Next we had Alan Lee present on Telehealth in Physical Therapy Practice
He started be explaining what words are being used that all follow under the telehealth umbrella: telemedicine, telenursing, tele-mental health, telerehabilitation (where PT and OT fit, telepractice (SLP). Then there are also apps for monitoring. There are 4 different telehealth models. The largest has a hub which houses all the specialists and rural sites call in for instructions on what to do with their patients. The second is a multi-site model which is similar to the first, only there are several “hubs” with specialists. There’s the for-profit model that does this for exorbitant amounts of money. And finally there is the hubless model which is basically a private practice. The reason medical system in particular are implementing telehealth is cost savings. However, when considering this type of business plan, you must look at the tech costs you will incur. There are also standards/guidelines on telehealth that must be adhered to. Need to make sure your patient gives you verbal consent and check the laws regarding licensure in telehealth. There are also laws and ethical considerations around liability insurance when providing telehealth and you would need to look at how you would handle an emergency during a telehealth visit. And finally, contact your insurance and provider networks to see what they reimburse. Medicare does not currently reimburse for telehealth. Please click here and here to see laws the govern telehealth currently and for more information on all those things that need to be considered before diving into telehealth.
In some of the question/answer time and in the case presentations, several clinicians brought up that they are using telehealth practically to follow-up with patients after they have been discharged from the clinic once per week to see how they are getting along with their home exercise program. Another mentioned using it as part of an eval prior to coming to the clinic to get the history portion down. Others mentioned using it in rural areas. I think it was Sweden they had telehealth kiosks set up in a mall where a patient would be guided on what exercises to do by a computer which had been pre-loaded with exercises remotely. Then the therapist would check in once a week to adjust the exercises as necessary. Interesting applications.