While we can likely expect formal, systematized methods of assessing via virtual care to develop in the near future, to date these have not yet been developed. Your best approach to gain clinical knowledge is to take a course from a physiotherapist/clinician who has experience in the field and has developed their own systems. Possibilities include:

1. Natasha Wilch (Canada)– Clinician’s Course for Telehealth

There are many studies that look at the validity of telehealth assessments versus in-person assessments. Many of these studies are conducted by the University of Queensland’s Centre for Research in Telerehabilitation. For a primer on some of these studies, please refer to the Alberta Physiotherapy webinar with guest Dr. Trevor Russell from the University of Queensland.

Virtual care can be used to provide much value, however, there are limitations and some situations will require in-person care. Patients should be informed of this during the consent process. Decisions made will always require clinical judgement for the best course of action given a particular patient, condition, and treatment/assessment goal with a consideration of the safety and value of the assessment proposed. The physiotherapist must make the decision about whether or not it is safe to proceed with virtual care.

Can I have the patient take a picture of their signature and the physiotherapist/clinician to insert it into the consent document?

No. The initial telehealth consent implies it is not just for one visit. However, you should re-establish consent as often as it is necessary. For example, if the patiernt brings up concerns in regard to the delivery, a new injury has occurred, or if there has been a significant time since the last telehealth treatment.

This is an area that may require some further investigation and you may wish to contact your malpractice insurer on the implications of digital signatures on clinical records. CPTBC suggests that electronic signatures should be password protected to ensure only the physiotherapist/clinician can apply the signature. Ask yourself if the digital signature has some security limiting who can apply them. If not, consider the risk of unauthorized access to your signature. A time and date stamp enhance this security.

As there are a number of items to explain to a patient when obtaining verbal consent, we have recommended written consent to ensure these points are covered. Having said this, it is still acceptable to obtain verbal consent providing risks and limitations of virtual care are adequately explained. Please see the consent section of the Virtual Care Toolkit. We also provide a chart template tool in this section that provides a cue for verbal consent within the session if written consent has not been obtained.

Not necessarily and often the ones we have seen are insufficient when compared with the guidelines referenced by our Virtual Care Toolkit. Please review the consent section in the Virtual Care Toolkit.

Some insurance companies like Pacific Blue Cross cover treatment through virtual means, but do not reimburse for initial assessments.

Currently, we have no further information that would indicate this would be a problem, however, it would be advisable to ask the patient to confirm their coverage for virtual care delivered this way as coverage may vary.

Please refer to the bulletins on WorkSafe’s Physiotherapists Page