Have you been wondering if Telehealth physical therapy is worth it? Well, the results are in and patients are satisfied with the at-home virtual treatment! Check out the study below for more information, or if you've been receiving Telehealth treatment this year, let us know in the comments what you think!
In this review:
Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine: A Survey Study of Patient Satisfaction with Virtual Visits During the COVID-19 Pandemic
The Message
While many lessons are still being learned about the potential for telehealth in physical, occupational, and speech-language pathology, a hospital system in Massachusetts has learned at least one thing for certain: telerehab is extremely popular with its patients. That popularity extended across age groups and types of therapy, and was consistently strong across a range of satisfaction areas, from execution of the treatment plan to perceived value of a future telehealth visit.
The Study
Researchers administered online surveys to 211 participants who received a telehealth visit for lower limb injuries, pediatric neurology, or primary impairments in sports during the COVID-19 public health emergency that opened up real-time telehealth to PTs, OTs and SLPs. The 16-item survey was designed to collect "measures of experience with a therapist," according to authors, and covered seven areas: addressing concerns and questions, communication with the therapist, developing a treatment plan, execution of the treatment plan, convenience, overall satisfaction, and perceived value of a future telehealth visit. The survey offered satisfaction ratings on a five-point Likert scale and included a single free-response question that allowed participants to provide comments. Researchers also collected demographic and condition data. The study focuses on 205 usable responses.
APTA members Irene Davis, PT, PhD, FAPTA, and Kester Cotton, PT, DPT, were among the co-authors of the study.
Findings
Overall, more than 90% of participants gave "excellent" or "good" ratings to having their concerns addressed, therapist communication, treatment plan development, treatment plan execution, convenience, and overall satisfaction. About 87% of respondents provided an "excellent" or "good" response to the perceived value of having a future telehealth visit. In all cases, the "excellent" ratings made up the clear majority of the ratings, from 69% for future telehealth visits to a high of 88% for therapist communication.
Satisfaction ratings remained independent of age, therapist type, visit type, visit duration, typical travel time to an in-person visit, or stated reason for visit, although women tended to report higher satisfaction ratings than did men. When researchers excluded patients younger than 18 (the group they believe was most likely to have the survey completed by a caregiver), they found patterns unchanged.
Authors write that in the comments section "many participants wrote that they would prefer to have the option of telerehabilitation visits in the future." Some resondents also identified areas in which telerehab fell short for them, including "lack of tactile feedback, inability to perform soft tissue work, and absence of 'healing touch.'"
More than half (53%) of the visits were with a PT. Visits with an SLP were the next most-common, at 30.7%, followed by a visit with an OT, at 14.1%. Most of the visits (80%) were for follow-up issues; about 60% of the visits lasted between 30 and 44 minutes.
Nearly 54% of the participants identified as women or girls, with 44.9% identifying as men or boys, and 1.5% identifying as transgender. In terms of age of participants, zero-to-seven-year-olds made up 25.4% of respondents; 6.3% were eight to 12 years old; 3.9% were 13 to 17; 12.2% were 18 to 34. 32.7% were 35 to 64; and 19.5% were 65 or older.
Why It Matters
Authors characterize research on telerehabilitation as "limited," mostly focusing on treatment for a specific condition, and say that the relatively recent payment changes that support telerehab have created an opportunity for study on a broader level. They believe their study, though small, provides a valuable perspective that reflects high levels of patient satisfaction.
Beyond pointing to the effectiveness of telerehab, authors also believe their study adds weight to the argument for making permanent changes in federal regulations that would allow for continued reimbursement under Medicare and Medicaid.
"The high patient satisfaction across ages, gender, and condition treated suggest these services were valued," authors write, pointing out that even if infection control were factored out, telerehab offers substantial benefits such as reduced travel time and convenience. "Recognizing reduced indirect costs of care that telerehabilitation may provide along with high patient satisfaction are reasons policy makers should adopt these services into future health care delivery models," they write.
More From the Study, and From APTA
Authors noted that women's satisfaction ratings tended to be higher than the ratings from men, and speculated that the reason may be related to disparities, noted in other studies, that tend to place more responsibility on women for "balancing work, household, childcare, and caretaking roles." They speculate that the convenience of telerehab, and perceived shorter wait times, may be a driver of the higher satisfaction ratings overall for women.
In terms of use of telehealth by PTs, a recently updated APTA report on the impact of the COVID-19 pandemic on the physical therapy profession found that before the public health emergency only 2% of PTs reported providing video consults. By July, that number rose to 47%, although 77% were treating no more than five patients a week through telehealth.
Keep in Mind …
Researchers acknowledge that telehealth has its limitations, making the use of telerehab "more appropriate for certain types of presentations than others." Authors also cite "discipline-specific challenges" associated with telerehab, including management of myofascial deficits, teaching hands-on techniques to caregivers, and delivering pediatric therapy for patients with behavioral or attention issues.
This blog comes to you from the American Physical Therapy Association.
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