According to an article appearing in the Veterans Administration’s (VA) Office of Rural Health www.ruralhealth.va.gov publication “The Rural Connection”, the VA has a successful program to effectively use telehealth to bring physical, occupations, and speech therapy into the homes of veterans.
The VA’s Central Iowa Health Care System (VACIHCS) www.centraliowa.va.gov made the decision on a case-by-case basis to use telehealth technologies to provide rehabilitation services. The selections are based on the practitioner’s clinical judgement, professional’s standards of care and ethics, veterans consent, and available technologies and resources.
Typically, each rehabilitation session is supported by a Telehealth Clinical Technician (TCT) to train the veteran and/or their caregiver on how to safely use the appropriate telehealth technology. The TCT is generally present with the veteran during the initial exam and select follow-up visits to ensure safety during the tests.
Physical therapy is done by replacing the Physical Therapist’s (PT) hands with various assistive devices so that the veteran is able to self-treat pain and range of motion limitation in muscles and joints.
The PT is also able to address balance issues with the veteran through specific tests that do not require a PT to be physically present with the patient. Once the source of the problem with balance is determined, the PT develops a treatment plan specific to each veteran as would be done in an in-person home visit. At this point, the veteran is instructed in an individualized home exercise program to improve and maintain gains.
Occupational therapy visits performed through Clinical Video Telehealth (CVT), enables the Occupational Therapist (OT) to obtain a real-time visual on the veteran’s home environment.
After the OT observes the veteran’s normal daily living tasks within the home, the OT then develops recommendations and treatment plans based on the assessment.
The TCTs are present to assist and take free standing photos for the OT to use to make home improvements and structural alterations for home modifications. Photos are required as part of the process to obtain grants to do the home modifications through the VA’s Home Improvement and Structural Alterations program.
Speech therapy services are also provided via CVT and the speech team at the VACIHCS provides voice therapy treatment specifically for Parkinson’s disease. This intense voice treatment with more than 16 treatment sessions spanning four weeks would be challenging to do with typical face-to-face therapy.
Go to www.ruralhealth.va.gov/docs/news/ORH_Newsletter_Winer2016_FINAL.pdf to view the article.