Tele-rehabilitation/Virtual Care

• Tele-rehabilitation may be appropriate if you cannot easily attend an in-person visit because there is a shortage of appropriate physiotherapy and/or chiropractic care available in the region where you live, because you have transportation or mobility problems or in the case of a global health pandemic such as with COVID 19.
• Tele-rehabilitation may offer a way for you to receive follow-up care by your original treating physiotherapist/chiropractor if you are no longer in the location where the initial treatment was provided.

• Tele-rehabilitation has limitations compared to an in-person encounter such as the inability to perform hands-on examination, assessment and treatment. For this reason, in many circumstances, if suitable in-person care is available it will be preferable.
• It is up to you and the therapist to determine what is best for you, based on your particular condition and preference, available technology, and other risks and benefits.

Many interventions and modalities can be provided virtually, this includes but is not limited to:

• Initial assessment (physiotherapy only); which includes subjective and some objective components, outcome measures, and ongoing assessments to monitor progress.
• Exercise prescription, supervised therapeutic exercise and appropriate progressions
• Home-based modalities, including electrical stimulation and heat and cold applications, if the equipment is available to you.
• Self-administered techniques such as soft tissue massage or frictions under the direction of the therapist, including patient education on how to do and at what intensity.
• Support for self-management, education, coaching and reassurance for patients and for caregivers. This includes teaching patient’s families how to assist in performing stretches or guide home exercises.
• Assessment of how patients are functioning and adapting in their home environments, including assessment of fall risks and other functional activities of daily living assessments.
• Brace use, instruction on self-measurement and evaluation of its effectiveness

Expect to receive the same safe, quality care that you would get during an in-person visit. Both the physiotherapy and chiropractic colleges expect each therapist to meet the same standards of practice regardless of how the services are delivered.

The risks of receiving physiotherapy and/or chiropractic care specific to tele-rehabilitation relate mostly to concerns about the privacy of your personal health information, and your personal safety. The therapist is required to ensure that the location where you receive care is safe, and that procedures are in place to ensure the availability of help in the event of an emergency. The physiotherapist or chiropractor may recommend that the visit proceed in the presence of another person to enhance the safety and value of the visit.

Videoconferencing for your appointment is available through doxy.me. Your therapist will provide you with a link to access your appointment. See the following requirements below:

• You can use a computer (PC or Mac) with enabled web-cam capabilities (preferred), or a mobile device (android or iPhone).
• Use strong WIFI connection or an Ethernet cable.
• Close any unused programs or re-start your computer or mobile device.
• Use Google Chrome, Firefox or Safari and update to the latest browser version.

If video conferencing is not appropriate or available, email communication and/or phone calls are other options to carry out the tele-rehabilitation appointment.

Doxy.me is a tele-medicine platform that is designed specifically for healthcare. It does not require you to download any software or create an account. You only need to clink the link provided by your therapist and enter your name. Doxy.me is PHIPA compliant (Personal Health Information Protection Act). Doxy.me uses 128-bit encryption and doesn’t record or retain any information. All information is destroyed immediately following the session.

Physiotherapists and chiropractors are required to ensure the privacy and security of your personal information at all times. This extends to the technology they use as well as the appropriateness of the setting in which services are delivered.

Doxy.me is PHIPA compliant (Personal Health Information Protection Act). Doxy.me uses 128-bit encryption and doesn’t record or retain any information. All information is destroyed immediately following the session.

Furthermore, your therapist will ensure that they choose a private setting for your tele-rehabilitation appointment and will recommend you do the same.

While some extended health care companies have announced that they will cover tele-rehabilitation services for physiotherapy and chiropractic, it is important that you check with your company to determine coverage details, requirements, and limitation.  If the service is not covered by an insurance plan, you would be responsible to pay in the same way as you would if you were attending an in-person visit.

Depending on the setting and the circumstances, physiotherapists and/or chiropractors providing consultation or treatment via tele-rehabilitation may have assistance from physiotherapy/chiropractic support workers, by other health care providers, or from your family members or friends. The physiotherapist or chiropractor is required to ensure that an appropriate level of support and assistance is available to address your needs and ensure your safety, and that you agree to the involvement of this assistance.