[Margaret Harlow]

My telehealth experience was to assess a patient following an ankle sprain injury to determine if they needed to go to the emergency department for X-Rays. During my evaluation, I took the patient’s history, subjective social information, and performed a virtual physical exam to determine the extent of the ankle injury. I felt that I was able to gather enough information to determine the proper course of action for the patient. I had some difficulty giving instruction over the telehealth call regarding ankle exam techniques – I kept using language that had medical jargon and continuously needed to correct myself to speak plainly and with simple speech. I felt I was able to provide a high level of care to the patient and determined that an ankle X-Ray was not appropriate at this time. Other members that could have been involved in the care of this patient included an athletic trainer, nurse practitioner, physician or family members. My partner did a fabulous job throughout her evaulation of a concussion. She was extremely thorough with her questioning and performed a spot on neurological exam to determine the extent of the concussion injury. She did an excellent job speaking clearly and was able to develop patient rapport over the telehealth visit.

Orientation 5
Verbal Clarity 5
Active Listening 5
Patient-Focused 5
Tone of Voice 5
Eye Contact 5
Other Body Language 5
Empathy 5
Rapport 5
Respect 5
Therapeutic Alliance 5
Environment 5
Overall rating 5/5

Rubric Score: 9/9

https://drive.google.com/file/d/1ccaVVcYh4jOPB7ZvkXLgw3qFi3LTnqf4/view?usp=sharing

[Margaret Harlow]

1.I would use a videoconferencing telehealth model as this would allow me to view the patient’s condition and be able to properly diagnose/provide education regarding therapeutic interventions in order to better provide rehabilitative services. Adding in mHEALTH would allow me to provide documentation and exercise prescriptions to the patient to complete in their home.
2.I would use equipment that would support videoconferencing and mHEALTH services (laptop, smart phone, tablets, etc).
3.I would try to see patient populations that would most benefit from a telehealth-care setting. This could include patients that are unable to leave their home, for reasons like transportation difficulties, other life commitments that make traveling difficult. There could also be patients that are sick/immunocompromised and unable to leave to the clinic. Telehealth allows patients the opportunity to receive health care in the comfort of their own home environment.
4.At this time, I would be providing telehealth services as a student physical therapist, but in the future, it will be as a licensed physical therapist.
5.During my sessions with patients, I would continuously seek feedback regarding the delivery of care through electronic means. I can have outcome measures to assess quantitatively my performance and the patient’s progress to determine if telehealth is still needed.
6.From a legal standpoint, I would need to make sure access is controlled on both ends to prevent a HIPAA violation, or any PHI being accessible by others in an unauthorized manner.
7.Other professions I could work with include PTA’s, OT’s, ATC’s. I could also collaborate with nursing or physicians for those patients with complex cases.
8.Protocols I would have includes:
a.Appropriate technology access – providing a check-list for the patient with test links to ensure they will have the appropriate internet and system access for the telehealth appointment
b.Screening measures and surveys to determine baseline levels for patients
c.Feedback surveys to ensure I am providing them the best care
9.In order to gain consent from the patient, I would obtain verbal consent during sessions. I would also have a signed consent form on file with their signature and their understanding of what telehealth visits entails.

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