotherapy services through the means of telehealth, some prerequisites need to be met.


== Overview of Practical Considerations in Telehealth ==
== Overview of Practical Considerations in Telehealth ==
The patient and therapist need access to the appropriate technology
There are four domains that need to be considered to ensure the appropriate delivery and consumption of telehealth services.
 
=== Technology ===
The patient and therapist would both need access to the appropriate technology to enable telehealth. They must include all components mentioned below.
 
Internet connectivity
 
Camera
 
Microphone
 
Software
 
=== Environment ===
The role of the environment must not be undermined. The following recommendations will assist in making the necessary modifications in your set-up.
 
Decor, client's clothing must not interfere
 
Noise
 
Lighting
 
=== Therapist ===
The therapist is the facilitator and therefore can either make or break the process.
 
Bedside manner
 
Assessment
 
Safety
 
Client selection
 
Tech literate
 
=== Client ===
The client must fully understand the telehealth model and decide for himself whether it is the appropriate delivery method for him.
 
Consent
 
Data privacy
 
Role of caregivers
 
Financial
 
Ethical


* Video: minimum requirements device with microphone and camera and a stable internet connection
* Video: minimum requirements device with microphone and camera and a stable internet connection
Line 22: Line 68:
* Continually ask patient to reposition the camera and themselves - get the patient position right
* Continually ask patient to reposition the camera and themselves - get the patient position right
* Position yourself to avoid mistakes with goniometry assessment.
* Position yourself to avoid mistakes with goniometry assessment.
{{#ev:youtube|XRlrxg0O_gI}}
 
These videos will assist you in designing your own telehealth sessions.{{#ev:youtube|XRlrxg0O_gI}}
{{#ev:youtube|Sl8WQmTH1LU}}
{{#ev:youtube|Sl8WQmTH1LU}}
{{#ev:youtube|h4EbzgcPO1M}}
{{#ev:youtube|h4EbzgcPO1M}}

Revision as of 19:09, 10 May 2020

Introduction to Telehealth[edit | edit source]

The ubiquitous nature of technology in our daily lives has paved the way for the development of alternative methods of healthcare delivery. Telehealth is an effective "next-gen" solution that helps clients receive equivalent if not better care than traditional practices.[1][2][3] To ensure the most effective, safe, and responsible delivery of physiotherapy services through the means of telehealth, some prerequisites need to be met.

Overview of Practical Considerations in Telehealth[edit | edit source]

There are four domains that need to be considered to ensure the appropriate delivery and consumption of telehealth services.

Technology[edit | edit source]

The patient and therapist would both need access to the appropriate technology to enable telehealth. They must include all components mentioned below.

Internet connectivity

Camera

Microphone

Software

Environment[edit | edit source]

The role of the environment must not be undermined. The following recommendations will assist in making the necessary modifications in your set-up.

Decor, client's clothing must not interfere

Noise

Lighting

Therapist[edit | edit source]

The therapist is the facilitator and therefore can either make or break the process.

Bedside manner

Assessment

Safety

Client selection

Tech literate

Client[edit | edit source]

The client must fully understand the telehealth model and decide for himself whether it is the appropriate delivery method for him.

Consent

Data privacy

Role of caregivers

Financial

Ethical

  • Video: minimum requirements device with microphone and camera and a stable internet connection
  • Environment for both therapist and patient:
    • Space
    • Clear form clutter
    • Private
    • Furniture required and how it should be arranged
    • Equipment required
  • Background: preferably stationary.
  • Lighting: clearly see your patient at all times.  Above or behind computer screen.  Close curtain and turn on the lights.  Work with patient
  • Noise: eliminate background noise, radio or television.  Headset with microphone useful for therapist.
  • Clothes the patient is wearing, light plain color
  • Position relative to the camera, front on.  Face and upper chest in view.  Are you looking at the patient or the camera. When demonstrating the action, position yourself correctly.
  • Continually ask patient to reposition the camera and themselves - get the patient position right
  • Position yourself to avoid mistakes with goniometry assessment.

These videos will assist you in designing your own telehealth sessions.

Resources[edit | edit source]

https://www.who.int/goe/publications/goe_telemedicine_2010.pdf

https://www.wcpt.org/sites/wcpt.org/files/files/congress/19/Presentations/WCPT-06.pdf

http://www.apta.org/Telehealth/

https://www.apta.org/Telehealth/Implementation/

http://www.apta.org/Telehealth/COVID-19/Modalities/

https://australian.physio/sites/default/files/APATelehealthGuidelinesCOVID190420FA.pdf

https://www.racp.edu.au/docs/default-source/advocacy-library/telehealth-guidelines-and-practical-tips.pdf

https://www.caot.ca/document/7171/Practical%20Considerations%20for%20OTs%20and%20Telehealth_covid19_March25.pdf

https://www.gtlaw.com/-/media/files/insights/published-articles/020810_new-york-law-journal-telemedicine-legal-and-practical-considerations.pdf

https://www.running-physio.com/telehealth

References[edit | edit source]

  1. Cottrell MA, Galea OA, O’Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clinical rehabilitation. 2017 May;31(5):625-38.
  2. Van Egmond MA, van der Schaaf M, Vredeveld T, Vollenbroek-Hutten MM, van Berge Henegouwen MI, Klinkenbijl JH, et al. Effectiveness of physiotherapy with telerehabilitation in surgical patients: a systematic review and meta-analysis. Physiotherapy. 2018 Sep 1;104(3):277-98.
  3. Chumbler NR, Quigley P, Li X, Morey M, Rose D, Sanford J, et al. Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial. Stroke. 2012 Aug;43(8):2168-74.