Telehealth Rehabilitation

This blog article focuses on how telehealth is impacting two independent physical therapy clinics.

I recently had the privilege of interviewing two physical therapy private practice owners, Emily Wilson, New Seasons PT, and Leonard Van Gelder, Dynamic Movement and Recovery. To watch a recording of my interview on our YouTube channel, click here.

Emily and Leonard share how telehealth is providing benefits to their patients and challenging the clinicians to learn new skills. They also share their plan for telehealth moving forward.

On April 30, CMS announced telehealth is available for PT, OT and SLP.

The APTA provides resources on the specifics of CMS regulations regarding providing telehealth services. The APTA also provides a summary list of telehealth regulations per state including active links to your state’s information. Each state provides regulatory guidance on whether or not PT, OT and SLP can practice telehealth. Please see your state chapter for additional information. If your state allows telehealth another great resource from the APTA is a Youtube video interview with live questions titled, “Medicare Telehealth for Physical Therapists 5.7.20”

Telehealth Barriers

Before we jump into the benefits of telehealth both clinicians reported there are barriers to starting telehealth services.

First, you will need to build your own telehealth tool before you can

use it. Both owners recommended researching and trialing different providers to see which telehealth provider works best for you.

Each clinic will also need to build systems to support telehealth. For example, all paper systems (intake forms, etc.) will need to be converted to electronic.

Leonard also suggested identifying a telehealth partner that is scalable if you anticipate significant growth.

Although current regulations do not require a service to be HIPPA compliant both clinicians recommend a service provider that is HIPAA compliant. In addition, at times technology is too much of a barrier for some patients. A segment of the population will prefer in-person visits. Another segment of the population may not own the necessary technology or may not have the ability to use technology to participate.

Patient Feedback

Emily and Leonard both spoke highly of the positive patient feedback regarding telehealth.

First, both reported that patients appreciate the flexibility of the schedule. It opens up more opportunities for patients to schedule.

Second, patients report it is more convenient not to have to drive to the facility.

Third, patients also appreciate the decreased exposure to Covid-19 provided by a telehealth visit.

They also reported that telehealth is also enhancing their practice in ways they did not anticipate. Both clinicians reported the benefit of seeing the patient function in their own environment.

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“It was so helpful to see a patient lift their child in and out of the car seat, made possible only from the fact that the visit was done virtually in the patient’s home,” said Emily.

Telehealth removes the therapists’ hands from the assessment and treatment which is dramatically different than in-person visits. One of our tools as educators – our hands – has been removed from the learning environment.

This reality challenges the clinician to engage the patient more in their own rehab and self-learning. For example, instead of the therapist putting their hands on the patient to guide or facilitate the movement, now the patient is walked through how to feel the muscle firing or facilitation for himself/herself.

Telehealth provides an opportunity for the clinician to gain valuable teaching experience of how to communicate with their patients. In addition, the patient benefits because they are gaining valuable insight into how to facilitate their own healing.

Is Telehealth Here To Stay?

Both PTs I interviewed gave a resounding YES. Both anticipate that CMS will permanently allow PT, OT and SLP to practice telehealth. I also asked them what percentage would they utilize telehealth visits vs. traditional in-person visits. Both suggested that they anticipate approximately 50% of their visits will be through telehealth, with each patient potentially receiving a mix of in-person and telehealth rehabilitation services.

In summary, both PTs believe that overall telehealth presents an opportunity to improve the delivery of rehabilitation services. And believe telehealth for rehabilitation is here to stay. I also agree it will be hard for CMS to “put the genie back in the bottle.”

However, I believe that we will need to prove ourselves worthy as rehabilitation professionals to keep this privilege. In an APTA video podcast on telehealth dated May 7, one of the presenters stated that we are currently in “a large pilot study for telehealth….and CMS will evaluate the data.”

The presenter continued, “our goal as clinicians is to document comprehensively to show that telehealth rehabilitation is effective and high quality.”

In other words, as rehab professionals, we have a responsibility to utilize this tool effectively and document thoroughly so we do not lose the privilege!

I would love to hear your comments on telehealth and how it has impacted your clinic, or your plan plans to utilize telehealth.

Covid-19 and Outpatient Physical Therapy: How Private Practice Owners are Coping was last modified: by

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