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Physical Therapy Goes Virtual

As communities around the world fight off the coronavirus pandemic, physiotherapists have faced a unique challenge of treating their patients while at the same time, social distancing. For a profession, that is primarily hands-on, this required changes to the way physiotherapists work on a day to day basis. Although we have embraced telehealth for many other types of medical care, the biggest obstacle in physical therapy has been for people to change their mindset and accept that patients can be treated virtually with excellent outcomes.  For many practitioners and patients, virtual physical therapy has been an oxymoron, with “virtual” and “physical” being thought of as mutually exclusive categories. Bridging this gap and bringing the two together turned out to be an effective and reliable way to provide exceptional care, while keeping patients and therapists healthy and safe.  The industry has been pushed to change its thinking, its assumptions, and its approach and to adopt virtual care.

Medical Colleges and Universities, education being the other known bastion of “tried and true,” have had to quickly adapt to new circumstances as well.  We saw this first hand when McGill University School of Physical & Occupational Therapy (SPOT) approached Lifemark Health Group after hospitals and clinics were forced to cancel physiotherapy students’ clinical placements due to COVID-19.  The University recognized the need to adapt their clinical teaching during these times to ensure students graduate on time, asked our organization to train their faculty and students on Virtual Care and most importantly, to offer digital care placements to physical therapy (PT) and occupational therapy (OT) students.  We took the challenge and welcomed 46 PT and 13 OT students in 21 digital care settings/facilities. The students’ experience has been so positive, and the fact that digital care has been approved by the regulatory body as being part of a valid clinical experience, that from now on, Digital Care will be introduced within of the regular PT and OT curriculum.  This shift is going to have a profound impact on patients and practitioners and bring a dramatic improvement in both accessibility and quality of care.

So, what exactly is Digital Physical Therapy? 

Digital practice – or virtual care – is the remote delivery of health care services using telecommunications technology. In appropriate circumstances, it can provide a mechanism for physical therapists to provide continued care while simultaneously limiting the potential spread of the virus. Tele-practice allows patients to be assessed and treated without in person visits to a clinic.

The concept of it is not entirely new or invented in 2020 – there have been pioneering practitioners, embracing new technologies and virtual physical therapy for years.  There have been hundreds of studies around the world that provide additional evidence in support of including virtual services within traditional models of care. The World Confederation for Physical Therapy (WCPT) launched a collaborative effort to develop initiatives for the global practice and regulations of digital physical therapy practice through a Joint WCPT/INPTRA digital physical therapy Practice Task Force. 

Within our industry, it is clear that digital practice is a transformation in physical therapists’ way of offering care to our patients. The COVID-19 presents digital practice opportunities for improved access, high quality and safety in physical therapy for both service user and provider. In addition to these benefits, digital practice increases the accessibility of care for remote locations, a long-standing problem previously not addressed. Speed to get treatment has also increased as there is no travel time involved allowing both patient and therapist to maximize the use of their time. Safety of patients has always been a concern which virtual treatments are addressing, not requiring the most vulnerable and least mobile patients to take risks traveling to therapy appointments. Ongoing challenges of no scheduling flexibility are of the past as the virtual appointments offer significantly more flexibility for patients and therapists.  

Besides the obvious and often repeated benefits of virtual healthcare, I have witnessed an improvement in our ability to make vital therapeutic connections, to effect change, and to promote self-management – all to the benefit of our patients. The speed at which many in our profession have embraced this new way of providing care is truly remarkable.  We have gone from 45 virtual visits per month to over 3500 virtual visits on an average day.

The use of modern technologies and digital practices afford the physical therapy profession an excellent opportunity to engage with wide-ranging audiences to better effect and impact. It can result in services being delivered in a way that our service users want, providing resources and information more easily and swiftly, supporting service design and easier access, and encouraging learning and collaborative opportunities globally. Workforce development that reflects embracing change, keeping up to date with practice and modes of practice and technologies, and developing new knowledge and skills will be critical.  The profession is grasping this opportunity, physiotherapists are a part of a global direction that focuses on safety, efficiency, acceptability, and effectiveness—always with the users of our services being at the core of all that we do.  Other benefits include supporting service design and better access, and encouraging learning and collaborative opportunities globally.

Going forward, a HYBRID model will emerge as a combination of In-Person and Virtual Care.  It will provide a whole new level of safety, flexibility and convenience for patients as well as benefits to society.

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