Covid-19 flooded the world like a tsunami. There were signs of it coming, but when it arrived we were hit and we were hit hard. From one day to the next strict social distancing was the new norm. al. Schools and shops were closed , and work from home was mandatory in most cases. Physiotherapy practices had to close. So we had to adapt to a new reality overnight.
This blog differs from my other blogs because I will not discuss specific scientific research but will write about ‘the uptake of telehealth by physiotherapists during the corona crisis’. My aim is to invite you to share your thoughts, experiences and tips regarding the use of telehealth in the comments below and learn and help each other! Please use this as a discussion blog.
Five years ago I attended a fully booked workshop about telehealth during the annual conference of the Dutch association for physiotherapy. An enthusiastic physiotherapist who was already using telehealth showed us the possibilities. Was this the beginning of a paradigm shift in healthcare? Not at that time – I think – because telehealth was still only used by a few colleagues.
Due to covid-19 face-to-face contact was avoided as much a possible all over the world. Physiotherapists had to adopt to telehealth quickly as a new way to provide continuous care for our patients and in addition protect themselves for loss of income.
A quick search on PubMed resulted literally in hundreds of articles published between march and today regarding physiotherapy and covid-19. I dived in deeper and selected those regarding telehealth to help me write this blog. You can find them in the description down below. I live in The Netherlands so that is my reference. Due to the fact that the healthcare systems, reimbursement and last but not least internet accessibility is different country by country, not all (that) I discuss might be applicable for your situation.
I will first discuss barriers regarding the uptake of telehealth. Then I will discuss some practical and important issues to consider.
So why was the uptake of telehealth before covid-19 so slow? There are several factors (barriers) that contributed like:
ue to covid-19 telehealth was implemented rapidly. In The Netherlands like many countries in Europe face-to-face treatment is at the moment allowed again. However, local lockdown can be necessary in case of a new rise in infections. Therefore, I think it is time to evaluate and consider if there is a place for telehealth in treating patients as part of usual care in the future.
Telehealth can be offered for instance as a stand-alone but also in a hybrid form. In a hybrid form some consultations can be face-to-face and some with telehealth. We know from evidence that a lot of women do not know how to contract their pelvic floor muscles properly so investigation of the pelvic floor and good instruction is important. But choosing for telehealth can also depend on the complexity and a lot of other issues. Another issue that we should not forget is; reimbursement!
It is not within the scope of this blog to discuss how to choose the appropriate telehealth software.
However, I would like to emphasize some important issues:
- Does the telehealth software of your choice meets your national privacy and security regulations.
- Does your insurance policy covers (liability) telehealth
- Check if and if yes, how you need to get patient consent for the telehealth consultation (patients always need to get information on what telehealth is, the difference with face-to-face consultations, advantage(s) and disadvantage(s)
Will covid-19 and result in a paradigm shift? Could telehealth contribute to avoid unnecessary and costly health-care ?
What do you think? Your comments are highly appreciated so feel free to leave your comment down below.
Cottrell MA, Russell TG. Telehealth for musculoskeletal physiotherapy. Musculoskelet Sci Pract. 2020 Aug;48:102193. doi: 10.1016/j.msksp.2020.102193. Epub 2020 May 30. PMID: 32560876 Free PMC article.
Lee A. COVID-19 and the Advancement of Digital Physical Therapist Practice and Telehealth. Phys Ther. 2020 Apr 28:pzaa079. doi: 10.1093/ptj/pzaa079. Online ahead of print. PMID: 32343836 Free PMC article.
Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer? Phys Ther. 2020 May 8:pzaa093. doi: 10.1093/ptj/pzaa093. Online ahead of print.PMID: 32386218 Free PMC article.