When is telehealth the right option?
Is providing telehealth right for you and your therapy company?
As providers, patients, and payers look for more cost-effective and efficient ways to provide health care, some are turning to telehealth as an option. Telehealth involves using electronic communication to provide healthcare information and services to a remote location. These services can include physical therapy.
Telehealth has developed mostly in rural areas as a response to long distances between patients and providers, but is also being considered in other geographic and clinical settings. It includes telemedicine consultations with physicians and nurses and telerehab consultations with physical, occupational and speech therapists.
Proponents say telehealth has the potential to enhance healthcare, public health and health education delivery and support using telecommunication devices. At present, telehealth is not covered by Medicare, though national organizations representing occupational, physical and speech therapy are working toward gaining government approval. Telehealth can be an especially helpful option in rural areas where few therapists are available.
As the cost of bringing therapists to rural areas or asking patients to travel long distances to find therapy services can be astronomical, telehealth can be an important tool to help reduce costs. Pilot studies about telehealth reveal promising results. A recent article in the Journal of Bone Joint Surgery shows patients who received knee surgery increased compliance with rehabilitation instructions when telehealth was a factor in their recoveries.
As with any new procedure in the healthcare arena, we will need to wait for all of the pilots and grants to be completed and analyzed before we are ready to begin providing this type of care. It could take a few years to become a common practice, but is worth the wait if it helps accommodate more patients in need of care.
The opportunities that present dilemmas for this practice include, but are not limited to, the following:
- Cost of equipment and connections
- Patients' understanding of how to work with electronic equipment/technology
- Adherence to HIPAA standards
- Liability insurance
Therefore, therapy and rehabilitation companies have to apply rules and regulations to telehealth practices to make sure we are in compliance with government agencies. Once that is done, I believe the opportunities are endless for delivery of patient care. Looking at the manner in which we educate our therapists and the manner in which we attain great outcomes, I am confident we can connect our protocols to this new phase of therapy.
Now is the prime time for organizations to get involved and add to the already growing field of knowledge that surrounds telehealth therapy. Universities and larger therapy providers are leading the way through grants and pilot programs to determine the best equipment, the most appropriate patients to receive telehealth care and expected outcomes.
It is also important to note that telehealth is not always appropriate. Patients need to be able to readily access a computer and connection to the provider. They should have the cognitive capability to follow directions provided by therapists.
Patients should also have the ability to judge when they are in too much pain or pushing too hard, in accordance with therapy guidelines. All are important characteristics that I feel patients receiving telerehab should demonstrate. Because telehealth is a very patient-driven type of delivery, patients need to be motivated.
While we wait to see if telehealth will become a routine way of providing therapy services, we have to begin conversations with state and federal licensing associations and boards to make sure they are aware of the benefits telehealth can provide. It is only through our concerted efforts that we can further advocate for the needs of patients who seek quality care at a reasonable cost.
CEO/President Kristy Brown brings more than 25 years of management experience to Centrex Rehab. Brown was the executive director of therapy services at Augustana Therapy Services between 1999 and 2012. A speech language pathologist by training, she developed a passion for management soon after graduating and sought to positively affect patient care.