What is TeleTherapy?
TeleTherapy is defined as the use of telecommunication technology to provide professional clinical services at a distance by connecting the clinician to a client or patient for evaluation, treatment, or consultation.
TeleTherapy is a subset of an wider term: TeleHealth. Many insurance companies offer a “Call a Doctor” or “Call a Nurse” feature within their plans, which connects someone immediately to a healthcare provider without the need to travel to a clinic. For routine issues such as sore throats, ear infections, skin conditions, and UTIs, this is is a very cost effective way to provide care.
TeleHealth in Rehabilitation
A growing trend in rehabilitation services (Physical, Occupational, and Speech Therapy) is the use of TeleTherapy for diagnosing and treating patient. Unfortunately, the major insurance companies do not cover TeleHealth services for Physical Therapy. So therapists who provide telehealth services may do so in a consulting role or provide their services in a self-pay setup.
TeleTherapy for Physical Therapy
As a PT, I use movement assessments to guide my diagnosis and treatment. By observing the movement patterns of someone, I can tell if they may be limited due to weakness in a certain muscle group or instability in another muscle. Through specific exercises, we can help to stabilize when necessary and strengthen or stretch when it’s appropriate.
Most of my assessment is visual and most of my treatment is provided with verbal instructions.
This type of treatment model could work great for TeleHealth (which is the argument by PTs and OTs who want to pursue TeleHealth).
Personally, I can see the benefits of providing Physical Therapy online.
- Patient convenience: avoid taking off or traveling to a clinic
- Immediate care: More convenient times for patients
- One on One Care: You speak directly to a therapist, not a tech or assistant
Does Physical Therapy TeleHealth Work?
As a Physical Therapist, I’ve personally used Skype to connect with a family member who had hip pain. We reviewed movements that bothered her hip and I instructed her on exercises that would help strengthen and stabilize her hip. We also reviewed stretches to address stiffness in other areas.
I was able to provide advice based on the movement patterns and symptom patterns she demonstrated with squatting and other special tests. She was experiencing a simple strain of the hip flexor muscle and the exercises and stretches helped to resolve her issue within a couple of weeks.
I absolutely know that certain people can resolve musculoskeletal pain through TeleHealth PT. However, I also realize there are limitations to providing care online.
Limitations of Telehealth
- Unable to provide hands on assessment
- You have to give very clear instruction without physical cueing
- A stationary camera is difficult to assess all angles of movement
- Unable to perform a standard strength or ROM assessment
- Not covered by insurance; patient must pay out of pocket
I think there is a place for Physical and Occupational Therapists to perform TeleHealth, but the population who will pay for these services is very narrow right now. It can be done, but it would take substantial marketing to educate the general public about such an option.
While I personally would not pursue any TeleHealth Physical Therapy jobs, I am optimistic about one subset of TeleRehab, and that’s Speech TeleTherapy.
Speech TeleTherapy
A Speech Language Pathologist (or SLP) provides assessment and treatment for speech, language, cognitive-communication, and swallowing disorders in children and adults.
The nature of their work fits perfectly in a TeleHealth setting as Speech Therapists can provide nearly all of their treatments without physically touching a patient.
By connecting through a face to face video call, Speech Therapists can bring convenience and personalized treatment to their patients regardless of location or time zone.
Benefits of Speech TeleTherapy
- Reach patients who don’t have access to Speech Therapists
- Ability to treat more patients through improved scheduling
- Improved quality through online resources.
TeleHealth continues to develop and evolve for SLPs, expanding into online interactive lessons with the therapist interacting with the patient at the same time.
For children, I can see this being a valuable, non-invasive approach to treatment as kids are very comfortable with tablets and computers starting at a very young age. In a live clinical setting, the child may experience greater apprehension or nervousness compared to interacting with a therapist on their computer screen at home.
Here are some great tools for SLPs to use in providing TeleHealth services.
Screen Sharing and Interactive Tools
Types of TeleTherapy Jobs
As this area of rehabilitation develops, you can expect to see multiple companies offer TeleTherapy as a part of their rehab services.
While a full-time TeleHealth position may be few are far between right now for PTs and OTs, I think the market for SLPs will continue to grow at a fast pace.
Keep an eye out for TeleHealth jobs for PTs, OT, SLPs, and even nurses as the technology develops and insurance companies see the value of these services. Use our therapy job board to find these types of positions as they become available.
As for now, TeleHealth an area of rehab that can be very well received for the right patient. Making it an available service within your practice is a good idea for therapists who want to grow outside the traditional clinic model.
What are your thoughts? Why d you think TeleHealth will work, or not work for that matter?