As Europe enters a second wave of COVID-19 cases and hot spots continue to spring up in the US, health professionals continue to think differently about providing care to their patients. The number of practitioners using telehealth medicine in primary care, in particular, has grown alongside the spread of the pandemic as clinicians try to segregate well and sick visits. The trend is worldwide, and guidelines, such as those provided by the Royal Australian College of General Practice, are helping practitioners transition. Sports clinicians face the same challenges as those in primary care, but due to the different structures in primary care and the sports medicine clinic, merely replicating primary-care telehealth protocols may not be ideal.
Key telehealth principles for sports clinicians
In response to the differences in practice environments, an international panel of orthopedic and sports medicine scientists identified the need for more clarity for sports clinicians who provide distance medicine(1). In a narrative review, the researchers defined tele-Sport-and-Exercise-Medicine (teleSEM) as,
“…the use of electronic communications and software to provide clinical SEM services such as diagnosis and patient care without an in-person visit.”
They then proposed guidelines for conducting a successful teleSEM visit. Firstly, establish the need for a remote consultation. Next, consider the options for the consultation delivery method based on the athlete’s circumstances, access to and knowledge of technology, and the nature of the injury. These include:
Text, audio, or video – Give patients the option to select a telephone or video consultation when making appointments.
Knowing the technology –Choose the technology that is the most compatible with the clinic’s and the patient’s resources. Ensure a good understanding of how the tech works and have a back-up plan should difficulties arise.
The multi-center team also provided clear guidelines on sticking to core ethical principles while delivering telemedicine services. These principles include ensuring patient safety, using secure and effective communication methods, recommending appropriate and practical treatment options, ensuring opportunities for patients to give feedback, and implementing strategies to evaluate patient satisfaction.
Six-step guide
In terms of an actual consultation itself, the researchers go on to to provide a ‘6-step’ approach(1):
Plan the consultation, securing as much background information as possible (e.g., medical records and online patient intake paperwork). Familiarize the patient with the format so they know what to expect before the consultation gets underway.
Make the connection and introductions. Check that the connection is good and that the correct patient is at the visit before beginning the assessment. Make sure the patient is aware of the limitations of the consultation.
Initial screening questions should assess the severity of the athlete’s injury and that the consultation is appropriate for teleSEM.
Take a history, adapting questions to the athlete as needed.
Examine the patient, assessing mental and physical function as able with the technology in use.
Explain and discuss the working diagnosis and the possible differential diagnoses. Decide on a plan of action going forwards.
Practical tips for practitioners
The 6-step guide described above provides clinicians with a useful framework to develop effective telehealth consultations. However, theory and practice are, of course, different. There are a number of practicalities to consider. These include patient camera set up, patient positioning, and the communication styles.
Learn more about how to successfully execute a remote examination in a recently published Sports Injury Bulletin article titled, Is telehealth the answer for clinicians in a new post-COVID-19 era? This article provides several practical recommendations, which will further ensure that your telehealth consultation is not a second-rate substitute for a face-to-face appointment, but a successful and effective way of interacting with your patients!
The inauguration of the United States’ first female vice president marks another example of the windows of opportunity opening to women in all aspects of society. One hallmark moment for female athletes was Title IX’s inclusion as part of the Education Amendments passed in the US in 1972. This amendment prohibited discrimination on the basis... MORE
In any given year, nearly 80% of runners will report a running-related injury (RRI). Hip weakness and faulty kinematics are frequently implicated in injuries such as iliotibial band syndrome and medial tibial stress syndrome. However, without a high-tech running lab, clinicians have few resources to analyze running form. Therefore, a group of researchers from Montana... MORE
Anterior cruciate ligament injuries remain one of the most common sports injuries(1). While sports injury science has made strides toward understanding the causes of injury and prevention strategies, many young athletes still suffer from ACL tears and ruptures. In 2019, sports professionals from various disciplines gathered in Pittsburgh, Pennsylvania, to reach a consensus on the... MORE
Paper Title: A Secondary Injury Prevention Program May Decrease Contralateral Anterior Cruciate Ligament Injuries in Female Athletes: 2-Year Injury Rates in the ACL-SPORTS Randomized Controlled Trial Publication: J Orthop Sports Phys Ther.2020 Sep;50(9):523-530. doi: 10.2519/jospt.2020.9407. Publication Date: Epub 2020 Aug 1 INTRODUCTION: Rehab of athletes after ACL reconstruction surgery (ACL-r) often includes quad strengthening, plyometrics,... MORE
Gluteus medius (GMed)weakness gets blamed for all manner of lower extremity injuries. This broad muscle lies under the gluteus maximus, arises from the ilium’s posterior portion and spans from the iliac crest to the sciatic notch, and attaches on the greater trochanter of the femur. The muscle spreads out like a fan and has three... MORE
There are two reasons why clinicians should consider rehabilitating athletes differently than other individuals. Firstly, athletes are already highly trained with muscular adaptations for their sport. Secondly, they desire to return to a level of performance beyond community-based activity. Therefore, they start with a baseline of strength beyond most individuals, and they need to return... MORE