Build case for telehealth now

WASHINGTON - The complex rehab industry needs to make the most of CMS's decision to expand telehealth services during the coronavirus pandemic, says Mark Schmeler.

The agency announced in late April that it would begin allowing occupational therapists and physical therapists to provide telehealth services—a big win for therapists who specialize in seating and mobility, and who are trying to continue serving patients remotely.

“We don't want this taken away (after the pandemic),” said Schmeler, associate professor and vice chairman for education and training in the Department of Rehabilitation Science and Technology at the University of Pittsburgh in Pittsburgh. “We need to start putting together best practices, so six months from now, we can say, 'This really worked well and we want it to continue.' (But) they're going to ask, 'What are your protocols and practices?'”

Schmeler was a special guest during the May 14 “CRT Industry and COVID-19 Update” sponsored by NCART, NRRTS, U.S. Rehab and The Clinician Task Force.

The CRT industry doesn't have to start its best practices from scratch, Schmeler says. The American Telehealth Association has established protocols and practices in four areas: administrative, clinical, technical and ethical. Also, the American Occupational Therapy Association published a position paper in 2018 with guidelines, including “consider the validity and reliability of measures” for telehealth.

“We should apply some strategy to doing some universal outcomes measures,” he said. “So we can show some comparative effectiveness between the two.”

Schmeler acknowledges that telehealth isn't for every patient, but even without the pandemic, it's a useful took for the 50% of the population that doesn't live in metropolitan areas, where most seating clinics are located.

“It's not something we do on everybody, but it does have benefits,” he said.

Schmeler has been a proponent of what he calls telerehab going back to the '90s. Still, before the pandemic, he estimates that UPMC was doing only about 2% of outpatient clinic appointments through telehealth; now it's up to 40%.

“It's a great opportunity for complex rehab,” he said. “Unfortunately, it's not well-recognized or respective due to concerns that it's not equivalent or as effective.”