How do we continue to provide quality Physical Therapy during the COVID-19 crisis and social distancing orders?

We are living in unprecedented times as people in our communities, our country, and our world try to find their footing amidst the uncertainty of social distancing, closures of stores and services, and a new virus that has interrupted our way of life. The novel coronavirus, and resultant COVID-19 infection, has forced many Physical Therapy clinics to close, reduce hours and staff, and has left many members of the community without access to care that has played an important role in their healing journey. While this virus may be keeping many of us apart, we must find ways of connecting with our patients and providing them with the care, guidance, and support that they need.

One of the most obvious options, and one that many PT companies are racing to develop, is telehealth. With many of the federal regulations on HIPAA compliant communication platforms currently relaxed, it is easier than ever to connect to our patients from a distance. With that being said, there are still restrictions on insurance reimbursement and patient access to keep an eye on, so make sure you’re up to date on your state’s regulations and any restrictions in place from payers. Another important component to keep in mind is your documentation. Regardless of whether it’s an in-person or telehealth visit, you still have to document on the encounter, and your documentation still needs to be protected and meet HIPAA standards for transmission and storage.

From my own personal experience with my patients, telehealth PT visits are a great option for continuation of care for a patient with whom you already have a working relationship. For obvious reasons, an initial evaluation can be difficult to navigate via telehealth, but this really depends on the patient and the reason for the visit. For many cases, you may find a thorough subjective evaluation, visual inspection of movement mechanics with symptom descriptions, and a good communicative patient, you’ll have no problem settling in on a working treatment diagnosis and plan of care. Manual therapy is unfortunately out when planning out your treatments, but this is where you get to scratch that creative itch and think outside the “physical” aspect of physical therapy. I’ve had patients use foam rollers, kid/dog toys, corners of walls, doorways, yoga straps, towels, and many other odds and ends from around the house to get the job done. Patients will be extremely grateful for your ingenuity and resourcefulness to use what they have around the house.

Instructing patients to record all or part of your visit is another trick to ensure they remember what was discussed, proper form for performing and exercise, and any of your tips that may not have made it to long term memory the first time around. Telehealth also makes the “check-in” even easier, for patients who need a quick refresher and 1-2 questions answered but don’t need another full session. With all that’s going on in our world right now, strive to be that connection to “normal life” for your patients, and help to keep them on track with their fitness and wellness goals. Your willingness to work with them during this time will go a long way as far as building a trustworthy and strong therapeutic alliance between patient and provider.

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