Bringing Telehealth to the Rehabilitation Industry

The future of telehealth continues to build interest due to its convenience and cost-effectiveness. Not only does it increase access to care and reduce travel time—especially for people living in rural areas—but telehealth also decreases the number of hospital stays and can improve communication between clinicians.

According to the American Hospital Association (AHA), 76 percent of hospitals in the U.S. utilize telehealth. A number of state Medicaid programs have some form of coverage for telehealth services, while private payers are embracing coverage for many telehealth services. Currently, 35 states and the District of Columbia have passed “parity” laws, which require health insurers to cover telehealth services equal to those provided in-person. In addition, approximately 89 percent of healthcare leaders expect telehealth to transform U.S. healthcare in the coming decade, with 74 percent of surveyed patients saying they would use those services.

Though it’s already being deployed by health systems and physician practices, telehealth is becoming more prevalent in rehabilitation services, including the areas of physical, occupational and speech therapy. As we prepare for the annual Insurance Rehabilitation Synergy Group (IRSG) conference, we’re highlighting how this growing practice is being implemented in various fields in rehabilitation.

Physical Therapy

As an industry worth $35 billion with a growth of 3.2 percent over the past five years, physical therapy is the biggest player in the rehabilitation market. According to the World Confederation for Physical Therapy (WCPT), there are more than 450,000 physical therapists around the world.

The physical therapy industry has been focused on employer-based healthcare, artificial intelligence and machine learning, especially in the role of big data and enrollment in the Merit-based Incentive Payment System (MIPS) for billing. In addition, telehealth is presenting this industry with a lot more options with which to engage patients. As the Center for Connected Health Policy (CCHP) notes, different telehealth modalities include:

• Live video: referred to as “synchronous” format and uses live interaction between two parties over video.
• Store-and-forward: Also called “asynchronous” format and involves the transfer of health history and/or medical records over secure electronic means.
• Remote patient monitoring (RPM): involves the remote monitoring of patients’ health and medical data over secure electronic means.
• Mobile health (mHealth): involves healthcare services, education and public health notifications being delivered over cell phones, tablets and other electronic devices.

Although there hasn’t been a wide array of research done on applying telehealth to physical therapy, it is increasingly being adopted throughout the industry. Telehealth treatments in regards to physical therapy are currently not covered by Medicare.

Occupational Therapy

At a market worth estimated at $24 billion, the occupational therapy industry has grown by nearly five percent over the past five years. There are approximately 480,000 occupational therapists worldwide, many of which are moving to the hospital and long-term care facility settings.

Some key ways telehealth is being leveraged in the occupational therapy arena include: education, home exercise programs, practitioner and patient guidance with assistive technologies, home safety evaluations, support of pediatric sensory integration therapies in schools and remote monitoring of patients’ progress. Some occupational therapists also utilize mobile health, or mhealth, to integrate technology and rehabilitation for their patients.

Telehealth isn’t used in occupational therapy as widely as in physical therapy, but there are a small handful of states that have Medicaid guidelines for the use of telehealth in the field.

Speech Therapy

In this field, telehealth is commonly referred to as “telepractice”. The American Speech Language Hearing Association (ASHA) defines telepractice as, “the application of telecommunications technology to the delivery of speech-language pathology and audiology professional services at a distance by linking clinician to client for assessment, intervention or consultation”. According to ASHA, venues that use telepractice are schools, medical centers, rehabilitation hospitals, community health centers, outpatient clinics, universities, client homes, residential health care facilities, child care centers and corporate settings.

Insurance policies are increasingly covering telepractice costs. The International Journal of Telerehabilitation showed that telehealth is a promising service delivery method for delivering speech and language intervention services to primary school-aged children. The article lists benefits of telepractice in speech therapy as:

• Improving access to services for children living in geographically remote areas.
• Reducing travel time.
• Alleviating the detrimental effects of communication difficulties on education, social participation and employment.

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