Professionals working in the musculoskeletal healthcare space tend to use their hands – to diagnose, to treat, to guide and to gain trust. COVID19 has thrown business as usual out the door and has therapists scrambling to remain connected to the patients in current care and attract new patients by offering telehealth services.
But how does telehealth stack up against face-to-face care?
You might be surprised to learn that what research is available is favourable.
“There is moderate-quality evidence that telephone-based interventions, compared to usual care, are effective for pain and disability for osteoarthritis and spinal patients collectively.”
Think about it – guidelines for treating osteoarthritis (OA) and back pain recommend education, exercise and weight loss as first level care. All these interventions are delivered by empowering patients to modify behaviour through counselling. Hands-on treatments are not recommended as first line care in most guidelines because they don’t work as well!
Self efficacy, another important predictor of outcomes in back pain and OA, can be improved when using telehealth compared to face-to-face treatment. Makes sense.
Using telehealth forces clinicians to align with best practice care for OA and back pain.
Despite the supporting research, both patients and clinicians are suspicious about telehealth. It’s new and it’s unfamiliar.
We have to communicate more in the absence of “hands” – we have to verbally describe what we are seeing, we have to guide self-examination, they need to know we are receiving objective assessment information, we have to use education, rely on digital ways of communicating exercises. We need to build in additional layers of monitoring or engagement so the patient gets a clear sense of value from the process.
A routine PROM collection strategy is another tool which will contribute another dimension to your patient’s experience. You can screen for yellow flags to add depth and insights to your care. You can monitor their progress between visits and after the episode of care has ended. Digital and automated platforms make this easier.
Myscoreit includes a patient dashboard that allows you to view the progress of your patients at a glance. This way you can reach out if it seems progress has stalled or there has been decline in scores. This is so valuable during COVID19 when patients are not presenting for their usual healthcare and risk a deterioration in their chronic conditions.