In this section, we will cover how to determine if telehealth is right for your patient. To do this, we will look at the Evidence-Based Decision-Making model and discuss how our clinical expertise fits into this decision-making process. We will also go through best practices for introducing telehealth to your patients by breaking down the what, where, when, why, and how.

This section will break down the model of shared informed decision-making (SIDM) in patient communication. Through an example patient/therapist conversation, we look at how we can use the three different types of talk (team talk, option talk, and decision talk) to navigate patient barriers to receiving treatment through telehealth.

Figuring out how best to blend telehealth and in-person treatment should be considered on a case-by-case basis with each patient. In this section, we will look at four patient case examples, each with its own unique barriers and conditions. We will discuss how telehealth can be blended within the clinical care continuum in order to add value for your patients and improve overall care.

Providing care through telehealth can mean having to navigate some technical challenges. In this section, we’ll go through best practices for hardware, software, and connectivity. We will also see how to troubleshoot technical challenges in real time with two different scenarios of a patient and therapist experiencing audio and video problems.

How you present yourself and frame your patient during a telehealth session can mean the difference between a positive or negative patient care experience. In this section, we will go through how to effectively present yourself to your patient, taking into account framing, lighting, environment, and clothing. We will also cover how to properly frame your patient to make sure you are able to successfully observe the patient’s movements during your session.

Translating in-person care to the virtual environment means changing the way that we think about conducting an assessment and delivering treatment. In this section, we will cover best practices for coaching and cueing patient assessment techniques in a telehealth platform. We will also highlight the ways telehealth can be used to improve the patient treatment experience, virtually bringing the therapist into a patient’s home environment.

Building a therapeutic alliance with your patient is a key element in patient engagement and adherence to the therapy program. In a teleheath visit, building this alliance with your patient is more heavily weighted on communication skills compared to an in-person visit. In this section, we will cover how to build rapport with your patient in a virtual visit and discuss tips for motivational interviewing.

In this chapter, you will learn how to align patient expectations for a telehealth visit. This includes utilizing intake forms with telehealth considerations, assessing the patient’s status through subjective report questionnaires, ensuring patient safety through appropriate medical screening, and establishing emergency procedures with the patient.

In this chapter, you will learn telehealth-specific considerations that should be addressed both before and during the encounter related to the subjective exam. This includes telehealth-specific education materials, intake forms, and consent forms. This chapter will also cover the safety and emergency information needed during every telehealth visit.

In this chapter, you will cover six different communication themes present during telehealth: preinteractional, educational, verbal, nonverbal, relational, and environmental. You will learn how the delivery of these themes will improve your ability to collect patient information and develop rapport. You will go over strategies to integrate these themes into your interactions in the telehealth environment to improve overall patient care.

In this chapter, you will learn why subjective screening is of vital importance and how best to screen for red and yellow flags in the remote environment. You will cover how to determine if a patient is appropriate for a telehealth visit and methods to blend in-person care with telehealth.

This chapter will cover how to structure a remote objective exam by dividing the exam into four main components: posture/movement, mobility, muscle performance, and additional tests. Each of these components can be performed in the telehealth setting, although some tests and measures may need to be modified. You will also learn how to sequence a remote exam as it relates to symptom irritability, patient position, and camera position, as well as how to determine whether a patient is appropriate for virtual care.

In this chapter, you will learn how to perform accurate analysis of posture and movement remotely. You will learn how to visualize, analyze, and modify a patient’s posture and movement during a telehealth visit. Tips will be given on how to share your findings with the patient, optimize functional movement tests, utilize symptom modification procedures, and progress functional tasks in the patient’s home environment.

In this chapter, you will learn how to accurately assess range of motion in the remote environment with both low-tech and high-tech methods. This includes on-screen goniometry and digital goniometry. You will also learn how to progress isolated joint range-of-motion assessments into functional range-of-motion measurements.

Assessing muscle performance in traditional ways poses challenges during a telehealth visit. In this chapter, you will go over simple alternate methods to assess muscle performance remotely. These methods include reps to fatigue, isometric holds, changing lever arms, and self-applied pressure. You will also go over various ways to quantify isolated lifts, compound lifts, and functional performance testing by adding household items with known weights.

