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Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington

Alan Chong W. Lee, Michael Billings
DOI: 10.2522/ptj.20150079 Published 1 February 2016
Alan Chong W. Lee
A.C.W. Lee, PT, PhD, DPT, CWS, GCS, Physical Therapy Department, Mount Saint Mary's University, Los Angeles, 10 Chester Pl, Los Angeles, CA 90007 (USA).
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Michael Billings
M. Billings, PT, MS, CEEAA, Infinity Rehab, Wilsonville, Oregon.
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Abstract

Background and Purpose Telehealth is defined as the delivery of health-related services and information via telecommunication technologies. The purposes of this case report are: (1) to describe the development, implementation, and evaluation of a telehealth approach for meeting physical therapist supervision requirements in a skilled nursing facility (SNF) in Washington and (2) to explore clinical and human factors of physical therapist practice in an SNF delivered via telehealth.

Case Description In 2009, Infinity Rehab conducted a pilot program to determine whether telehealth could be used to meet physical therapist supervision requirements in an SNF. In 2011, language allowing telehealth physical therapy was approved by the Washington Board of Physical Therapy (Board). In 2014–2015, telehealth outcomes were evaluated in a 51-person sample at an Infinity Rehab SNF. Cost savings of telehealth implementation from 2011 to 2015 were estimated.

Outcomes The Board deemed the telehealth pilot program a success and subsequently established telehealth practice language for physical therapy. Both human factors and clinical outcomes were required to implement a successful telehealth practice. Clinical outcomes and user satisfaction in telehealth and nontelehealth groups were equivalent. Cost savings were identified.

Discussion Human factors, such as the need for provider education in appropriate bedside manner with a telehealth session, were identified. Since 2011, more than 1,000 telehealth physical therapy sessions were conducted at Infinity Rehab SNFs in Washington State. In the future, alternative payment models focused on valued-based clinical outcomes may facilitate wider telehealth adoption in physical therapy. Future research on efficacy and cost-effectiveness is needed to promote broader adoption of telehealth physical therapy in SNFs. This experience demonstrates that telehealth implementation in an SNF for the purpose of physical therapy re-evaluation is a feasible alternative to in-person encounters.

Footnotes

  • Both authors provided concept/idea/project design and writing. Mr Billings provided facilities/equipment. Dr Lee provided consultation (including review of manuscript before submission).

  • The authors acknowledge the contributions of Joan Brassfield, PT, Tim Esau, PT, Stacy Portier, PTA, and Julie Buker, PTA, for their participation in the telehealth innovation initiative at Infinity Rehab, as well as the Washington Physical Therapy Board. In addition, the authors acknowledge the leadership from Dr Steven Wolf and Dr Colleen Kigin from the Frontiers in Rehabilitation Science and Technology (FiRST). Lastly, the authors are grateful to the residents at the skilled nursing facilities for participating in the telehealth programs.

  • Received February 13, 2015.
  • Accepted December 4, 2015.
  • © 2016 American Physical Therapy Association
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Vol 96 Issue 2 Table of Contents
Physical Therapy: 96 (2)

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Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington
Alan Chong W. Lee, Michael Billings
Physical Therapy Feb 2016, 96 (2) 252-259; DOI: 10.2522/ptj.20150079

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Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington
Alan Chong W. Lee, Michael Billings
Physical Therapy Feb 2016, 96 (2) 252-259; DOI: 10.2522/ptj.20150079
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  • Article
    • Abstract
    • Need for Telehealth in Washington SNFs
    • Telehealth Pilot Program
    • Telehealth Program Evaluation
    • Telehealth System
    • Considerations for Telehealth Implementation
    • Telehealth Outcomes
    • Discussion
    • Appendix.
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

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Subjects

  • Intervention
    • Patient/Client-Related Instruction
  • Physical Therapist Practice
    • Professional Issues
  • Special Series and Special Issues
    • Health Services Research Special Series
  • Health Policy & Administration
    • Health Policy & Administration: Other
    • Economics

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