State of Telehealth Post Pandemic: Thematic Analysis of In-depth Interviews of Outpatient Occupational, Physical and Speech Therapists

Research Objectives: 1. To investigate how practice has evolved post pandemic for Occupational, Physical and Speech Therapists; including common interventions utilized, challenges faced in therapy practice, and synthesis of clinicians' perspectives regarding optimal telehealth practices

2. To describe clinicians' perspectives regarding the similarities and differences of telehealth vs in person practice

Design: Qualitative- Case Study including semi-structured interviews of 18 clinicians. Analysis completed via thematic coding by the main author. No followup was completed.

Setting: Outpatient Therapy Clinics (Occupational, Physical, and Speech Therapy)

Participants: Participants were selected via random purposeful sampling. 20 clinicians were contacted, with data collected from 18 clinicians. Representation came from 5 total organizations--4 large rehabilitation hospitals and one private practice.

Interventions: Interventions: Not applicable.

Main Outcome Measures: Thematic analysis was completed based on data gathered in semi-structured interviews. The main author coded all interviews and used member checking for validation.

Results: Thematic analysis determined several commonalities amongst post-pandemic telehealth practitioners including themes of: Areas of challenge in providing telehealth practice, Common intervention areas targeted, Recommendations for session structure (including pre and post session guidance), and Areas of disagreement among participants recommended use of telehealth. Specifics regarding each theme and practice utilization will be described.

Conclusions: Therapy services have mostly returned to an in-person delivery model, however the benefits of utilizing telehealth continue to drive practitioner use as appropriate. Despite most therapists agreeing that telehealth is not always the preferred therapy platform, it was emphasized by all interviewees that the ability to provide services, that otherwise would not be available to patients, far outweigh the challenges faced. The recommendation is to continue to offer telehealth as an option for patients to increase access to care. Traditionally, access to telehealth has been limited by regulatory and payment models, however, flexibilities post pandemic has opened access that therapists are now utilizing.

By sharing the work therapists have done to enhance their telehealth sessions, an infrastructure is being built to better patient experiences and to promote positive rehabilitation outcomes. However, additional research is needed to detail the translation of in-person modalities and methods to those that can be used in telehealth practice. Specifically, research around validated outcome measures and treatment approaches will be required to build the evidence-based body of work for therapists to draw from.

Whether online or in-person, the ideals, foundations, and philosophies of therapy practice guide clinicians to provide skilled and necessary care to boost patient independence and healthcare access.

Author(s) Disclosures: The authors report no conflicts of interest.