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The Beginner’s Guide to TeleHealth and Virtual Care

If you feel like you’ve been hearing a lot more about TeleHealth in the last few weeks, it’s because the current social distancing norms have forced some big changes in the way that non-essential health care has to be delivered. While most people have heard the term “TeleHealth” or “Virtual Visit”, they still have questions about what it really means and when to use it. If you are one of those people, read on for an overview of TeleHealth and what to expect from a virtual health care visit.

What is TeleHealth?

Telehealth refers to “the delivery of healthcare services, where distance is a critical factor, by all health care professionals using [communication technologies] for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities.”1

It might sound like a very modern concept, but in fact a 1879 article published in the Lancet medical journal talked about using the telephone to reduce unnecessary office or home visits. And no, it’s not a typo. The article was actually published in 1879, three years after Alexander Graham Bell invented the pone. https://www.ncbi.nlm.nih.gov/books/NBK207141/

What’s the Difference between TeleHealth and Virtual Care

Nothing really. TeleHealth is just a term for all health care services that are delivered remotely. TeleRehab is a term that specifically refers to physiotherapy services. Virtual Care is a term that involves “live, two-way, audio-video communication”.

What are the Benefits of TeleHealth?

In most cases, TeleHealth is a benefit. The original benefit was that it could provide treatment for patients who were located in remote places far from health facilities or in areas with shortages of health practitioners. While it is still used to address these problems, it has become an increasingly popular tool for convenient and accessible care. TeleHealth engages patients by allowing them to connect with their practitioner more frequently, in a convenient way which results in a stronger relationship and patients who feel empowered to manage their care.

Who is TeleHealth For?

Although it has long been an option for patients who live in rural areas, the current COVID-19 pandemic has created a new reason for this type of delivery method. Many communities have had to institute physical distancing measures requiring brick and mortar clinics to temporarily close to all non essential services. Additionally, people have become reluctant during this time to be in close personal contact with a health care practitioner if not absolutely necessary.  

TeleHealth can be a great primary or additional form of care for:

    • Any individuals with transportation or mobility difficulties (acute or chronic)
    • New moms who find it difficult to come in person
    • Individuals whose care no longer requires manual therapy, but is focused more on exercise progression, education, lifestyle management and integration
    • When inclement weather prevents you from getting to the clinic
    • Other medical practitioners who are looking to consult with our multi-disciplinary team
    • Those who travel frequently for work and have difficulty making it into the clinic
    • Patients who want to ask a question about whether or not therapy is needed for a new injury

TeleHealth and Musculoskeletal Problems

Just because you are at home, injuries and falls can still occur and people are still trying to manage the musculoskeletal conditions they had prior to the pandemic. Evidence suggests that rehabilitation through real-time TeleHealth interventions are effective for improving pain and function in individuals with spinal conditions, osteoarthritis and other musculoskeletal conditions. Ruling out serious pathologies, and providing education, exercise and self-management strategies are essential first-line management for musculoskeletal conditions. This first line management is effective in improving function, facilitating recovery and maximizing independence. Patients and caregivers have demonstrated satisfaction with the convenience, usefulness, and perceived benefits of TeleHealth.

Although TeleHealth is naturally devised for services that don’t require physical examination, it can still be an effective way to gather all the history and many important pieces of the examination necessary to provide safe, effective treatment for many health issues. The history provided by a patient is always one of the most important pieces of any health care visit and that can be accomplished remotely. 

Available treatment includes care for musculoskeletal and orthopedic conditions, acute and chronic pain management, self care for headaches and migraines, support for post-concussion recovery, strength and conditioning coaching (personal training), and running assessments (if you have access to a treadmill) for any individual who can not make it to the clinic for an appointment.

TeleHealth sessions can empower, support and motivate patients to keep up with their personalized rehabilitation program. Most importantly, it can be an important tool to facilitate the transition from passive care to active care and finally to self care.

Frequently Asked Questions About TeleHealth

What kind of equipment do I need?

Accessing TeleHealth is easy and does not involve any specialized equipment.

All you need is a strong Internet connection and access to a webcam and microphone through a desktop or laptop computer, tablet, or smartphone. You can use a Chrome, Firefox or Safari browser, and it works on both Android or iPhone. The video platform we use (Phzio) is safe, secure and compliant with government privacy laws (PIPEDA). There is no special software needed and you don’t have to download anything to your computer.

What could I expect during a TeleHealth session?

  • You can expect the same service you would receive during an in-person appointment:
  • History-taking, and review of your current goals and expectations
  • Education about your condition
  • Education regarding self-care treatment techniques
  • We can answer any questions you may have about your condition or health

**For chiropractic and physiotherapy appointments:

  • Virtual physical assessment including range of motion, movement scan/screen, etc.
  • Adjust and improve the efficacy of you current management plan
  • You may get exercise prescription, progression and modifications
  • Detailed walk throughs of exercises and show the specific areas to use self-massage and rehab tools
  • Education about activity/movement modification to decrease pain and speed healing, and to understand how load management affects symptoms

What do I need to do before starting my TeleHealth session?

  • Ensure you have an up to date emergency contact should something happen to you during your session.
  • Be connected to a strong Internet connection and access to a webcam and microphone through a desktop or laptop computer, tablet, or smartphone. PLEASE NOTE: The Phzio platform works BEST when using the Chrome browser.
  • Be sure that your device and/or your phone batteries are fully charged or plugged in if needed.
  • Test your video camera and microphone to make sure they’re working.
  • Ensure that you’re logged in to the same email account that you used to book the appointment. Please be logged in and prepared at least 10-15 minutes in advance.

**For chiropractic or physiotherapy appointments:

  • Try to set up in a relatively quiet, private and clear space (approx. 4’x4’ area) around you to move and exercise. Think about where and how your device will sit or be supported to allow for the best view and interaction through video. Don’t stress too much about it. Most setups work fine.
  • Have any exercise or therapy equipment that you may need for your session close by. This could be exercise bands, weights, balls, rollers, yoga mats, yoga props, a chair, etc. If you don’t have any of these things, don’t worry! We can get creative with common items you have in your house like a hard water bottle, soup cans, tennis ball, etc.
  • Please wear shorts and a tank top/sports bra, or form-fitting clothing (for us to be able to more easily assess your movement).
  • Please have an alternative way to communicate (telephone) at the ready in case there is a disconnection.

For more information, read our FAQ’s About TeleRehab.

The Last Thing You Need to Know About TeleHealth:

Virtual appointments are just as effective as person-person appointments. This even applies to neck pain, back pain, knee pain, osteoarthritis and post-operative conditions. Thanks to the latest technology, your rehabilitation and health goals don’t have to be quarantined by COVID-19.

Some of the most important parts of our time with patients is when we are talking with them and asking a very detailed series of sequential questions. This is called history taking. For musculoskeletal care, this discussion along with the visual assessment of the body and posture allows us to understand what is happening inside the body. When we combine this with movement-based tests and screens, we have the ability to determine the underlying issues related to your symptoms. We can then show you the path forward to better function, decreased pain and improved quality of life.

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