Smart application of the telehealth trend can provide clear benefits to physical therapists and patients, but there are still some significant challenges to widespread adoption.

Imagine you’ve suffered a recent musculoskeletal injury. You’re doing at-home exercises daily, but you’re worried your form may be off. What if instead of driving into the office, all you had to do was reach for your smartphone to videoconference with your therapist?

Advances in technology—in addition to growing needs prompted by the Affordable Care Act and an aging population—have telehealth projected to grow to 1.8 million users worldwide by 2017, according to the World Market of Telehealth. Now, telerehabilitation is becoming a viable option for physical therapists who want to supplement hands-on therapy with remote offerings such as online exercise demos, workout supervision, and secure patient communication tools.

How Telehealth is Changing Physical Therapy

How could telehealth stand in for the hands-on therapy and face-to-face communication integral to successful musculoskeletal treatment? The answer is, simple: it can’t.

Not all patient-provider interactions are currently translatable to telepractice. For instance, massage and manual manipulations are undeniably in-person treatment methods (although solutions like Microsoft Kinect, which uses a 3D motion sensor to allow patients and therapists to interact in real time, may soon change that).

While telehealth may never replace therapy appointments, the accessibility and convenience of a virtual therapist visit make it an ideal option for follow-up treatment, home treatment plans, questions and answers, and consultations with specialists.

Let’s look at few of the primary advantages this method of therapy has to offer.

• Cost and time savings: The incorporation of telerehabilitation into traditional care plans may allow PTs to develop more time-efficient and less costly care models. Electronic check-ins save patients the trip to and from their therapist’s office, which can be a significant return to their pocketbook—especially in rural areas.
• Flexibility: With the ability to facilitate patient-provider interactions remotely, telerehabilitation can connect patients with hard-to-find specialists that may be located hours away. It also allows therapists to deliver care in a more flexible way, even allowing some patients who are typically seen in clinical or hospital settings to be managed in their homes instead.
• Smoother care coordination: The option of checking in with your PT from home can strengthen the patient-therapist relationship, possibly even shortening the road to recovery. Additionally, telehealth can improve communication between providers, with potential benefits including quicker screening, assessment, and referrals for patients.

While it is clear how telehealth could bolster the rehabilitation process, there are still several barriers for physical therapists who want to offer virtual support services. Current challenges include:

• Hardware/software requirements: While many of the most common videoconferencing software programs don’t offer the level of security required by healthcare law, secure, HD platforms like GoToMeeting do comply with the Health Insurance Portability and Accountability Act (HIPAA) and allow for synchronous live video streaming, screen sharing, and shared presenter controls.
• Billing and coding issues: Telerehabilitation presents some coding complexities for physical therapists as billing codes have yet to adapt to telehealth activities. Some billing codes currently exist for PT telehealth, but they are not yet the standard and can vary depending on state and by insurer. Physical therapy has not yet been cited in federal legislation regarding telehealth services reimbursement.
• Legislation and regulations: Current law prohibits PTs from treating patients who live outside of the state in which the therapist is licensed. This precludes PTs from practicing across state lines—even in a virtual environment. Both the American Physical Therapy Association and the Federation of State Boards of Physical Therapy are working toward defining and eventually altering legislation to facilitate more widespread adoption of telehealth.

Could virtual PT become a mainstream piece of the recovery process? Quite possibly. But until legislations and regulations catch up to advancing technologies and growing patient demand, we must rely on innovative physical therapists to find a way to make telehealth work within the given parameters, to demonstrate the value it delivers to their patients, and to blaze a trail for this much-needed form of support in the rehabilitation world.

Bibliography

“APTA 2014 Recap: Forging Ahead with Telehealth: A Roadmap for Physical Therapists,” last modified February 11, 2014, http://wellpepper.com/apta-2014-recap-forging-ahead-with-telehealth-a-roadmap-for-physical-therapists.

“Telehealth,” last modified September 8, 2015, http://www.apta.org/Telehealth/.

“Telehealth in PT: Expanding Possibilities,” last modified March 31, 2015. https://www.webpt.com/blog/post/telehealth-in-pt-expanding-possibilities.

“Telerehabilitation: Will Telepractice Catch On for Occupational and Physical Therapy?” http://myptsolutions.com/telerehabilitation-telepractice-occupational-physical-therapy/.