Can occupational therapy hand assessment and treatment sessions be conducted via telehealth?

Tess Worboys1, Melinda Brassington2, Elizabeth Ward3, Petrea Cornwell

1Occupational Therapy, Charleville Hospital, South West HHS, PO Box 219, Queensland, 4470, melindapetkov@hotmail.com
2Occupational Therapy, Charleville Hospital, South West HHS, PO Box 219, Queensland, 4470, tess.worboys@health.qld.gov.au
3Centre for Functioning and Health Research, Metro South HHS and The University of Queensland, PO Box 6053, Buranda, Queensland, 4102, liz.ward@uq.edu.au
4Allied Health Research Collaborative, Metro North HHS, and Menzies health Institute of Queensland, Griffith University, 627 Rode Rd, Chermside, Queensland, 4032, Petrea.cornwell@health.qld.gov.au

Background

A solution to help deliver Occupational Therapy (OT) services for hand therapy in rural and remote locations is telehealth, however to date no research has been conducted. The current study aimed to determine the level of agreement between a Telehealth OT (T-OT) and a Face-to-face OT (FTF-OT) during a hand assessment and treatment session and explore patient and clinician satisfaction.

Methods

Eighteen (18) patients referred for hand therapy to a rural/remote hospital based outpatient service were assessed simultaneously by a T-OT and FTF-OT via videoconferencing. An Allied health assistant (AHA) assisted with the collection of objective measures at the patient end. Clinicians assessed patients across a range of objective measures, subjective scales and patient reported information. Minimal level of percent exact agreement (PEA) between T-OT and FTF-OT was set at ≥ 80%.

Results

Level of agreement for all objective measures (dynamometer/pinch gauge reading, goniometer flexion, goniometer extension, circumference in millimetres) ranged between 82-100%PEA. Clinician judgements for scar and general limb observations were 82-100%PEA. Assessment of exercise compliance showed 80-100%PEA. Documentation of patient’s pain severity and sensitivity location were 100%PEA. Ratings of activities of daily living (QuickDASH) was 89%PEA. The multiple Global Ratings of Change scales (GROC) collected were ≥95%PEA. Patient and clinician satisfaction was high. There were 3 instances where visual issues impacted the session.

Discussion

Clinical decisions made via telehealth were comparable to a traditional clinical session model. Consumers were also satisfied, therefore supporting the potential for implementing a telehealth model of hand therapy in a regional/rural setting.

Biography

Tess and Melinda are generalist Occupational Therapists currently working within the South West Hospital and Health Service in Queensland. Tess is based in St. George and Melinda is based in Charleville.