TELEHEALTH
IN PHYSICAL THERAPY
Jesse Song
MSPH Student
Board of Physical Therapy Examiner
• Regulating physical therapy since 1947
• Mission: Protecting the citizens of Maryland
1) Facilitating licensure of both Physical Therapists
and Physical Therapist Assistants
2) Receive and resolve complaints
3) Setting standards for the practice of physical
therapy that reflect current and upcoming
developments
Project Overview
1) Comprehensive review of current best telehealth
practices and regulations in the 50 states
2) Contact state boards, professional association,
academia, and private parties
3) Create a literature review of evidence supporting
telehealth practices
What is Telehealth?
“Use of electronic communications to provide and
deliver a host of health-related information and
health care services, including, but not limited to
physical therapy-related information and services,
over large and small distances.
Telehealth encompasses a variety of health care and
health promotion activities, including, but not limited
to, education, advice, reminders, interventions, and
monitoring of interventions”
– American Physical Therapy Association
Physical Therapy in Telehealth?
Image Courtesy of Clay Brown, PT, DPT
Methods
1) Consulted literature on telehealth from
professional associations and telehealth special
interest groups
2) Searched for regulations through Lexis Nexus
State Capitol for telehealth regulations
3) Contacted and interviewed boards and
practitioners in states with relevant regulations
Location of Regulations
WA
PA
MD
NM
TX
AK
NJ
GA
Alaska’s Example
Images Courtesy of Clay Brown, PT, DPT
• Alaska is very large and travelling can be difficult
• Travel can only happen by flight, often costing $7005
• “Moving information rather than moving people”3
Regulatory Language Recommendations
• Broad definition of Telehealth
• Secure Data Encryption and HIPAA Compliance
• Initial Consultation as In-person Requirement
• Inter-state Jurisdiction Issues
• Clinical Records Documentation
Limitations and Challenges
• Lack of states with telehealth regulations in physical
therapy
• Concerns are of speculative nature
• Limited evidence in physical therapy and telehealth
of current practices
• Telehealth is still a growing and changing field
Lessons Learned
• A better understanding of the regulatory process
• The importance of networking
• People are happy to help
• There may not be a concrete answer
Implications
• Maryland is pushing for the growth of telehealth7
• Statute requiring reimbursement from private
insurance passed October 2012
• A need to develop regulations soon
• Based on limited examples
• Predict growth of the field
• Telehealth can be an important tool for increasing
access to healthcare and improving health outcome
References
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Alaska State Physical Therapy and Occupational Board: Standards for practice of telerehabilitation by
physical therapists, 12 A.A.C. pt 54.530 (2011). Retrieved from:
http://www.commerce.state.ak.us/occ/pub/PT-OTStatutes.pdf
American Physical Therapy Association. (2012, August 15). Telehealth - definitions and guidelines. Retrieved
from http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/Practice/
TelehealthDefinitionsGuidelines.pdf
Brown, C., Henderson, N., & McAdoo, P. Physical therapy telemedicine (tele-pt) in rural southwestern Alaska.
Hanson, D. (2012, June 22). Telehealth. Retrieved from http://www.infinityrehab.com/telehealth
Lee, A. (Host), & Stout, K. (Guest) (2012, September 13). Advances in PT practice: Telehealth essentials.
APTA Learning Center. [Video podcast].
Maryland Board of Physician: Telemedicine, 10 C.O.M.A.R. pt 32.05 (2009). Retrieved from:
http://www.mbp.state.md.us/pages/regulations.html
Orlando, V. Rural Maryland Council, (2011). December 2010 maryland telehealth and telemedicine (thtm)
roundtable . Retrieved from website: http://www.rural.state.md.us/Roundtables/
Telehealth_2010/THTM_Roundtable_FINAL_Jan2011.pdf
Texas State Board of Examiners for Speech-Language Pathology and Audiology Telehealth, 741 T.A.C. pt
741.211-215 (2012). Retrieved from: http://www.dshs.state.tx.us/speech/sp_rules.shtm
Washington Board of Physical Therapy: Use of telehealth in the practice of physical therapy, 246 W.A.C. pt
915.187 (2011). Retrieved from: http://apps.leg.wa.gov/wac/default.aspx?cite=246-915-187
Acknowledgements
• The Board of Physical Therapy Examiners
• Carlton Curry, Joy Aaron, and the staff
• Board Members John Baker and Rhea Cohn
• Maryland’s Boards and Staff
• Robin Bailey from the Board of Physicians
• State Boards of Physical Therapy
• Kris Waidley from Washington
• Connie Petz from Alaska
• New Mexico’s Board
• Practitioners in Telehealth
• Alec Kay, Clay Brown, and Diana Christiana
• Alan Lee, Associate Professor at Mount St. Mary’s College
• Phase Advisors Jennifer Le and Beth Resnick
Questions?
Jesse Song
MSPH 2014
Health Policy & Management
[email protected]
Board of Physical Therapy Examiners
4201 Patterson Avenue
Baltimore, MD 21215
Telephone: (410) 764-4718