The COVID-19 pandemic is still upon us, meaning we must continue to be creative about how to bring the care and services our patients need in a safe and effective way. Through outpatient telehealth services at Patricia Neal Rehabilitation Center, patients still benefit from our excellent care while staying safe at home. In order to understand how the outpatient telehealth process works, we sat down with Director of Therapy Operations Christy Williams to learn more.
What services are offered via telehealth?
Wheelchair Seating/Mobility Evaluations: A specialty-trained physical therapist assesses a patient for customized power or manual wheelchairs. During a telehealth visit, an assistive technology provider (ATP) travels to the patient’s home to assist the therapist with a seating evaluation through a tablet or smart device. The ATP is able to assess the patient’s home while there, addressing any barriers to mobility in a wheeled device.
Augmentative/Assistive Technology Evaluations: A specialty-trained speech therapist and occupational therapist assess the patient’s ability to use technology to support, enhance and supplement communication when he/she is unable to speak independently. During a telehealth visit, the equipment provider comes to the patient’s home to trial different types of equipment.
Some Speech, Physical and Occupational Services: These services are decided on a case-by-case basis, after an in-person evaluation is completed. In these cases, telehealth is used in addition to therapy—it doesn’t replace in-person therapy sessions. For instance, if a patient is in school and isn’t able to miss school to travel to our clinic several times a week, we can do a session during a break period while the student is in the school building. We can also do a telehealth visit if a family is quarantined and can’t bring the patient to our facility for therapy or if the patient needs to schedule around another medical visit for the day.
Some Behavioral Medicine/Rehab Psychology Services: These services are decided on a case-by-case basis, after an in-person evaluation is completed.
How does telehealth at PNRC work? If I’m a patient who used to come in person, how do I get started with telehealth?
For a first-time visit: Our admissions coordinator will make sure you have the appropriate internet connection for the appointment. There will be an equipment provider there in your home for the appointment, so he/she will have the necessary device (tablet or smart phone) to communicate with the therapist at Patricia Neal Rehabilitation Center.
For a follow-up visit: Your therapist will discuss the possibility of telehealth visits on a case-by-case basis. If you meet the criteria, he/she will determine if you have the appropriate equipment (smart phone, tablet or desktop computer with camera) and internet connection. You will also have the opportunity to practice opening the appointment link while in your in-person sessions to ensure success when at home.
Each session will be unique, based on your individualized plan of care with your therapist.
I’m technology challenged. Can I still use telehealth services?
Yes. As long as you have an internet connection and a device with a camera. We’re here to help you!
Why should patients care about telehealth services?
Telehealth will never replace what we can do in person in our clinic. However, during a pandemic, it provides another opportunity to access our services while reducing the risk of contact with other people in the community. It also allows the therapy staff to assess barriers in a patient’s home in a way we never had access to before. During a telehealth visit, the therapist can do a virtual home assessment, where he/she can make recommendations for adaptive equipment to improve a patient’s performance with activities of daily living (bathing, dressing, etc.).
Will insurance cover my telehealth treatment?
Yes. There is no difference in coverage for virtual/telehealth sessions. This is currently related to the public health emergency we are under, but on a national level, therapy associations are pushing for this to be a covered service even after the pandemic.
Is telehealth as effective as in-person treatment?
In the case we are using it, it is a different therapy session, for sure, but it allows therapists to assess barriers in ways we can’t when working in the clinic. For instance, a therapist can observe a patient performing exercises in their actual home environment and better assess why he/she is having difficulty completing the activity when attempting them alone.
How has the pandemic impacted your work?
I don’t think this will come as a surprise to anyone, but the pandemic has really forced us to be more adaptable. For a time, patients were fearful of coming into the clinic. We imposed new guidelines to operate in a safe way, while maintaining social distancing. As therapists, we are very often in a patient’s personal space. We had to adopt very strict guidelines around personal protection equipment to continue to allow our staff to operate in effective ways when encountering patients in these close quarters. We also have had to adapt how we provide therapy services when we deliver care through a telehealth visit. Our therapists are used to using their hands—that doesn’t translate very well through a phone. They all have had to adapt to providing more useful verbal cues to compensate for the lack of tactile cues they would normally provide.
Another very important way this pandemic has impacted our work is how it has limited our social interactions. Our support groups as well as the spontaneous support each patient receives when chatting with a peer between sessions are both such valuable pieces of recovery. Any therapist can share their expertise with a patient, but there is something comforting when you have a shared experience with another human being. We look forward to having our patients interact socially again, in and outside the clinic. It’s just good for the soul—theirs and ours!