TeleOrthopaedics.com is owned and operated by Canadian Orthopaedic Physiotherapist Terry Kane.
The goal of all healthcare systems is to help patients move from a state of disability, dependency and inactivity towards a state of wellness, in-dependency and physical activity – as safely, as effectively and as quickly as possible. The evolution of internet technology represents one of the greatest opportunities in history, to improve patient access to clinical expertise and improve the effectiveness and speed of care globally.
The goal of TeleOrthopaedics.com is to leverage internet technology to improve orthopaedic triaging and the standard of patient care by connecting people with the right healthcare professional at the right time, every time.
Given that the overwhelming majority of musculoskeletal conditions get better without an MRI, injections, prescription medications or a surgical consult, our first project is to explore online physiotherapy consultations, patient education and home based rehab exercises to Canadians living in areas without access to a local orthopaedic physiotherapist.
THE PROBLEM = NO ACCESS TO A LOCAL PHYSIOTHERAPIST
Physiotherapists are regulated primary contact healthcare professionals, competent in a differential diagnosis model of assessments and triaging, evidence based treatment methods and designing safe, appropriate and progressive rehab exercise programs based on a patient’s medical profile, current condition and stage of tissue healing.
In addition, research conducted at the University of British Columbia (Canada) into a physiotherapy triage model for orthopaedic surgery, found that experienced physiotherapists were four times better at identifying patients requiring surgery than emergency room physicians and family physicians (90% vs 22%) (1). It was noted that a physiotherapy surgical triage model could reduce surgical consult wait lists by seventy-five percent in Canada (1).
Ninety-two percent of all physiotherapists in Canada are concentrated in only eight percent of Canada’s total landmass (2); which means there are thousands of Canadians – young and old – that are not receiving the same access and standard of orthopaedic care as Canadians in urban centres.
Unfortunately, Canadians who receive delayed, inadequate or inappropriate treatment for an orthopaedic injury or condition are considered to be at a higher risk:
- To develop chronic and disabling neuromuscular pain.
- To become dependent on prescription pain medications (see opioids),
- To develop permanent disability that prevents them from working or performing normal activities of daily living,
- To place a greater burden on families and other caregivers for support over their lifetime.
- To become increasingly dependent on the healthcare system over their lifetime.
- For patients who’ve undergone orthopaedic surgery and returned home without access to a local physiotherapist, there is a greater possibility that they (a) will not do their rehab properly or regularly, (b) will fail to meet their rehab goals on schedule and (c) potentially achieve a sub-par surgical outcome / result.
THE SOLUTION = ONLINE PHYSIOTHERAPY CONSULTS
Clinical pathways are only as valuable as the ability to implement them among front line healthcare providers so patients benefit by seeing the right clinician at the right time.
Online physiotherapy is not meant as a substitute for face-to-face care, however – for patients without easy access to a local physiotherapist;
- Online physiotherapy is considered better than receiving “no care” for their condition,
- Communicating with a physiotherapist is helpful to interview, assess and ensure patients have been triaged onto the right clinical pathway for their condition,
- Physiotherapists are considered ‘movement’ experts in designing safe, appropriate and progressive rehab exercise programs based on a patient’s medical profile, condition and stage of healing.
- Communicating with a physiotherapist, is helpful to educate patients (and their families), answer questions and to identify warning signs of potential problems and complications.
- In the event the health and safety of a patient becomes an issue, a physiotherapist can communicate immediately with appropriate healthcare professionals to prevent and/or manage them.
- In the event a patient has undergone orthopaedic surgery and is behind schedule in their rehabilitation, a physiotherapist can communicate with a surgeon to determine most appropriate solution.
According to the Canadian Alliance of Physiotherapy Regulators;
“Tele-rehabilitation technologies and applications are expanding rapidly and have the ability to improve patient access to care and otherwise increase efficiencies when used with the right patient at the right time. In some cases, such as when travel is difficult or there is no provider nearby, the use of the technology is preferable to a traditional (in-person) encounter.”(3)
- A physiotherapy triage service for orthopaedic surgery: an effective strategy for reducing wait times. Napier, C , McCormack RG, Hunt, MA, Brooks-Hill A, Physiother Can. 2013 Fall;65(4):358-63
- Strengthening Rural Canada: Fewer and Older: Demographic and Population Challenges Across Rural Canada, A Pan-Canadian Report; CIHI Physiotherapist Data Tables 2015.
- Tele-rehabilitation in Physiotherapy Guidelines for Physiotherapists, Physiotherapy Alliance of Canada, Approved 170926.