Telehealth: A Rapidly Developing Service Delivery Model for Occupational Therapy
Over the past decade, the practice of occupational therapy has been increasingly influenced by technological advances in the use of information and communication technologies (ICT) and associated changes in health care policy. Emergent from this evolution is the application of telehealth to deliver occupational therapy services to clients who are in a different physical location than the provider. This article furnishes an overview of the evidence for telehealth use in occupational therapy, discusses key policy considerations, and provides resources to guide practitioners in the ethical use of telehealth.
Accreditation Council for Occupational Therapy Education [ACOTE]. (2013). 2011 Accreditation Standards and Interpretive Guide (Effective July 31, 2013) - December 2013 Interpretive Guide version. Retrieved from http://www.aota.org/-/media/Corporate/Files/
American Occupational Therapy Association. (2014). Emerging niche: Telehealth. Retrieved from http://www.aota.org/Practice/Rehabilitation-Disability/Emerging-Niche/Telehealth.aspx
American Occupational Therapy Association. (2013a). Telehealth ethics advisory opinion. Retrieved from http://www.aota.org//media/Corporate/Files/Practice/Ethics/Advisory/telehealth-advisory.pdf
American Occupational Therapy Association. (2013b). Telehealth [Position paper]. American Journal of Occupational Therapy, 67(Suppl), S69-S90. doi:10.5014/ajot.2013.67S69
American Telemedicine Association. (2014a). State Medicaid best practice-Telerehabilitation (January 2014). Retrieved from http://www.americantelemed.org/docs/default-source/policy/state-medicaid-best-practice---telerehabilitation.pdf?sfvrsn=4
American Telemedicine Association. (2014b). 2014 State Telemedicine Legislation Tracking (as of 6/24/2014). Retrieved from http://www.americantelemed.org/docs/default-source/policy/state-telemedicine-policy-matrix.pdf?sfvrsn=32
American Telemedicine Association. (2013). Removing medical licensure barriers: Increasing consumer choice, improving safety and cutting costs for patients across America. Retrieved from http://www.americantelemed.org/fixlicensure-org
American Telemedicine Association. (2012). ATA applauds congressional proposal to increase telemedicine reimbursement, fix licensure for federal health programs. Retrieved from http://www.americantelemed.org/news-landing/2013/01/04/ata-applauds-congressional-
American Telemedicine Association. (2010). A blueprint for telerehabilitation guidelines. Retrieved from http://www.americantelemed.org/docs/default-source/standards/a-
Barlow, I.G, Liu, L, & Sekulic, A. (2009). Wheelchair seating assessment and intervention: A comparison between telerehabilitation and face-to-face service. International Journal of Telerehabilitation, 1(1), 17-28. doi: 10.5195/ijt.2009.868. Retrieved from http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/view/868
Bendixen, R., Levy, C., Olive, E., Kobb, R., & Mann, W. (2009). Cost effectiveness of a telerehabilitation program to support chronically ill and disabled elders in their homes. Telemedicine and eHealth, 15(1), 31-38. doi:10.1089/tmj.2008.0046
Brannon, J.A., Cohn, E.R, & Cason, J. (2012). Making the case for uniformity in professional state licensure requirements. International Journal of Telerehabilitation, 4(1), 41-46. Retrieved from http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/view/6091
Cason, J. (2012a). An introduction to telehealth as a service delivery model within occupational therapy. OT Practice, 17(4), CE-1–CE-8.
Cason, J. (2012b). Telehealth opportunities in occupational therapy through the Affordable Care Act. American Journal of Occupational Therapy, 66, 131-136.
Cason, J. & Brannon, J.A. (2011). Telehealth regulatory and legal considerations: Frequently asked questions. International Journal of Telerehabilitation, 3(2), 15-18. doi: 10.5195/ijt.2011.6077. Retrieved from http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/view/6077
Cason, J., & Cohn, E.R. (2014). Telepractice: An overview and best practices. ASHA Perpectives, 23(1), 4-17.
Cason, J., Hartmann, K., & Crutchley, S. (2011, August 29). Use of telehealth in early intervention and school system practice. American Occupational Therapy Association
National Pediatric Virtual Chat. Retrieved from http://otconnections.aota.org/media/p/78416.aspx
Centers for Medicare and Medicaid Services. (2012). Telehealth services. Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
Children’s Hospital of Richmond at Virginia Commonwealth University. (2014).Feeding program. Retrieved from http://www.chrichmond.org/Services/Feeding-Program.htm
Clawson, B., Selden, M., Lacks, M., Deaton, A., Hall, B., & Bach, R. (2008). Complex pediatric feeding disorders: Using teleconferencing technology to improve access to a treatment program. Pediatric Nursing, 34, 213-216.
