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Telemedicine, Telehealth, Telerehabilitation, or Online Physical Therapy --- What do you call it?

What do you call it? Online Physical Therapy. Virtual PT. Telemedicine. Telehealth. Telerehabilitation?

When I started this company in 2019 (feels like that was that a decade ago? oh Covid, make it make sense), "online physical therapy" was the preferred term because no one understood what it was and it was the most simple of all the names. How can you do physical therapy online? Do people get better? Don't you have to touch people for them to improve? People only want to come into clinic and will definitely not want to be seen in the home. There were many questions about how telemedicine for PT would work.

Online PT was controversial pre-pandemic. In 2019, at the Educational Leadership Conference (the annual conference by the APTA Academy of Education), the headliner, the event of the event, was a debate about whether telemedicine should be included in physical therapy education. Because a large portion of people at that time thought it useless.

I can hear the collective gasp from here! Telemedicine was not included in the majority of educational PT programs in 2019. And now look where we are. When I was working at the University of Washington through the pandemic, the only way people could get PT in some cases was via telemedicine. Even when Covid cases were low and people felt safe, because of the benefits of telemedicine, we were still seeing at least 20% of our clients via a mode that offers flexibility, convenience, and high quality of care. When cases rose, so did the number of folks who wanted tele.

Vestibular Rehabilitation is especially suited for telemedicine. Harrell, et al surveyed physical therapists during the pandemic and found that over 80% of physical therapists thought telemedicine was effective for vestibular rehabilitation. I find this figure quite high considering the difficulty for some clinics to get telemedicine up and running so quickly. In my experience, telemedicine is often preferred for vestibular rehabilitation because it occurs in the patient's home and often clients with vestibular issues have a lot of difficulty travelling by car or bus to clinic. Many are also still working and getting the time off work for medical appointments is difficult. Telemedicine makes all those barriers disappear.

Do patients like telemedicine?

Eannucci and colleagues surveyed patients The Hospital for Special Surgery, in New York City, about their satisfaction with physical therapy during the pandemic in 2020. There were 1147 respondents and on a 0-5 scale, in-person PT patients reported satisfaction as 4.7 +/- 0.6 and patients who did telehealth reported 4.6 +/- 0.6. This difference was not statistically different.

Insurance companies are paying the same for telemedicine as for in person care. The term they use is "parity." The skills of the practitioner stay the same and the level of care is the same. So far this is holding true, but many payers are threatening to eliminate telemedicine as an option for their paying customers (why is healthcare a business??).

Telemedicine is here to stay. It is essential to comprehensive medical care. I am so glad the medical system, insurance companies, providers, patients, and educational program are finally on board. Let's hope it stays that way.

Ashley Stanley PT, DPT

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