[Christiane Kayal]

I was the patient for the ankle case and the PT for the stroke case. I performed a subjective interview followed by gross screening of ROM and strength. Pt stated she was trained and DC with a walker from the hospital but continues to exhibit difficulty with walking and utilizing R side of body (UE + LE). I did not assess gait due to A.D. not being near the patient and being at an increased risk of falls, especially with no family member or aid near to provide assistance. I reported to pt that these symptoms are to be expected following her stroke and that an HEP would be created and uploaded to her patient portal for access, so that she can work certain exercises until our next visit in the clinic. For this visit, it would have been beneficial to have another person there to assist the patient, in order to assess gait and other measures. I would also recommend this pt see speech pathology to address speech deficits. As the PT, I would also correspond with her neurologist in the future.
Zoom Recording: https://drive.google.com/drive/u/0/folders/151BCvv7lowmPB_qTizunp_6Z1zsE3Iqv
Telehealth Etiquette Checklist:
1. Orientation 5
2. Verbal clarity 5
3. Active Listening 5
4. Patient-Focused 5
5. Tone of Voice 5
6. Eye Contact 5
7. Other Body Language 5
8. Empathy 5
9. Rapport 5
10. Respect 5
11. Therapeutic Alliance 5
12. Environment 5
Overall Rating: 5

Telehealth Exam/Education Rubric:
1. 1
2. 1
3. 1
4. 1
5. 1
6. 1
7. 1
8. 1
9. 1
Total: 9/9

[Christiane Kayal]

1. The telehealth model I would use is videoconferencing. Videoconferencing would allow me to provide PT services were I can observe the patient’s body language and facial expressions, as well as allowing me to assess their current environment to ensure their home is safe and no hazards are present. During telehealth session, the videoconferencing would allow me to assess and correct the patient’s form and technique while performing exercises in the home.
2. To perform telehealth communication, I would require a safe, strong, and secure internet connection, laptop/tablet/or smartphone, and a subscription to a HIPAA safe videoconferencing system.
3. The population that I would cater to is: 1) patients would need an updated HEP for maintenance 2) geriatric patients who are homebound and cannot attend their in-clinic appointment 3) patients from OP setting who cannot attend their clinic appointment due to being out of town, sickness, or emergencies that arise.
4. Using my clinical judgment, my role as a therapist in telehealth is to serve and treat my patients just as I would if they were coming in-person to my clinic. My role is to evaluate and assess my patient & ensure their environment is safe. If their environment is not safe due to tripping or slipping hazards, it is my job to point those out/address them and make sure the patient takes care of it immediately to prevent any risk of falls. Based on the individual patient, I would also assess for any needed equipment and provide patient education on precautions and how to maintain safety in their home environment.
5. Things that I would evaluate about the session include the effectiveness of the exercises I provide and modifying the POC if that is what is necessary to improve patient outcomes. Changes or stagnancy will be apparent and evaluated throughout daily and progress notes. Patient satisfaction is also a crucial part of maintaining a good POC.
6. Laws that I would address include informed consent, HIPPA, & the state laws and regulations of telehealth.
7. Professions that I would like to include are PTA, OT, SLP, medical providers, nurses, nutritionists, orthotists, and chaplains.
8. Protocols I would develop include written informed consent forms & provide intake forms prior to evaluations to assess current functional status and pain from the patient perspective. At the end of each videoconference, I would ask for patient satisfaction and ask if there are any further questions or concerns before signing off on the call.
9. Whether patients come to in-person clinical visits or a Telehealth visit, I would have the patient sign a written consent form on their first evaluation visit and then ask for verbal consent with each following visit they participate in.

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