Physical Therapists and Physical Therapy Assistants Preparedness Levels to Deliver Telerehabilitation Services

Purpose/Hypothesis: Telerehabilitation (TR) has long been considered as a convenient and effective method to provide services. Yet, adoption by clinicians and patients has been slow. The novel coronavirus pandemic accelerated adoption of this service methodology by physical therapists, patients, and payers. Readiness of all constituents for this methodology was questionable given the necessary speed of adoption. The purpose of this study was to investigate physical therapists’ (PT) and physical therapy assistants’ (PTA) readiness to deliver TR services. Number of Subjects: All licensed PTs and PTAs in the state of California were invited to participate in the study during October 2020. Materials and Methods: Institutional Review Board approval was obtained for this study. An electronic survey was distributed to eligible participants by email. After completing a demographic questionnaire, participants were asked to provide input on perceived telehealth readiness according to the Maryland Telehealth Readiness Assessment Tool (MTRAT). The MTRAT consists of 57 items that measure core readiness, financial considerations, operations, staff engagement, and patient readiness. Responses on the MTRAT were coded to a 5-point Likert scale, ranging from Strongly Agree (SA) to Strongly Disagree. The frequency MTRAT items achieving a median score corresponding to Agree (A) and SA was analyzed. Kruskal-Wallis testing was used to compare scores between respondents who were and were not self-reported decision-makers regarding TR in their settings. Data from participants who did not respond to at least 50% of the MTRAT were excluded. Statistical significance was determined at p\u3c05. Results: Of the n=481 respondents, n=337 completed the survey and were included in the study (mean years of practice: 17.2, standard deviation [SD]: 12.2; mean hours/week spent in patient care: 30.8, SD: 13.9). Of the respondents, n=144 (42.9%) reported having decision-making authority regarding TR in their setting. Sixty percent of items in the core readiness domain had a median score of A/SA, 80% of items in the financial consideration domain had a median score of A/SA, 75% of items in the operations domain had a median score of A/SA, 86% of the items in the staff engagement domain had a median score of A/SA, and 80% of the patient engagement domain items demonstrated a median score of A/SA. Respondents who self-identified as decision makers demonstrated a significantly stronger assessment of readiness than non-decision-makers on n=40 items (70.2%), while non-decision-makers showed significantly stronger assessment of readiness on n=8 items (14.0%). Conclusions: Data from this study identified that potentially important gaps remain across all areas of readiness. Observed limitations in agreement between decision-makers and non-decision-makers may present organizational challenges to TR adoption. Clinical Relevance: Information from this study may help identify areas of focus to improve individual and organizational readiness the availability and quality of TR in physical therapy