Technology is increasingly impacting the way that people work. Physiotherapy is no exception.
While some of us may have entered the profession with a desire to “work with people, not computers,” even those who are reluctant to use technology are finding it increasingly difficult to avoid. Meanwhile, physiotherapists who are eager technology adopters see endless possibilities, with new tools and applications emerging daily.
The calls to the College of Physiotherapists’ Practice Advisor tell a clear story: we are seeing increased uptake in the use of email and text messaging between physiotherapists and patients, the emergence of telerehabilitation, and major initiatives related to electronic medical records and electronic health records both within Alberta Health Services and private practice environments. At the same time, a long-standing issue is physiotherapists in some settings continue to be challenged by a lack of access to key systems (i.e., patient data contained in Netcare).
The content of those practice advice calls and the rapid rate of change in technologies and technology use in health care suggest that physiotherapists may need more information when adopting technology in clinical practice. Some of the key issues include:
- Developing the basic skills and competencies needed for the electronically mediated health-care environment
- Security/Privacy considerations
- Electronic medical record and electronic health record considerations
- Electronic communication with patients
What are eHealth Competencies and Why Should I Care?
Whenever the College of Physiotherapists of Alberta uses the term competent we are referring to having the knowledge, skills, and attitudes required to perform a certain skill or engage in a specified activity. When applied to eHealth, we are referring to the ability to work in an increasingly electronically mediated health-care environment and to use technologies ranging from email and electronic records, to informatics or big data.
Electronic Medical Record System
Electronic medical record systems (EMRs) are no longer a rarity in physiotherapy practice. Once the domain of the early adopter, these systems are increasingly common, and for good reason. The use of EMRs offers a wide range of benefits ranging from business efficiencies, to improved clinical care, and health system benefits.
EMR First Steps
So, you’ve decided to implement an Electronic Medical Record System (EMR) in your office. Congratulations! Now comes the challenge of researching and implementing the system. The move to an EMR can be a daunting one, with significant costs and many choices to be made. Although the College of Physiotherapists of Alberta doesn’t make recommendations regarding products or suppliers, here are some things to consider as you work your way through the process of selecting an EMR.
Emailing or Texting Patients
The College of Physiotherapists of Alberta has heard anecdotes of organizations that actively discourage their employees from using email, due to perceived risks related to the technology. However, email and text messaging constitute powerful tools to enhance communication with patients and fellow health-care providers and meet the performance expectations outlined in the Standards of Practice, provided the technology is used effectively and appropriately.
Understanding Administrative Controls
Administrative controls include procedures, policies, standards, and rules designed to reduce risk or control a hazard. The concept of an administrative control comes from the occupational health and safety world but can be applied to the worlds of privacy and eHealth. When it comes to eHealth, the hazards in question include privacy breaches due to unauthorized access to private information, or cyberattack that prevents authorized access to information and disrupts care (viruses or ransomware). Administrative controls seek to control an identified risk at the level of the employee, but do not eliminate the hazard or risk.
Common Technical Controls and Why They Matter
A technical control or safeguard is a technology-based measure put in place to address the unique security risks present in electronic environments. These risks would include the risk of having a system hacked or being subject to a phishing or ransomware attack. Below are some examples of standard technical controls and a brief description of what they are and why they should be adopted.
Phishing and Ransomware - Why You Should Care
Planning for disaster used to mean preparing a contingency plan for what to do in the event of a fire or a flood. Alberta has seen plenty of these types of events in the recent past, so this type of preparation is clearly relevant for physiotherapists. In addition to these more “traditional” disasters, the use of electronic systems such as EMRs and online databases to collect patient outcome information creates the risk of phishing and ransomware attacks which can have similar disastrous implications.
These days, telerehabilitation is increasingly popular among physiotherapists, with members contacting the College of Physiotherapists of Alberta on a regular basis with questions about how to incorporate telerehabilitation into their practice. Broadly speaking, telerehabilitation is “the remote delivery of physiotherapy interventions mediated by communication technologies.” Examples include video conferencing and telephone consultation services, with new methods and approaches emerging daily.