Covid-19's 'silver lining': an expansion in the delivery of physiotherapy using digital options
Last year’s spread of the Covid-19 pandemic around the world appears to have had an unexpected ‘silver lining’, according to a briefing paper published by World Physiotherapy, the London-based body that represents 125 member organisations.
As the pandemic unfolded and lockdowns occurred sporadically, ‘receptive and creative’ physiotherapists began to embrace new approaches through using digital platforms, resulting, in some cases, in a ‘significant expansion’ in provision, the report states.
The paper, titled World Physiotherapy Response to Covid-19: Physiotherapy digital practice experiences and insights during Covid-19, is based on the responses to a survey from all five of World Physiotherapy’s regions at the end of 2020.
Thirty-four member organisations took part, and three sub-groups and 148 individual physiotherapists from 48 countries or territories also submitted responses.
One member organisation said: ‘We must also make the most of the cultural change in the profession and in the public with acceptance of digital. If we don't make the most of this it will take years to regain any lost ground.’
While some respondents had previously mainly used digital platforms to deliver musculoskeletal services, a ‘significant growth’ occurred in cardiorespiratory, paediatrics and treating long-term conditions as the pandemic unfolded.
Progress was not achieved universally, however, in part perhaps because responses came from countries with ‘low’, ‘medium’ and ‘high’ resources.
The paper’s list of ‘barriers’ includes poor ‘technology infrastructure’ (a factor that can also hamper developments in high-income countries), reimbursement issues, and policy and data security factors. Other topics include a lack of competence in ‘digital technology solutions’ and ‘negative attitudes’ among both physiotherapists and service users alike.
Future potential: key points from section titled ‘Future insights and action’
• progress to be maintained but innovations will need reviewing
• technology solutions have advanced rapidly but need further development
• a blended delivery approach needed, combining in-person and digital services
• students and practising physios need education to support the development of competencies
• research is needed to assess modes of delivery and outcomes
• advocacy needed to retain funding support
• address poor technology infrastructure and the ‘digital divide’
The paper states: ‘Many [respondents] noted that digital solutions would be an adjunct to face-to-face services and not a replacement. The overwhelming observation was that digital practice solutions were here to stay.’
It also notes: ‘Whilst much of the evidence base for telerehabilitation comes from musculoskeletal practice, new insights are emerging from other digital practice services prompted by the pandemic. An example is the transition to digital delivery of a support programme for those newly diagnosed with Parkinson’s disease.
'It is interesting to note the coaching model used in the programme; the importance of communication skills in the provision of digital services and the requirement to recognise the different strategies and techniques required has been reported.’ See: https://academic.oup.com/ptj/article/100/10/1730/5876269
In one day ... I completed a home visit with special permission and precautions; a video call; a phone appointment and a Microsoft teams meeting, along with online training conducted from Canada on the opposite time zone. The world is closer, even while being further apart [anonymous respondent]
According to the paper, a submission from a physiotherapist based in Australia offers a ‘valuable summary of how digital practice can complement practice and the profession can make connections across borders’.
The physio said: ‘In one day during Western Australia's very short lockdown I completed a home visit with special permission and precautions; a video call; a phone appointment and a Microsoft teams meeting, along with online training conducted from Canada on the opposite time zone. The world is closer, even while being further apart.’
Permission granted: a mixed picture
In World Physiotherapy’s 2020 census, 75 per cent of member organisations said physiotherapists were permitted to provide telehealth services. This varied by region, however: Africa 67 per cent; Asia Western Pacific 65 per cent; Europe 76 per cent; North America Caribbean 92 per cent; South America 91 per cent.
To download a copy of World Physiotherapy Response to Covid-19: Physiotherapy digital practice experiences and insights during Covid-19, visit: https://world.physio/covid-19-information-hub/covid-19-briefing-papers
To see a related PhysioUpdate article, visit: https://www.physioupdate.co.uk/news/physios-around-the-world-lacked-safety-equipment-as-covid-19-spread-last-year-/Author: Ian A McMillan