Delivering rehabilitation services during the COVID-19 pandemic: How CAF Physiotherapy is using telehealth to ensure “physical and measurable solutions to maintain and enhance operational readiness, anywhere, anytime”

Abstract

In response to COVID-19, the Canadian Armed Forces (CAF) activated Operation LASER, a force health protection strategy to preserve its operational capabilities. Operation LASER resulted in a quarantine of healthy CAF members to minimize the risk of contraction and transmission of COVID-19. The physical distancing inherent to quarantine challenged Canadian Forces Health Services to adapt its health care delivery. CAF Physiotherapy responded by integrating telehealth to maintain provision of essential primary health care services. A modified After-Action Report was used to capture preliminary telehealth experiences of Defence Team physiotherapists since the activation of Operation LASER. To date, seven Physiotherapy Officers and six civilian physiotherapists, have delivered a total of 196 assessments lasting an average of 45 minutes, and a total of 765 follow-ups lasting an average of 25 minutes. Most respondents reported no previous experience or formal training providing telehealth. Most respondents reported delivering telehealth by telephone and acknowledged challenges, including non-standardized patient instructions, inadequate equipment, unsuitable environments, and limited patient feedback. To maximize the quality of telehealth delivery, respondents recommended standardizing patient instructions, establishing suitable work environments, and using telephone headsets, videoconferencing, and digital exercise software. These recommendations are an investment in the capacity of CAF Physiotherapy to maintain rehabilitation services in the post-COVID-19 environment.

Rehabilitation post-COVID-19: cross-sectional observations using the Stanford Hall remote assessment tool

“… 9 11 25 29 30 Issues encountered at DMRC Stanford Hall during creation and delivery of this tool have been seen elsewhere, with similar findings described by preliminary use of telemedicine in 196 consultations by Canadian Armed Forces. 31 Robitaille and MacRae describe the need for reliable technological platforms (preferably VTC over telephone), with standardised patient information and using patient feedback to improve services, and specific equipment, training and location requirements. 31 …”

“… 31 Robitaille and MacRae describe the need for reliable technological platforms (preferably VTC over telephone), with standardised patient information and using patient feedback to improve services, and specific equipment, training and location requirements. 31 …”

“…9 11 25 29 30 Issues encountered at DMRC Stanford Hall during creation and delivery of this tool have been seen elsewhere, with similar findings described by preliminary use of telemedicine in 196 consultations by Canadian Armed Forces. 31 Robitaille and MacRae describe the need for reliable technological platforms (preferably VTC over telephone), with standardised patient information and using patient feedback to improve services, and specific equipment, training and location requirements. 31 Given the likely demand of post-COVID-19 care, with estimate of 10% of individuals suffering prolonged symptoms, 8 it is likely that some of this will be provided by non-rehabilitation specialists, as part of their parent specialty (such as respiratory medicine), or in the new models of care recently commissioned by NHS England.…”

“…31 Robitaille and MacRae describe the need for reliable technological platforms (preferably VTC over telephone), with standardised patient information and using patient feedback to improve services, and specific equipment, training and location requirements. 31 Given the likely demand of post-COVID-19 care, with estimate of 10% of individuals suffering prolonged symptoms, 8 it is likely that some of this will be provided by non-rehabilitation specialists, as part of their parent specialty (such as respiratory medicine), or in the new models of care recently commissioned by NHS England. 32 The findings from this study have relevance for the commissioning and development of these much-needed clinical services, and any individual training required to meet this demand.…”