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LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Understand the elements of synchronous and asynchronous telehealth.
Identify 3 benefits of telehealth to the patient, provider, and society.
Cite 5 elements of technology that contribute to the success of telehealth.
Identify special considerations for pediatric telehealth service delivery.
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Telehealth in pediatric physical therapy has been gaining traction over the past few years. Although, 96% of surveyed pediatric physical therapists had never practiced using telehealth services prior to the coronavirus disease 2019 (COVID-19) pandemic, there has been a rapid increase in utilization of telehealth services with good clinical success.1 With the advancement of technology in rehabilitation, the delivery of physical therapy to advance clinical care is adopting digital practice.2 This includes the use of telehealth to provide evaluation, assessment, intervention, monitoring, and discharge to our patients.
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American Physical Therapy Association Position
According to the American Physical Therapy Association, “Telehealth is a well defined and established method of health service delivery. Physical therapists provide services using telehealth as part of their scope of practice, incorporating elements of patient and client management as needed, to enhance patient and client interactions.”3
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Physical therapists (PTs) are advocates for and users of telehealth. Telehealth in physical therapy, often called telerehabilitation, refers to the delivery of rehabilitation and habilitation services via information and communication technologies. Telerehabilitation is primarily applied to physical therapy and occupational therapy services via telehealth, whereas telepractice is the term used for telehealth in speech-language pathology services.1 PTs can use telephone, video, and synchronous and asynchronous modes of communication to deliver telehealth services in accordance with state practice, licensure, and regulatory bodies.
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THE HISTORY OF TELEHEALTH IN HEALTH CARE AND PHYSICAL THERAPY
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In the United States, telemedicine began in the 1950s with a collaborative project between NASA, Lockheed, and the US Public Health Service. A mobile van was connected via microwave television and phone to a fixed hospital that provided health care on the Papago Indian Reservation in Arizona. This project spanned 20 years. In 1968, Massachusetts General Hospital linked in microwave television with a medical station at Boston Logan Airport into the Bedford, Massachusetts, Veterans Affairs (VA) hospital. This later expanded to include local schools, courts, and prisons. During the same time, Dartmouth Medical School developed the Interact System servicing 8 communities in Vermont and New Hampshire plus the local VA hospital. Dartmouth medical school also supported an extensive continuing medical education program for physicians, nurses, and ancillary staff. Both of these programs spanned a period of 10 years. In the 1980s, telemedicine moved to television tape satellites linking the main campus of major medical centers.4 Advancements in the delivery of telemedicine progressed over the decades as technology continued to advance. In the 1990s and 2000s, telehealth progressed to monitoring patients ...