In response to the evolving COVID-19 pandemic, physical therapists may be considering alternative methods of service provision including telerehabiliation services. There are many considerations a physical therapist must address prior to implementing this practice.
**Update - see updated resource here: https://bcphysio.org/physios/library-resources/clinical-resources/covid-19/telerehab-and-covid19
PABC has several resources and links related to telerehab that members may find valuable.
- Physiotherapy Telerehabilitation and Virtual Care: A Quick Guide in Response to COVID-19 (March 15, 2020) Includes information from 3rd party insurance companies. These are the two missing embedded documents from the end of the paper: PABC Telehealth Application Feature Comparison Chart, and Categories of Potential Telehealth Videoconferencing Software Applications.
- PABC also advises members to access the College of Physical Therapists of BC website resource on practicing telerehabilitation. They have provided links to resources they have created, including their guidelines and short webinar.
- In April 2019, Jeremy McAllister produced an informative education session on providing telerehabilitation services in BC (Getting Online with Telerehabilitation in BC). Members can access a recording of the lecture (including guest speakers and panel).
- Advice about fees from physios already using telehab practices: Fees would be your usual one-on-one time for appointments (20 minutes, 30 minutes, etc…). However, as you are developing this virtual skill, you may need to bill for slightly less time as you adjust to the new technology (ie it may take 45-minutes in your virtual visit to cover what you would normally cover in a 30-minute hands-on session so you would invoice for 30-minutes).
Of note, CPTBC highlights the following information for billing:
According to Bylaw 71(k) and Standard 10: Fees and Billing, receipts must not be misleading and must be transparent. The best practice is to disclose on receipts that physical therapy services were delivered via telerehabilitation. Clients should be advised in advance to check with their insurance provider to confirm services provided by telerehabilitation are covered by their plan.
What are the special considerations for telerehabilitation?
Physiotherapists must comply with all regulatory requirements and deliver the same safe and effective care… but what other factors do you need to consider? It is up to you, the physiotherapist, to decide if telerehabilitation is the most appropriate and available way to deliver care.
Here are some considerations:
- Is an in-person, hands-on examination needed to complete the assessment and determine a clinical analysis, treatment goals and plan?
- Are there physical, cognitive or sensory deficits that may make the delivery of physiotherapy care unsafe or ineffective?
- Can someone be available to assist the patient if needed at their location?
- How will you protect the safety of your patient’s personal health information?
- Are you competent in the use of the technology, its capabilities and its limitations?
Additionally, you should have a plan in place to deal with potential adverse events such as patient medical emergencies, failure of the communication technology or environmental hazards.
You need informed consent. You must have a discussion with the patient and provide all the information they would need to make an informed decision about their care. Be sure to include things like: the difference between in-person and telerehabilitation services including options to receive in-person care, the risks to the privacy of their health information and any safeguards in place to reduce these risks.
Please note we will be updating this page with more information as we produce it. This is an emerging situation and we are working diligently to create accurate and useful resources for our members .**Update - see updated resource here: https://bcphysio.org/physios/library-resources/clinical-resources/covid-19/telerehab-and-covid19
Created with resources from:
CPTBC
https://cptbc.org/physicaltherapists/practice-resources/advice-toconsider/tele-rehabilitation/
Alberta and Manitoba Colleges
https://www.physiotherapyalberta.ca/files/guide_telerehabilitation.pdf
CAPR
https://www.alliancept.org/publications/
College of Physiotherapists of Ontario
https://www.collegept.org/blog/post/college-blog/2019/01/23/tele-rehabilitation-another-tool-in-your-toolkit