This text is part of the special section Professions and careers
Five years ago, consulting a physiotherapist or occupational therapist online might have seemed like a far-fetched idea. for several patients. However, the pandemic has changed the situation. In 2023, more Quebecers have become familiar with the world of virtual meetings and are asking that it also apply to their care.
Professor at the School of Rehabilitation at the University of Montreal, Anne Hudon observed this during research with employees shaken by a work accident. “Patients told me: “Often, we are stuck in fixed models. Either you are followed 100% online, as was the case during confinement, or you are in person. But can we have a certain openness? When I’m alone at home in the evening with the children, can I do this by videoconference?” » she illustrates.
According to the Order of Occupational Therapists and the Professional Order of Physiotherapy of Quebec, in this post-health crisis period, more professionals are offering 2.0 support. However, many of them closed their video cameras and returned to the clinic as soon as the restrictions ended. “We really saw a decline,” notes Anne Hudon.
However, online rehabilitation sessions — telerehabilitation — prove useful in several circumstances: they make it possible to reach families and workers with busy schedules, regional residents, people who do not have a car or, even , those who have mobility problems. “We lost a bit of that flexibility,” says Anne Hudon.
How can we explain this step backwards on the part of specialists? “It’s certain that it’s more comfortable to return to known, usual practices,” she formulates as her first hypothesis. But in his eyes, it is also a question of education. “At school, we don’t teach 45 hours on telerehabilitation, so comfort may not be there. And, as a provider, do I believe I offer care that is as credible, as good? They must be convinced. »
Recommendations
To democratize virtual practice, there is still a lot of work to do. Anne Hudon and her colleague Dahlia Kairy are rolling up their sleeves in their own way: they are co-directing research on the subject which brings together around twenty researchers across Canada.
“One of the reasons for the project is that we are a large team and we all heard the same type of concerns raised by the clinicians. They said to us: can you guide us to use telerehabilitation appropriately? I want to make sure I provide quality services,” puts Dahlia Kairy in context.
A survey is being conducted among patients and clinicians from different provinces to determine what are the best virtual practices. The questionnaires also aim to point out gaps and ethical questions.
“We ask them: who do you not offer telerehabilitation to? For what ? » explains Anne Hudon. Indeed, one of the concerns of his research group is to avoid marginalizing certain populations as the Quebec health system would do. How can we reach people who cannot afford a computer? Those who have no digital literacy?
Discussion tables are planned to find solutions and make recommendations to decision-making bodies. “As long as we change our ways of doing things, we want to do it correctly,” summarizes Anne Hudon.
Online, in person, same result?
The Professional Order of Physiotherapy of Quebec conducted studies to compare the effects of an exercise program, presented firstly as part of an in-person rehabilitation session and secondly by videoconference. Both options were found to be similarly effective.
“It is important that we assert that telerehabilitation is a modality, it is a way of doing things which has a reason for existing and which will remain. It will evolve with technology. But that cannot be the only modality,” argues the president, Manon Dufresne. Remote meetings are not suitable for all contexts, particularly when the physiotherapist needs to palpate the patient to make a diagnosis or provide treatment.
Same story with the Order of Occupational Therapists of Quebec. For an identical problem, a digital interview may be beneficial in one case, and to be avoided in another. “It’s part of clinical judgment, it’s up to the professional to determine,” underlines the president, Alexandre Nadeau.
The important thing is to respect the code of ethics and guarantee the safety of the patient and their confidential data, maintain the two orders. The physiotherapists have already prepared a guide. For occupational therapists, it is currently being prepared.
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