Telerehabilitation: Things to Consider When Choosing a Platform
The Coronavirus (COVID-19) outbreak has forced many therapy Providers to be creative with their practice strategy and rapidly adapt to new models of care delivery. The use of technology to communicate with patients through telerehabilitation (telerehab) during this crisis is one method to maintain contact with patients, keep them engaged in their treatment plans, and progress toward recovery and goal-attainment, while adhering to public health mandates.
As the country begins to see a resurgence of COVID-19 cases, many Providers see value in continuing to offer this option to their patients or are prepared to offer it in the future as part of an emergency preparedness strategy.
- Know your state’s practice act regarding telerehab
- Prepare your telerehab policies and procedures
- Train your staff on telerehab best practices
- Educate your patients
- Verify reimbursement with your Payors
- Ensure your malpractice insurance covers telerehab
However, one very important decision Providers will have to determine is which technology platform they will use to carry out remote visits.
Choosing a Platform
The Federation of State Boards of Physical Therapy (FSBPT) provides technical guidelines for Providers who employ telerehab services. These guidelines state that Providers should fully understand the capabilities, limitations, and functionality of the system they use in order to ensure safe and effective delivery of services.
Security of the telerehab system should be the primary starting point when evaluating technologies. This includes encryption of transmitted data and HIPAA-compliant message, voice and file transfer, and information storage.
Although privacy protections have been recently reduced to allow for flexibility in care delivery during the COVID-19 crisis, these reductions are only temporary. Therefore, if a Provider is planning to provide telerehab services after the pandemic, consideration should be given to choosing a platform that delivers a long-term solution.
According to the Department of Health & Human Services’ Notice of Enforcement Discretion for Telehealth, if Providers choose to utilize an application that does not comply with HIPAA rules related to telehealth during the national pandemic, they are encouraged to enable all available encryption and privacy modes, and notify patients of potential privacy risks associated with their use. The notice does not allow the use of public-facing applications such as Facebook Live, Twitch, Tik Tok, etc.
Another consideration when selecting a telehealth platform is the vendor’s willingness to enter into a HIPAA Business Associate Agreement (BAA). While the Office for Civil Rights will not impose penalties against providers who do not have a HIPAA BAA with their technology platform vendor during the COVID-19 emergency, it is advised. There are many vendors who are willing to enter into this type of agreement.
Choosing a platform that is user-friendly to the therapist as well as the patient is also very important. One of the top barriers to adoption of telerehab is the inability of patients to learn and correctly use mobile technology. Selecting a telehealth platform that meets the needs of the therapist as well as being accommodating to the technological needs/comfort level of the patient will help improve satisfaction and adherence.
Consider usability across multiple devices—mobile phones, tablets, and laptops. Not all platforms function the same across devices, and some are equipped to accommodate certain devices better than others.
Determine if an application (app) is required, if you will have to install any software to use the product, or if it is web-based. Identifying existing technology, as some may already have telerehab functionality built in.
Many telerehab vendors offer add-on features such as marketing, outcomes tracking, Artificial Intelligence (AI), Home Exercise Program (HEP), documentation, secured messaging, and conferencing options to allow additional participants. These features can be very useful but are not necessarily available with each platform.
Finally, thoroughly review the terms of the agreement with the vendor. Understand the costs (if any) for use of the platform, if a contract is required to use the product, and what the terms of that contract are.
Whichever platform you decide works best for you, be sure to periodically evaluate its effectiveness in meeting your needs as well as the needs of your patients, in order to improve satisfaction and adoption of this mode of care delivery.
While telerehab cannot replace in-person care, it has allowed many practices to offer an alternative mode of care delivery, allowing their patients to continue to receive care, and their businesses to remain open. To ensure optimal success, Providers should adequately prepare when integrating the technology into their practices.