Telerehabilitation Program for Physical, Occupational and Speech Therapy

Through Kessler’s tele-rehabilitation program, patients connect with a licensed therapist from the convenience of their own home. Sessions are delivered one-on-one in real-time through web-based technology and are HIPAA compliant to ensure privacy. For patients limited by injury, a weakened immune system, travel concerns or quarantine, Kessler’s clinicians provide services virtually, to continue building strength, skills and independence. This flexibility, offered under unusual circumstances, provides quality care in a safe environment and puts the needs of patients first, creating patient trust.  Why does this build trustworthiness?  The telehealth visits provided needed safety measures for their patients during the pandemic and provided a message of caring and compassion.

How It Works

Telerehabilitation is the treatment of patients via a synchronous, virtual platform by a physical, occupational and/or speech therapist trained to provide therapy via this electronic medium. Kessler telerehabilitation-competent clinicians are able to perform single or multidisciplinary assessments and focused interventions for patients, while they remain safe at home. As part of the session, the clinicians also perform high-level screenings for red flags and differential diagnosis skills to simultaneously assess the safety of patients during the telerehabilitation session.
Our telerehabilitation services are available for patients located in New Jersey for various conditions such as orthopedic, neurological, and cancer (through the ReVital Cancer Program). Additionally, Kessler also offers telerehabilitation services for pre/post-surgical care, sports medicine, hand therapy, vestibular/concussion and vision rehabilitation, pediatric therapy, and women’s and men’s health. All telerehabilitation services are performed via a HIPAA-compliant platform. Patients are referred for rehabilitation at Kessler by their physician or through a self-referral. Then based upon each patient’s needs and the applicable therapy discipline, the patient is directed to a Kessler telerehabilitation-competent clinician for evaluation and, as needed, follow-up telerehabilitation care. If a patient is not appropriate or is a safety risk for telerehabilitation, the patient is directed to the applicable healthcare provider or a nearby therapy center for in-person care as appropriate.

Skills and Competencies

Kessler’s telerehabilitation physical, occupational and speech therapists complete a series of competency trainings, focused on all aspects of telerehabilitation to ensure the safe, effective and compliant delivery of care in a virtual environment. To begin the training, the clinicians review a standard telerehabilitation educational course and set up the HIPAA-compliant software platform. The rigorous program then progresses to a virtual training that includes components of practice act compliance and scripting, and specific training focused on the regulatory, compliance, environmental and clinical standards required to treat patients via the HIPAA-compliant telehealth platform. We also review additional topics such as: creating a therapeutic alliance virtually, utilizing a customized exercise video platform for auditory and visual patient learning, and increasing patient reported outcome compliance for telerehabilitation patients. The clinicians are then required to take a written exam to assess their understanding of all aspects of the provision of telerehabilitation services, including: patient safety, provision of effective care and treatment virtually, proper documentation and billing, and compliance with all regulatory requirements. Self-paced practice sessions are required prior to completing and passing a practical examination to ensure the Kessler standard of care is met for environment, therapeutic alliance, assessment skills, utilization of high definition virtual exercise platform, patient reported outcomes and compliance standards and equal to the in-person center experience. Regular chart audits of all telerehabilitation-competent staff occur to ensure compliance of the program.

Origins

Since the beginning of the COVID-19 pandemic, Kessler has complied with all aspects of the CDC and NJ DOH recommendations for therapy providers. Nonetheless, many of our patients did not feel safe or were unable to leave their homes to attend therapy or even other healthcare appointments. Referral sources who required therapy for their patients requested this virtual alternative. Additionally, workers compensation carriers did not want their patients seen in a center due to perceived risk of COVID-19, and required only telerehabilitation care for their patients. We needed a solution to ensure that patients continue to progress in their treatment and recovery, despite the pandemic. A Kessler Rehabilitation Center task force, along with the clinical and operational teams at Select Medical, reviewed the evidence and best practice for a telerehabilitation platform to meet the needs of our patients and communities. Kessler Rehabilitation Center rolled out a competency-based telerehabilitation program that has excelled in providing high quality services to patients based on the newest telehealth literature and patient experience feedback. We are now able to provide multidisciplinary rehabilitation to patients in their home, rather than on-site in a center, with the use of a HIPAA-compliant synchronous virtual platform via their computer, tablet or smart phone devices. Patients who preferred to come into our centers or were not appropriate for telerehabilitation were directed to a nearby center. Since the inception of the practice we have performed over 7800 patient therapy sessions.

Effectiveness

The in-person care that we have provided for many years has made Kessler Rehabilitation Center a trusted rehabilitation provider, with net promoter scores consistently over 90. Through the established patient-centered telerehabilitation competency program, competent clinicians utilize the information learned in the rigorous training and apply it to those patients that have not been able to come into our centers since the pandemic began. In over 7800 telerehabilitation visits that have been completed from Kessler clinicians at almost every center, we have achieved net promoter scores >90. Our patient reported outcomes, which are monitored on every patient throughout care, has an increased completion rates per case in the telerehabilitation setting (2-3 in center to 4-5 telerehabilitation/patient) with scores consistently above the Minimal Clinical Difference. This demonstrates the effectiveness and patient centered approach that our competent clinicians have provided to those that trust us with their care.

Scalability

In March 2020, we began the training and implementation of our telerehabilitation program with a single clinician. Due to patient demand, Kessler has now trained over 140 staff members throughout Kessler’s network of over 100 centers to provide the Kessler Rehabilitation Center Standard of Telerehabilitation therapy. This competency-based model of on-line training, live training, written examination, structured practice and a final practical check out focusing on the environment and the main tenets of care, continues to expand to self-selected clinicians and new clinicians for the unforeseeable future. Kessler Rehabilitation Center telerehabilitation services can now be provided to patients in all NJ counties, which is especially important for patients with high-risk health conditions and concerns about being in a therapy center, as well as under-served specialty populations requiring therapy care.