With forethought, care, and a keen eye, one can still obtain quality objective information during a telehealth visit. Just like in the in-person setting, the objective information is meaningful, but what is most important is your interpretation of the data. In this chapter, you will go over how to perform and modify additional tests and measures remotely, put it all together into a full objective assessment, and interpret the data with clinical reasoning.

This chapter will cover the basics of getting started with implementing telehealth interventions. This includes resources to give to patients, that indicate the rehabilitation tools they have available and instructions on how to adapt household items into rehab tools. You will also be introduced to the four categories of interventions: neuromuscular reeducation, joint/muscle mobility, muscle performance, and patient education.

In this chapter, you will learn how to utilize verbal, visual, and tactile cues to improve your ability to perform neuromuscular reeducation in the telehealth environment. There may be situations during a telehealth visit where it is difficult to use more than one type of cue, so it is helpful to gain proficiency in all forms of cueing remotely. This chapter will cover each type of cue and will provide strategies on how to integrate motor learning principles into your remote practice.

In this chapter, you will review the research on joint and muscle mobility interventions. You will go over many options for patients to self-perform joint mobilizations, soft-tissue mobilization, and stretches. You will learn how self-performed mobilizations can be as effective, or in some cases more effective, than clinician-assisted mobilizations. Additional resources will be provided to show how to adapt clinician-applied mobilizations into creative patient self-mobilizations.

In this chapter, you will learn how to dose muscle performance exercises remotely based on strength, hypertrophy, power, and endurance parameters. You will go over telehealth clinical scenarios addressing how to prescribe muscle performance exercises based on patient goals and functional positions.

In this chapter, you will be introduced to the VAK model and taught how it can be applied to patient education during a telehealth visit. You will go over various forms of visual, auditory, and kinesthetic education modalities and will learn how to tailor your patient education remotely by matching education delivery methods to a patient's preferred learning style.

In this chapter, you will be introduced to the structure of the course and the breakdown of each chapter. You will then learn how to set expectations for telehealth visits with your patients, frame your video for optimal patient interactions, and troubleshoot common tech issues during a telehealth session.

This chapter introduces telehealth subjective examination tips for neurologic physical therapy. We also dive deeper into asking questions to screen for sensory loss and problematic areas throughout the home.

In this chapter, we will review a full neurologic screen in the telehealth setting. We demonstrate how a successful screen can be performed for the motor system, sensory system, cranial nerves, and coordination in a person with brain stem/cerebellar stroke.

This chapter demonstrates intervention tips for challenging balance and mobility safely in the telehealth setting for a person with ataxia. We will demonstrate the use of the home setup and care partners to safely challenge balance, gait, and functional mobility.

In this chapter, we will recap the course content, key concepts, and learning objectives. Additionally, you will watch an interview that will include subjective, objective, and intervention-related clinical pearls that you can use to maximize the benefit of your telehealth sessions for people with neurologic conditions.

In this chapter, you will be introduced to the structure of the course and the breakdown of each chapter. You will then learn how to set expectations for telehealth visits with your patients, frame your video for optimal patient interactions, and troubleshoot common tech issues during a telehealth session.

This chapter introduces telehealth subjective examination tips for geriatric physical therapy. We also dive deeper into screening balance and cognition via telehealth.

In this chapter, we will review a quick screen of the cardiovascular system and education with use of the rating of perceived exertion (RPE). We also demonstrate the TUG and introduce the Rate of Perceived Stability Scale usage for balance testing with the modified CTSIB test.

This chapter demonstrates intervention tips for challenging balance and mobility safely in the telehealth setting. We will demonstrate the use of the OPTIMAL theory to provide the patient autonomy and choice for setting the balance challenge during treatment.

In this chapter, we will recap the course content, key concepts, and learning objectives. Additionally, you will watch an interview that will include subjective, objective, and intervention-related clinical pearls that you can use to maximize the benefit of your telehealth sessions for older individuals.