First, let’s pretend there isn’t a world-wide pandemic currently turning our world upside down and changing the healthcare system as we know it. If I were to put the words “Telehealth” and “Vestibular Therapy” in the same sentence, your first thought would most likely be “that couldn’t possibly work and provide quality care!” Aside from talking just about vestibular therapy, I think many physical therapists would think the same thing applied to telehealth physical therapy in general. However, COVID-19 has us all thinking and feeling a little differently these days, and let me say… I wish I saw the light sooner!
We’re now living in times where we have shelter-in-place or stay-at-home orders that are keeping a large amount of our patients in their homes. Many PT clinics and additional healthcare settings remain open, leaving all of us scrambling to keep up with the constant rule changes for Medicare/Insurance Companies, figuring out how to best serve our patients, and monitor changes in our practice acts. Not to mention we’re now navigating the increased stress of stepping-up health precautions in the clinic, worrying about getting yourself or your family sick, managing caseloads with massive amounts of cancelations, and now learning how to perform telehealth visits! Yikes!
At first, I was not a fan of the idea of learning how to perform telehealth visits, but now I must admit that I’m really liking it since I’ve been getting the hang of it! Here’s why…
Before completely dismissing the idea, let me make some things clear:
Consider these things in terms of a vestibular telehealth visit:
Telehealth may be a way to manage a patient’s anxiety
Subjective history alone gives you a ton of information
We don’t need to perform every test under the sun
“But what if I miss something because I’m not using my Infrared Goggles?”
So, what’s the takeaway?
I’m not going to go into the nitty-gritty of how to perform a vestibular telehealth visit. That’s going to differ from clinician to clinician. My hope is that this blog entry will help vestibular clinicians feel more comfortable with the idea of telehealth, and to see the potential in front of us to help more vestibular patients. Aside from the pandemic, there are SO MANY patients in areas without access to comprehensive resources for vestibular diagnosis and treatment. Others may lack transportation or the mobility to be able to attend a session in the clinic. Consider how much easier a BPPV follow up visit could be if performed over telehealth!
If you’re one of the many currently furloughed from work, start to consider how you could replicate tests you perform in the clinic over a virtual visit. Think outside the box! There are already a few brave pioneers who are forging a path ahead for us and letting us in on their accumulated knowledge. Take Kathleen Stross, PT, MS, CHC for example. Here is a fantastic video she put together that she sends out to her vestibular telehealth patients before their first visit.
In January 2019 at the APTA Combined Sections Meeting, Linda D’Silva, PT, PhD, NCS, Sarah Gallagher, PT, DPT, NCS, Alan Chong W. Lee, PT, PhD, DPT, CWS,GCS, Sara Oxborough, PT, and Karen Skop, PT, DPT, MS gave a fantastic presentation on “Telehealth and Vestibular Rehabilitation” where they shared their insights and experience on performing telehealth with patients. (See a summary here)
Abbie Ross, PT, DPT, NCS also presented a poster at CSM on “The Use of Telerehabilitation in the Treatment of Post-Concussion Syndrome: A Case Study”. Back in 2018, she opened one of the first completely virtual physical therapy (telehealth) practices in the nation and has provided care through live videoconferencing ever since. I should mention here that I had the pleasure of meeting Abbie at CSM back in 2019, and now I couldn’t be more excited to be joining her and Balancing Act Rehabilitation on a flexible part-time basis treating patients from South Carolina, Maryland, and Virginia.
Here are some great resources for you if you’re interested in learning more about telehealth:
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