Cohn, E.R., Brannon, J.A., & Cason, J. (2011) Resolving barriers to licensure portability for telerehabilitation professionals. International Journal of Telerehabilitation,
(2), 31-34. doi: 10.5195/ijt.2011.6078. Available at:
Darkins, A., Cruise, C, Armstrong, M., Peters, J., & Finn, M. (2008). Enhancing access of combat wounded veterans to specialist rehabilitation services: The VA Polytrauma Telehealth Network. Archives of Physical Medicine and Rehabilitation, 89, 182-187. doi: 10.1016/j.
deGolian, C. (2014, January/February). Medical licensing compacts – A new approach to healthcare. Retrieved from http://www.csg.org/pubs/capitolideas/enews/issue128_2.aspx
Federation of State Boards of Physical Therapy [FSBPT]. (2011). Feasibility of establishing a multistate compact for physical therapy licensure: Report to the delegate assembly on 2010 delegate assembly motion DEL-10-05. Retrieved from http://www.fsbpt.org/download/2011DH_
Federation of State Medical Boards [FSMB]. (2013). Interstate compact for physician licensure moves forward with consensus principles. Retrieved from http://www.fsmb.org/pdf/nr_interstate_compact.pdf
Forducey, P.G., Ruwe, W., Dawson, S.J., Scheideman-Miller, C., McDonal, N.B., & Hantla, M.R. (2003). Using telerehabilitation to promote TBI recovery and transfer of knowledge. NeuroRehabilitation, 18, 103-111.
Hoffmann, T., & Russell, T. (2008). Pre-admission orthopaedic occupational therapy home visits conducted using the internet. Journal of Telemedicine and Telecare, 14 , 83 - 87.
Hoffmann, T., Russell, T., Thompson, L., Vincent, A., & Nelson, M. (2008). Using the internet to assess activities of daily living and hand function in people with Parkinson’s disease. NeuroRehabilitation, 23, 253-261.International Journal of Telerehabilitation
Jacobs, K., Blanchard, B., & Baker, N. (2012). Telehealth and ergonomics: A pilot study. Technology and Health Care, 20, 445-458.
Kairy, D., Lehoux, P., Vincent, C., & Visintin, M. (2009). A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disability and Rehabilitation, 31, 427-4 47.
Kinley, A., Zibrik, L., Cordeiro, J., Lauscher, H., & Ho, K. (2012). Telehealth for mental health and substance use: Literature review. BC Ministry of Health, Mental Health, and Substnace Use (MUSU) Branch. Retrieved from http://ehealth.med.ubc.ca/files/2013/04/TeleMental-
Schein, R.M., Schmeler, M.R., Holm, M.B., Pramuka, M., Saptono, A., & Brienza, D.M. (2011). Telerehabilitation assessment using the Functioning Everyday with a Wheelchair-Capacity instrument. Journal of Rehabilitation Research & Development, 48, 115-124.
Sanford, J., Hoenig, H., Griffiths, P., Butterfield, T., Richardson, P., & Hargraves, K. (2007). A comparison of televideo and traditional in-home rehabilitation in mobility impaired older adults. Physical and Occupational Therapy in Geriatrics, 25(3), 1–18.
Steel, K., Cox, D., & Garry, H. (2011). Therapeutic videoconferencing interventions for the treatment of long-term conditions. Journal of Telemedicine & Telecare, 17, 10 9 -117.
Taber-Doughty, T., Shurr, J., Brewer, J., & Kubik, S. (2010). Standard care and telecare services: Comparing the effectiveness of two service systems with consumers with intellectual disabilities. Journal of Intellectual Disabilities Research, 54, 843-859.
Telehealth Resource Centers. (2013). Telehealth resource centers. Retrieved from http://www.
telehealthresourcecenter.org/ Thompson, G. (2011, December 11). Thompson bill included in final national defense policy agreement, provisions praised by army leadership. Retrieved from http://thompson.house.gov/press-release/thompson-bill-included-final-national-defense-policy-agreement-provisions-praised-army
U.S. Department of Defense. (2014). National Center for Telehealth & Technology. Retrieved from http://www.t2.health.mil/
U.S. Department of Health and Human Services, Health Resources and Services Administration (2001). Health Licensing Board Report to Congress. Retrieved from http://www.hrsa.gov/ruralhealth/about/telehealth/licenserpt10.pdf
U.S. Department of Veterans Affairs. (2014a). VA telehealth services. Retrieved from http://www.telehealth.va.gov/
U.S. Department of Veterans Affairs. (2014b). VA telehealth services: Real-time clinic based video telehealth. Retrieved from http://www.telehealth.va.gov/real-time/index.asp
Watzlaf, V., Fahima, R., Moeini, S., Matusow, L. & Firouzan, P. (2011). VoIP for telerehabilitation: A risk analysis for privacy, security, and HIPAA compliance – Part II.
International Journal of Telerehabilitation, 3(1), 3-10. doi: 10.5195/IJT.2011.6070 Available at http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/view/6070
Watzlaf, V., Moeini, S., & Firouzan, P. (2010). VoIP for telerehabilitation: A risk analysis for privacy, security, and HIPAA compliance - Part 1. International Journal of Telerehabilitation, 2(2), 3-14. doi: 10.5195/ijt.2010.6056 Retrieved from http://telerehab.pitt.edu/ojs/index.php/
Whelan, L., & Wagner, N. (2011). Technology that touches lives: Teleconsultation to benefit persons with upper limb loss. International Journal of Telerehabilitation, 3(2), 19-22. doi: 10.5195/ijt.2011.6080. Retrieved from http://telerehab.pitt.edu/ojs/index.php/Telerehab/article/
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