TELEHEALTH IN PHYSICAL THERAPY

Jesse Song MSPH Student

Board of Physical Therapy Examiner • Regulating physical therapy since 1947

• Mission: Protecting the citizens of Maryland 1) Facilitating licensure of both Physical Therapists

and Physical Therapist Assistants 2) Receive and resolve complaints 3) Setting standards for the practice of physical

therapy that reflect current and upcoming developments

Project Overview 1) Comprehensive review of current best telehealth

practices and regulations in the 50 states

2) Contact state boards, professional association, academia, and private parties

3) Create a literature review of evidence supporting telehealth practices

What is Telehealth? “Use of electronic communications to provide and deliver a host of health-related information and health care services, including, but not limited to physical therapy-related information and services, over large and small distances. Telehealth encompasses a variety of health care and health promotion activities, including, but not limited to, education, advice, reminders, interventions, and monitoring of interventions” – American Physical Therapy Association

Physical Therapy in Telehealth?

Image Courtesy of Clay Brown, PT, DPT

Methods 1) Consulted literature on telehealth from

professional associations and telehealth special interest groups

2) Searched for regulations through Lexis Nexus State Capitol for telehealth regulations

3) Contacted and interviewed boards and practitioners in states with relevant regulations

Location of Regulations

AK

WA

NM

TX GA

PA

MD

NJ

Alaska’s Example

• Alaska is very large and travelling can be difficult

• Travel can only happen by flight, often costing $7005

• “Moving information rather than moving people”3

Images Courtesy of Clay Brown, PT, DPT

Regulatory Language Recommendations

• Broad definition of Telehealth

• Secure Data Encryption and HIPAA Compliance

• Initial Consultation as In-person Requirement

• Inter-state Jurisdiction Issues

• Clinical Records Documentation

Limitations and Challenges • Lack of states with telehealth regulations in physical

therapy

• Concerns are of speculative nature

• Limited evidence in physical therapy and telehealth of current practices

• Telehealth is still a growing and changing field

Lessons Learned • A better understanding of the regulatory process

• The importance of networking

• People are happy to help

• There may not be a concrete answer

Implications • Maryland is pushing for the growth of telehealth7

• Statute requiring reimbursement from private insurance passed October 2012

• A need to develop regulations soon • Based on limited examples • Predict growth of the field

• Telehealth can be an important tool for increasing access to healthcare and improving health outcome

References 1. Alaska State Physical Therapy and Occupational Board: Standards for practice of telerehabilitation by

physical therapists, 12 A.A.C. pt 54.530 (2011). Retrieved from: http://www.commerce.state.ak.us/occ/pub/PT-OTStatutes.pdf

2. American Physical Therapy Association. (2012, August 15). Telehealth - definitions and guidelines. Retrieved from http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/Practice/ TelehealthDefinitionsGuidelines.pdf

3. Brown, C., Henderson, N., & McAdoo, P. Physical therapy telemedicine (tele-pt) in rural southwestern Alaska. 4. Hanson, D. (2012, June 22). Telehealth. Retrieved from http://www.infinityrehab.com/telehealth 5. Lee, A. (Host), & Stout, K. (Guest) (2012, September 13). Advances in PT practice: Telehealth essentials.

APTA Learning Center. [Video podcast]. 6. Maryland Board of Physician: Telemedicine, 10 C.O.M.A.R. pt 32.05 (2009). Retrieved from:

http://www.mbp.state.md.us/pages/regulations.html 7. Orlando, V. Rural Maryland Council, (2011). December 2010 maryland telehealth and telemedicine (thtm)

roundtable . Retrieved from website: http://www.rural.state.md.us/Roundtables/ Telehealth_2010/THTM_Roundtable_FINAL_Jan2011.pdf

8. Texas State Board of Examiners for Speech-Language Pathology and Audiology Telehealth, 741 T.A.C. pt 741.211-215 (2012). Retrieved from: http://www.dshs.state.tx.us/speech/sp_rules.shtm

9. Washington Board of Physical Therapy: Use of telehealth in the practice of physical therapy, 246 W.A.C. pt 915.187 (2011). Retrieved from: http://apps.leg.wa.gov/wac/default.aspx?cite=246-915-187

Acknowledgements • The Board of Physical Therapy Examiners

• Carlton Curry, Joy Aaron, and the staff • Board Members John Baker and Rhea Cohn

• Maryland’s Boards and Staff • Robin Bailey from the Board of Physicians

• State Boards of Physical Therapy • Kris Waidley from Washington • Connie Petz from Alaska • New Mexico’s Board

• Practitioners in Telehealth • Alec Kay, Clay Brown, and Diana Christiana

• Alan Lee, Associate Professor at Mount St. Mary’s College • Phase Advisors Jennifer Le and Beth Resnick

Questions?

Jesse Song MSPH 2014

Health Policy & Management jsong@jhsph.edu

Board of Physical Therapy Examiners

4201 Patterson Avenue Baltimore, MD 21215

Telephone: (410) 764-4718