The Basics of Telehealth Assessment and Treatment: Difference between revisions
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== Practice using different platforms: == | == Practice using different platforms: == | ||
Tele-Rehabilitation requires a strong platform that offers competent technical and technological services. and technological support. In today's world many platforms offer such services. | |||
== Technical support practice == | == Technical support practice == | ||
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Instruct patients how to do ROM, with How and order of the tests and patient movements | Instruct patients how to do ROM, with How and order of the tests and patient movements | ||
Teach patients to perform- | '''Teach patients to perform the exercise:'''- There are multiple ways to teach a patient a particular exercise and continually monitor as it is done in a face to face rehabilitation session. These methods can be followed with family members assisting whenever required | ||
* Prerecorded video | |||
* Online video demonstration | |||
* Display of visual feedback | |||
* Video conferencing | |||
* Sensors embedded in task devices if they are available can track and relay information to the therapist<ref>Brennan DM, Lum PS, Uswatte G, Taub E, Gilmore BM, Barman J. A telerehabilitation platform for home-based automated therapy of arm function. Conf Proc IEEE Eng Med Biol Soc 2011 Sep 3 (pp. 1819-1822). IEEE.</ref> | |||
* Family member to assist if needed like with passive ROM | |||
Tests that are not safe to perform. Replace with another test or additional questioning or rather in-person. | Tests that are not safe to perform. Replace with another test or additional questioning or rather in-person. | ||
Revision as of 16:48, 17 May 2020
Practice using different platforms:[edit | edit source]
Tele-Rehabilitation requires a strong platform that offers competent technical and technological services. and technological support. In today's world many platforms offer such services.
Technical support practice[edit | edit source]
Guidelines for Consultations:[edit | edit source]
It is always considered better to
Before the Consultation |
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Start of the consultation |
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The consultation |
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Closing the consultaion |
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After the consultation |
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Initial assessment:[edit | edit source]
Be prepared
Develop a list you want to ask
List of key tests you want to perform
Your focus in on technology so a list is good
Observation: Additional questions instead of your observation skills
Examination:
Safety is priority: Before we venture into the technicalities of this section it is important to understand that safety f the client is and must be the prime concern of every therapist. In the unlikely event that something goes wrong, a therapist must be able to reach out to the patient or have a system in place
Camera placement: The placement must give a good view of the client. This can be done by a few trial placement areas tried out in the subjects vicinity (EG: on a table ,adjusting the tilt of the laptop or placing the ipad on a stand that is aligned to give a good view of the client a he/she performs what is asked of him/her.
Adaptations for examinations:
Adaptations for usual tests.
Instruct patients how to do ROM, with How and order of the tests and patient movements
Teach patients to perform the exercise:- There are multiple ways to teach a patient a particular exercise and continually monitor as it is done in a face to face rehabilitation session. These methods can be followed with family members assisting whenever required
- Prerecorded video
- Online video demonstration
- Display of visual feedback
- Video conferencing
- Sensors embedded in task devices if they are available can track and relay information to the therapist[2]
- Family member to assist if needed like with passive ROM
Tests that are not safe to perform. Replace with another test or additional questioning or rather in-person.
- Exclude all reg flags
- Rationale if a referral is necessary
- identifying a support network of seniors or experts in the field who can advice and assist at any stage required. This channel needs to be active and the clinicians must be able to contact , as an when necessary
- The contact details shouldn't be kept confidential, it would even be recommended to get seperate lines and contact ids for this purpose, after the consultation the numbers must be deleted or stored only i the official records[3]
Always maintain the records of the patients
Reduce the amount of identifiable patient details that you share digitally
Assessment needs:
Empowerment of the patient
Individually tailored
Not recommended to assess:[edit | edit source]
Assessing high risk patient or patients with potentially high risk conditions
Patients with internal examination including any pelvic area examination
Coniditions or comorbidities affecting the ability to us technology including delusion, anxieties about using tecnology
Deaf and dumb individuals, may be difficulat , however the use of assitive technolgy may aid the process
Recommendations to the Organizers[edit | edit source]
Telehealth networks must be establishes, preferably standardized software or systems
Consulting and refereeing sites must be made available , probably like a smaller unit for immediate consultation when required
Standardized, goal oriented and time driven protocols must be in place for the efficient delivery of rehabilitation services specially in he acute phase
Continuing education and mock simulation conditions are suggested to continually train and update professionals offering services[4]
Telerehablitation includes one mode of communication. In fact to optimize results and to evaluate adherence , multiple modes of of communication may be necessary, like video conferencing, telephone, desktop video phones, messaging devices, online chat sessions, video recordings, email.[5]
Patient guide:[edit | edit source]
- Decide what type of a consultation you would like or need (telephone consultation works well if a video isn't necessary). Video consultations are more reassuring due to the visual feedback.
- Ensure your details last updated at the hospital are your current details (email id, phone number). locate a quite place, with good connectivity to the internet. test the device you will be using prior to the consultation. Make sure the Physical therapist has your credential details to know it is you and to respond timely. Login to the connection a few minutes prior to the consultation
- During the process of the consultation, you can look at the screen, it isn't mandatory to look at the camera as this may be difficult. Any questions that require verification can be clarified. If the connection is disrupted in between , reconnect the call
- Make sure to follow u on anything you have agreed to.
Evidences:[edit | edit source]
- Stroke rehabilitation: Quality of life, activities of daily living and upper limb function improved in the same capacity as that of face to face rehabilitation. No adverse events reported with the practice of telerehablitation,[5]
- ↑ Specialty guides for patient management during the coronavirus pandemic. Clinical guide for the management of remote consultations and remote working in secondary care during the coronavirus pandemic. NHS Report number: 001559 [27/03/2020]
- ↑ Brennan DM, Lum PS, Uswatte G, Taub E, Gilmore BM, Barman J. A telerehabilitation platform for home-based automated therapy of arm function. Conf Proc IEEE Eng Med Biol Soc 2011 Sep 3 (pp. 1819-1822). IEEE.
- ↑ Chartered Society of Physiotherapy. Telephone Guidance from Musculoskeletal Practise. Avaialable from: https://www.csp.org.uk/news/coronavirus/remote-service-delivery-options/telephone-guidance-msk-practice
- ↑ Blacquiere D, Lindsay MP, Foley N, Taralson C, Alcock S, Balg C, Bhogal S, Cole J, Eustace M, Gallagher P, Ghanem A. Canadian stroke best practice recommendations: Telestroke best practice guidelines update 2017. Int J Stroke. 2017 Oct;12(8):886-95.
- ↑ 5.0 5.1 Laver KE, Schoene D, Crotty M, George S, Lannin NA, Sherrington C. Telerehabilitation services for stroke. Cochrane Database of Syst Rev. 2013(12).