Transforming modes of service delivery or transitioning from in-person to teletherapy can be a scary and exciting leap. OTs, PTs, and SLPs often wonder if switching to teletherapy or creating a combined caseload of in-person and telehealth clients is worth the hassle. The following summarizes what transitioning into a teletherapy role could look like and highlights what to look for when making this change.
Defining teletherapy:
Teletherapy, telehealth, and tele-rehab (etc.) can all be defined as delivering health-related services from a distance using a two-way interactive mode of technology.
Barriers and opportunities
Access: Teletherapy can be especially helpful in rural areas lacking service providers and public transportation.
Mobility Issues: Teletherapy can also have immense benefits for clients experiencing mobility difficulties preventing them from easily getting in and out of vehicles to get to teletherapy appointments.
Mental Health or Cancellations: Cancellations can be frequent and challenging. All of our lives are filled with an abundance of tasks and to-dos. Offering clients the opportunity to have a teletherapy session can be hugely beneficial on days when coming into the clinic is just not an option.
Evidence in Support of Teletherapy
A systematic review of 43 telehealth studies performed by Speyer et al which included cognitive, social-emotional, and physical interventions performed by nurses and allied health professionals, highlighted teletherapy to be as effective as in-person sessions. Thus, making it an excellent evidence-based mode of service delivery for many clients.
Regulations:
The Affordable Care Act (ACA) recognizes telehealth as an approved health care service delivery mode. On a federal level, Medicare has approved the use of telehealth for healthcare treatment with some stipulations. CMS.gov is a great source of information to learn about policy in this area.
Medicaid, on the other hand, is state-regulated and state-specific telehealth regulations can be found by accessing https://www.medicaid.gov/ and state-specific websites. Most states vary in the laws that guide clinicians, telehealth practices, and insurance reimbursement making it incredibly important to understand the individual state’s regulations where a clinician decides to be licensed to practice.
Parity Laws: Parity laws state that the service delivery of teletherapy and in-person visits be reimbursed by insurance providers. 40 states and the District of Columbia have parity mandates. Checking to see the status of your state's regulations and what they are specifically for your discipline can be incredibly helpful in assisting clinicians in determining how they want to proceed with teletherapy. A helpful article on the specifics of this can be found here: https://www.mercatus.org/publications/healthcare/telehealth-payment-parity-laws-state-level
Finding a Platform and Implementing Effective Teletherapy Sessions:
HIPAA Compliance with BAA Agreement:
There are many platforms and methods a clinician can utilize when discovering which teletherapy platform is the right choice. Finding one that is HIPAA compliant and with a BAA agreement is crucial. Ambiki offers an interactive teletherapy platform that is HIPAA compliant with a BAA agreement. Finding a platform that a clinician feels most comfortable with is essential, yet HIPAA compliance should be non-negotiable.
Telehealth Screening:
If you are unsure as a clinician which clients may be good candidates for teletherapy, feel free to use the attached brief teletherapy screening tool to assess if that client may be someone who not only has an interest in telehealth yet would also be a candidate that would continue to obtain good outcomes remotely.
Some clients need so many tactile cues that teletherapy may not be the best method while others may be working on higher-level cognitive or physical skills that could just as easily (if not even more effectively) be done in their own environments.
(You can download this screening from our resource library.)
Test Run:
Set up a test run with your client before your first teletherapy session starts. This can even be done in person if your client is looking to transition to part-time teletherapy. Troubleshooting before beginning a session can make both parties feel more confident in the initial teletherapy appointment.
Let us help you make the leap:
We are passionate about teletherapy and client access to physical, occupational, and speech and language services at Ambiki. Our goal is to expand service delivery to minimize disparity and limited access to care. If teletherapy and exploring what our interactive platform has to offer is of interest to you, we invite you to schedule a free demo and one-month trial with us here: https://ambiki.com/teletherapy
Works Cited:
Speyer, R., Denman, D., Wilkes-Gillan, S., Chen, Y., Bogaardt, H., Kim, J., Heckathorn, D., & Cordier, R. (2018). Effects of telehealth by allied health professionals and nurses in rural and remote areas: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 50(3), 225–235. https://doi.org/10.2340/16501977-2297
Dills, A. K. (2022, June 7). Telehealth payment parity laws at the state level. Mercatus Center. Retrieved September 20, 2022, from https://www.mercatus.org/publications/healthcare/telehealth-payment-parity-laws-state-level
Medicaid, U. (2022). Renew your Medicaid or chip coverage. Medicaid. Retrieved September 20, 2022, from https://www.medicaid.gov/
