3. Virtual Care Tools - Technical Considerations
Not really. While you will inevitably encounter occasional difficulties (as we all do with technology), the level of digital literacy you require to operate in society generally will allow you to participate in providing virtual care. Of course, you will encounter some frustrations as you initiate service, but as you do more, it becomes quite easy.
In all likelihood, no. Most modern laptops and tablets purchased in the last few years will suffice, as long as they have a camera and microphone. Using a phone is not recommended for physiotherapy virtual care as the small screen size inhibits the visual observation of movement, etc. that is very important to assessment.
It is likely that you already have sufficient bandwidth if you operate in an urban centre. At a minimum, your connection should be capable of 5 Mbps, but more modern systems are now suggesting 15 Mbps or more. Most high-speed internet connections will have no trouble with this, even though wireless connections. For example, note that Telus’s basic fibreoptic high speed hook up in the Lower Mainland is a way-more-than-necessary 150 Mbps wirelessly. As you move away from urban centres the connectivity may become more of an issue, particularly on the patient side. However, even satellite connections (e.g. Xplornet) can be used successfully for telehealth.
Firstly, CPTBC and PABC do not approve/reject software platforms. The security of a telehealth set-up should be considered along a continuum from low risk to high risk. No set-up is 100% secure, but you minimize your risk by using good administrative processes and software that is designed for telehealth purposes. The role of both CPTBC and PABC in facilitating virtual care is to provide the information clinics and physiotherapists need to make their own decisions on effective, safe, and secure virtual care.
Having said this, recent so-called “Zoombombings” were primarily occurring in larger group meetings in the non-telehealth version of Zoom where the email invitation was shared broadly, waiting rooms were not used, and passwords were not required. To our knowledge, this did not occur with Zoom Healthcare accounts and there are built-in protections against this type of privacy breach within Zoom Healthcare. Zoom Healthcare appears to continue to be a successful solution for many practitioners.
It is possible to use regular Zoom (non-telehealth version) for Telehealth in some circumstances if you are only subject to PIPA legislation (see privacy questions above). However, you should understand that regular Zoom has not been designed with healthcare in mind, and as a result does not have the higher degree of data protection and security that Zoom Healthcare does. Your risk for a privacy breach is very likely higher than with Zoom Healthcare. If you choose to use regular Zoom, you should pay extra attention to your administrative controls. See Zoom’s easy-to-read Best Practices For Securing Your Zoom Meetings document.
If you are interested in what sets Zoom Healthcare apart from regular Zoom, you can see Zoom Healthcare features here. Consider a membership with Embodia where a Zoom Healthcare membership is included within the membership fee.
The same principles of software platform evaluation apply to Microsoft Teams as to all other platforms. Microsoft Teams is quite similar to Zoom in its videoconferencing features; however, it has the added benefit of having Canadian servers and is thus more broadly usable across sectors. Again, keeping in mind that it is not designed specifically for telehealth, clinicians using Microsoft Teams will want to ensure they use it with administrative processes that maximize the security of the session such as those noted for the regular version of Zoom. If you are using Microsoft Teams in a public sector organization, you will want to check with your IT department (if you have one) for compliance with your organization’s policies. Those already using Microsoft 365 may wish to consider Microsoft Teams as it can be packaged with your other office products.
Physitrack is one of the earliest exercise software packages to integrate telehealth. It has been used successfully for quite a while with no privacy breaches that we are aware of. Physitrack has Canadian servers, end to end encryption, and is designed with telehealth in mind. Physitrack is compliant with multiple privacy statutes and we would expect it to be one of the most secure virtual care solutions
Group exercises will require a platform that allows for multiple attendees. Zoom Healthcare’s architecture is well-known for its group meeting capacity. Other capable platforms for this purpose include doxy.me (up to 10 attendees) and NeoRehab (up to 6 attendees).
