Miskin integrating teletherapy 2If you’re a physical therapist during this COVID-19 pandemic, there’s a good chance you are already integrating teletherapy into your practice or will be soon. The staff at the RMUoHP Community Rehabilitation Clinic (CRC) have successfully utilized teletherapy into their daily routine. Here are five tips from CRC Director Coleby Clawson, PT, DPT, CSCS, and CRC physical therapist Crystal Miskin, PT, DPT, OCS, to you help ensure your use of teletherapy can be a success.    

1. Understand Local and State Teletherapy Laws

“Understand your local and state laws and regulations for performing and billing for teletherapy visits,” Clawson said. “Be sure you are using practices and software that abide by HIPAA regulations. If you plan to bill insurance companies for your teletherapy visits, make sure that insurance companies reimburse for teletherapy visits. “

2. Find a Reliable Teletherapy Software Platform

“We experimented with several different software programs before deciding on Google Meets. Many patients already have Google accounts, and it allows us to share content, as well as share our computer screens for educational content,” said Clawson.

Miskin integrating teletherapy

With virtual technology, Miskin adds, “Remember the patient sees you through your camera, not your screen. 

If you don’t use a built-in webcam, set up the camera close to your screen. When talking, look at the camera rather than the screen. This best replicates ‘eye contact’ and presents a more personal experience.”

Miskin also said the environment of the appointment is important. “Conduct the telehealth visit in a quiet, distraction-free environment. This will help ensure that the visit will best replicate an in-person interaction in which you and the patient are fully present for the visit.”

3. Help the Patients Understand the Teletherapy Technology

Miskin said, “If you have additional time or support staff available, complete a rehearsal call with the patient prior to the visit. By completing set up and sorting out technical issues prior to the visit, the visit can be conducted as smoothly as possible.”

Clawson explained, “We use our office staff to help get patients familiarized with the technology and the flow of the visit before the teletherapy appointment so we can hit the ground running.”

Overall, it’s important to be patient and supportive, said Miskin. “The patient may not have the best setup, and you may not be able to see them. Troubleshoot appropriately, and provide meaningful feedback in order to ensure a successful visit.”

Miskin adds that communication is key. “If you will be documenting during the session, advise the patient that you will be documenting in order to accurately record the patient’s perspective and plan of care. Since they cannot see you, patients may perceive your documenting as being distracted and not being present for the visit.”

4. Understand the Benefits and Limitations of Virtual PT

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It can be difficult for patients (and other providers) to understand how physical therapy can be done virtually.

Despite the barriers and challenges, Clawson said, “Many issues can be helped or solved virtually. Just as an example, I received three calls just this week from family and neighbors seeking advice for their ailments over the phone. For more complex conditions or problems that require a hands-on approach, we do our best virtually, then put them on a waiting list for an in-person visit.”

5. Be Creative with Teletherapy

“Let’s be honest,” said Clawson, “teletherapy visits aren’t as good as an in-person visit, so you have to learn to be creative for your patients. We have learned creative ways to examine patients, demonstrate exercises, correct technique, and show videos and educational content through screen sharing.”

He adds, “For patients that need exercise equipment such as a theraband, we have established a pick-up location at the clinic where they can obtain equipment while maintaining social distancing guidelines. We even have language interpreters join our visits as a third party for patients with a language barrier. Technology is awesome; sometimes you just have to think outside of the norm to solve problems and make teletherapy work!”

Miskin added, “Telehealth is a new experience for many patients and providers. It may not be perfect every time. That’s okay! Simply, do the best you can.”