Due to the coronavirus, most municipalities and regions are under a stricter level of social distancing. Many are calling for people to ‘shelter-in-place’. Depending on where you reside and practice, you’ve likely shuttered your clinic by now. That doesn’t mean you have to stop treating patients.
Sports professionals around the world are exploring telehealth or telemedicine to continue to treat athletes. Despite the wholesale canceling of nearly every athletic event, including the upcoming summer
Olympics in Japan, athletes will continue to need your expertise. Those currently on your treatment schedule need further guidance with their rehab and retraining so they are ready to return to sport. Others will participate in whatever activities they can to stay fit during the competition hiatus. Inevitably, they will suffer injuries that need input from a physio or trainer. Finally, some need to stay in performance shape and ready once given the ‘all clear.’ These may be younger athletes that have limited access to equipment and don’t know where to start with a home-based program.
There are many resources for setting up a telemedicine practice. The focus of today’s newsletter isn't on the mechanics of telehealth. Rather, it’s to show those used to working with athletes face to face how to make telehealth an effective treatment approach. Even if you've shied away from public video content, it’s time for you to step up to the telehealth role! Here are a few tips which will make you seem like a telehealth star.
- Casting call: Make sure all patients complete the same paperwork as they would in the clinic. There are multiple ways to handle this from fillable forms to print and scan forms. The information such as full name, address, and emergency contact is still just as important. Don’t be complacent and think that because someone is sitting in their home, there might not be an emergency during your treatment.
- Supporting roles: Consult with your local and state officials regarding the use of telehealth. By now, most have made it within everyone’s scope of practice. However, minimize liability by making sure you’re within all regulations. Review the privacy standards with whatever portal you are using to communicate and treat patients. Some states require specific privacy standards, such as HIPPA in the US. Also, check with your professional insurance provider to ensure that your policy covers telehealth treatments.
- Star of the show: Communicate with the patient before the session and advise them to wear clothing appropriate for exercise. If you need to see the injured area, ask them to wear shorts or a tank top. Remind them they will need a private and quiet area but with room to move. Chatting from the front seat of their car typically won’t work.
- Technical difficulties: Glitches are bound to happen. As you get more comfortable with the tech, things will go more smoothly. Address any technical issues right away. If the patient is out of focus because they are moving the camera too much, have them stabilize the camera. Poor internet connections might mean they need to move closer to their router. If you’re having trouble hearing them because of their noisy background, advise them that to make the most of the session, they should move someplace quieter.
- Quiet on the set: Unlike Skyping your mom from the kitchen, telehealth sessions should be conducted somewhere quiet and private. In your home, this can be a closet or nook away from others. Some patients, new to this mode of treatment, may want assurance that no one else is around. Try to minimize distractions in your camera background. A blank wall or a virtual backdrop helps keep the patient focused on what you’re saying. And while all the pets are getting their big moment these days with onscreen debuts, they are a distraction to both you and the patient, thus better left off-screen.Minimize onscreen distractions as well. Close browser tabs and put your computer on ‘do not disturb’ during clinic time. Otherwise, the patient can hear a chime with every email that comes in, and you’ll be tempted to take a peek.
- Lights, camera, action: The Academy Awards have a whole category for lighting and sound. It makes a big difference if your client can see you. Try to add a lamp or additional light to your setup. Use earbuds or headphones with a microphone to improve hearing on both ends.
- Winning performance: You may be at home, but you don’t want to show up in your dressing gown. Dressing as you would at the clinic gives the patient confidence that this new mode of therapy is just as effective. To further help with building rapport and connection, try to look directly at the camera as if you are looking at the person. You may need to use exaggerated expressions and gestures to engage the athlete over telehealth. Stop frequently throughout the treatment to confirm verbal understanding from the patient, as you may miss non-verbal cues. Sometimes the brief delays in video conferencing interrupt the natural flow of conversation. Frequent pauses give the patient time to ask questions.
- Take a bow: Therapists can learn a lot from the subjective interview, but rarely do we sit still for long. When able, adjust the camera so that you can demonstrate any tests or exercises you want the patient to perform. If space is limited, cue up several YouTube videos to show what you’re talking about. Most platforms have a screen sharing option where the patient can see the what you pull up on your screen.
End the meeting by quickly reviewing what you’ve discussed during the session, including the plan for their home program, the materials you will send to them separately via email, and the need for future appointments. Have an agreed-upon mode of communication, such as email or text, to follow up and ask questions.
This new mode of practice seems strange at first but can be effective at providing the athlete with what they need while keeping everyone healthy. Follow the listed guidelines, and you will look like a pro from the start!
References
- Seager van Dyk, Ilana & Kroll, Juliet & Martinez, Ruben. (2020). COVID-19 Tips: Building Rapport with Youth via Telehealth. 10.13140/RG.2.2.23293.10727.