PT and Telehealth
In the latest edition of Physiotherapy, there is an article about "PhysioDirect." This is a program designed to improve access and quality of care by decreasing wait times for physiotherapy. Essentially it is physiotherapy by telephone.
Patients call and receive triage, initial assessment and advice over the phone. This is done through a computer program with algorithms containing drop-down menus and free text areas to assist the clinician in making a diagnosis. Patients may then be sent information on self-management and/or exercise. If the assessment indicates an in-person visit is required, then an appointment is arranged.
The primary concerns raised about this program were not about quality of service, but rather "flooding" of physiotherapy services beyond capacity, inequity of service because only those with phones could benefit from it, and then (third on the list) was safety.
Does that bother anybody else out there? The studies about the service show that 60 percent can be managed by phone alone, 40 percent require face-to-face interventions, no-shows dropped from 15 percent to less than 1 percent and both general practitioners and patients appear to be satisfied with the service.
Objective outcomes? Anybody? So obviously I'm a little put off by this practice. What about you, my colleagues back in the States? Would you feel comfortable working in this way? Does anyone out there work in this way already? Could it actually be beneficial in remote rural areas? Might this be a dangerous way of cutting costs?
I really want to hear back on this one!
Source: Foster, N., Williams, B., Grove, S., Gamlin, J., & Salisbury, C. (2011). The evidence for and against "PhysioDirect" telephone assessment and advice services. Physiotherapy, 97:78-82.