With the COVID-19 pandemic, the need for telehealth services has skyrocketed all over the healthcare industry. For many, telehealth—the broad umbrella term for remote healthcare services under which telemedicine resides—has become a favorable alternative for seeing patients and keeping treatments moving forward. But how does this work for chiropractic?
Let’s look at the use of telehealth being applied to chiropractic as we adapt to life with COVID-19.
Keeping up and engaging with patients is key for all practitioners. In light of the pandemic, this has never been more true. Finding ways in which patients can reach out and continue to make progress is the ultimate goal of telehealth, which provides physicians and patients alike with the ability to continue patient care remotely.
Though traditional physical manipulation is not possible with telehealth visits, chiropractors are able to provide chiropractic care to patients in between visits through all other procedures, including examinations, consultation, advice, and demonstration of rehab exercises patients can perform at home. Telehealth makes it easy for patients to have their concerns addressed and to stay safe while still receiving treatment.
Types of services included under telehealth include but are not limited to:
- Traditional one-on-one patient visits and
- Non-clinical services like
- Admin meetings,
- Training, and
- Educational seminars.2
Real-Time Video Conferencing
The main facilitator of remote musculoskeletal care through telehealth is real-time video conferencing, or RTVC.1 To successfully implement RTVC for patients, computers and other devices used in treatment must meet HIPAA compliant security requirements so that patient information is secure and uncompromised. Skype, Facetime, WhatsApp, and other programs do not meet HIPAA requirements and cannot be used.
In practice, patients will often log in to their visit using an electronic health record (EHR) app or other HIPAA compliant portal option that patients can access through their computer or smartphone.1 All administrative tasks can be performed as normal through the portal, including patient identification, filling out required forms, etc.
During the visit, chiropractors can engage with patients, asking them to identify areas of concern and leading patients through verbal instructions while assessing issues. Oftentimes, chiropractors will need to lead patients through the assessment process by physically demonstrating what patients must do, such as identifying muscle tenderness or checking limits in range of motion, to diagnose issues and provide feedback. Documentation, suggested treatments, payments, and scheduling of future visits will also be completed through the portal after the visit.
As a note, it is important to maintain professionalism while providing telehealth visits, namely in appearance and presentation. Backgrounds in camera view should be free from clutter and present a professional setting. In addition, practitioners should wear professional attire for any patient-facing visits. For many patients, telehealth is uncharted territory, and with the level of uncertainty in day-to-day life, seeing their physician in standard, professional attire as usual is a reinforcement of stability, normalcy, and physician credibility that cannot be overlooked.
Finding a way to bridge both virtual and in-office services is a challenge3; however, the benefits of incorporating telehealth into chiropractic care can be essential for many practices. Widening the field to include more remote services can have larger appeal to many patients, especially those for whom at-home care would be ideal. It would also help practitioners expand their reach to help patients who otherwise could not make the trip to the office. This is not only beneficial during the pandemic but also moving forward when consultative visits can be performed remotely as an alternative to overcrowded waiting rooms and as a solution to maximize in-office efficiency during visits.
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1Green, Bart N, et al. “Rapid Deployment of Chiropractic Telehealth at 2 Worksite Health Centers in Response to the COVID-19 Pandemic: Observations from the Field.” Journal of Manipulative and Physiological Therapeutics, By National University of Health Sciences., 11 June 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7286829/.
2“What Is Telehealth? How Is Telehealth Different from Telemedicine?” HealthIT.gov, 17 Oct. 2019, www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine.
3Jercich, Kat. “Telehealth’s Post-COVID Challenge: Integrating in-Person Care.” Healthcare IT News, 4 June 2020, www.healthcareitnews.com/news/telehealths-post-covid-challenge-integrating-person-care.