Telehealth and
occupational
therapy: What's
changed?

Occupational therapy has leveraged the benefits of telehealth for years, helping patients in remote locations improve activities in their daily lives and work. But as telehealth has evolved, the practice of occupational therapy has grown along with it, providing more options to patients and supporting providers in a new era of their profession.

The American Occupational Therapy Association (AOTA) describes telehealth occupational therapy as "the application of evaluative, consultative, preventative, and therapeutic services delivered through telecommunication and information technologies," meaning that understanding the emerging field of telehealth and occupational therapy and the technology that supports it can benefit anyone in the field.

To understand the extensive potential of telehealth and occupational therapy, it's important to understand exactly who uses the therapy, how it's delivered and why.

First, occupational therapy is helpful for people of all ages: Elderly patients recovering from strokes can use this form of therapy to improve range of motion and learn how to use the equipment needed to perform everyday activities. Teenagers with ADHD can tap occupational therapy to improve impulse control, time management and attention. Adults can engage with an occupational therapist to recover from an injury and return to work.

Occupational therapy services are offered anywhere from pediatric private practices to schools, hospitals and even the workplace. Telehealth occupational therapy can help overcome challenges such as relocation (of either patient or practitioner) or a shortage of professionals. Patients can also benefit from engaging in the therapeutic process in their own environment.

Telehealth occupational therapy also has benefits for the therapists themselves, including location independence, decreased overhead and improved patient communication.

The application of telehealth occupational therapy will undoubtedly be shaped by COVID-19. In response to the pandemic, the AOTA offers guidance in a changing regulatory environment that gives practitioners insight into reimbursement, expansion of service options, and shifting laws and regulations.

But the pandemic is only the most recent development in a years-long evolution of modern use of telehealth in occupational therapy. For example, the Patient Protection and Affordable Care Act of 2010 inspired new perspectives for occupational therapy, focusing on an improved care experience, population health and the cost efficiency of occupational therapy care. Telehealth has been integral in reaching these goals and will undoubtedly continue to play an even more important role as value-based care initiatives take hold and technology like telehealth presents even more opportunities for building cost efficiencies.

With all the potential in the telehealth and occupational therapy space, there are some challenges of realizing the potential of telehealth:

Telehealth and occupational therapy regulations vary by state, with some having minimal guidelines or defaulting to federal regulations and others specifying interactions with patients, detailing the definition of an "originating site," and outlining patient consent requirements.

An AOTA survey found that a significant number of providers (51%) have also stated that at least some of their clients were not appropriate for telehealth services. This challenge was acute for practitioners delivering services in hospitals, skilled nursing settings and long-term care facilities.

The AOTA survey also found that technology was the top barrier for therapists working in schools, early intervention, freestanding outpatient facilities and home health.