Telehealth Occupational Therapy Guide

Here is your complete guide to occupational therapy and telehealth!

Telehealth occupational therapy continues to change the way we practice, and it will impact our profession in ways we have yet to imagine. 

The more we know about telehealth, the better positioned we’ll be to leverage it in ways to best serve our clients.

I set out to write this article so that we would have a comprehensive resource on telehealth OT as we know it today, along with some information to help us stay up-to-date with this quickly changing landscape.

Here’s what you’ll find below:

 

What is telehealth OT?

Telehealth OT refers to occupational therapy services provided over a technology platform. Pretty much any form of OT delivered via technology vs. in-person means can be considered telehealth.

That means some of you might already be using telehealth without even knowing it.

If you use a secure texting platform to exchange messages with your patients, you’re already using telehealth.

If you deliver HEP exercises and updates to your patients, as with MedBridge Go, that’s telehealth, too.

If you review patients’ records in a shared health system portal, you’re using telehealth.

And, if you securely message your patients with sometime like secure texting—yep, that’s also telehealth.

Technically, telehealth can be broken into four categories:

  • Live video
  • Store-and-forward
  • Remote patient monitoring
  • Mobile health

Live video (also called “synchronous”) is exactly what you’d think. This is what most people think of when they think: telehealth OT. 

Store-and-forward is also called “asynchronous,” and is used to transmit imaging, as well as store and send health records. Remote patient monitoring involves electronically transferring information like blood pressure results or blood glucose levels. MedBridge Go and other forms of patient-facing HEP software are forms of mobile health.

At this point, most forms of telehealth occupational therapy will use a blend of these methods to deliver care.

 

Why telehealth?

Telehealth occupational therapy was originally devised to bring much-needed healthcare services to underserved or rural populations, enabling patients to receive care when they might not otherwise be able to.

But, even for patients who can access care, telehealth has its appeal. In today’s modern age of on-demand technomania, telehealth is a wonderful option in terms of convenience and, frankly, staying on trend. If other professionals are meeting customers’ demands for on-demand care, why can’t occupational therapists?

Here are some pros and cons of telehealth: 

The pros of telehealth OT

  • Improves access to those who wouldn’t otherwise get OT
  • Convenient
  • Often time saves money! 
  • Clients get seen in their natural environment
  • Puts more emphasis on patient education and coaching
  • Delivers care on-demand to meet today’s consumers

The cons of telehealth OT

  • Lacking the human touch of OT
  • In the United States, OTs can only treat in the state where they’re licensed (this is slowly changing)

Here’s an example of when telehealth OT is a good fit: 

Consider a post-CVA patient whose son would normally need to drive her to OT—but now that patient can ask questions and receive teletherapy in the comfort of her own home. That means her son doesn’t have to miss work! And, now that we have so many cities shutting down to stymie the spread of COVID-19, this seems an ideal way to deliver care without endangering our patients or their caregivers.

Here a teletherapy OT explains how telehealth is different than in-person OT:

In the YouTube clip below, Adam Griffin, explains what makes telehealth OT unique.

 

How to find a telehealth OT?

If you found this post in search of a telehealth OT, and pros outweigh the cons for you, I want to help you find the right telehealth OT for you, without further adieu. 

Below you will find OTs from the OT Near Me Directory who have tagged themselves as using telehealth. 

(If you are an OT looking to find an OT telehealth job or start using telehealth keep on scrolling!)

 

How to get into telehealth occupational therapy?

As of today, there are three ways you can get involved with teletherapy. Here’s how to do each.

1. Start your own practice

If you start your own practice, you’ll need to understand state laws where you’re planning to treat, get licensed in the state(s) where you’re planning to treat, set up a business, attract your own patients, get liability insurance, set up a fee schedule, and all that fun stuff that goes along with owning your own clinic.

Plus, there’s the tech. You’ll need to figure out the software you’ll want to use, but most solutions make it fairly easy to hang a shingle. (In the next section we will cover available platforms.)

2. Join an existing company

If you’re not feeling entrepreneurial, no problem! You can always find a job at an existing teletherapy company. 

Here are some of the companies that provide telehealth OT services, where you may be able to find a telehealth OT job:

3. Convince your existing practice to incorporate elements of teletherapy

Telehealth can be a wonderful ancillary service, and it can also add value to a clinic’s offerings. By incorporating a telehealth wing in a clinic or facility, you will help improve patients’ access to care, and might help decrease cancellations.

This would be especially helpful in states where Medicaid is reimbursing OT treatments.If you’re able to convince your workplace to incorporate telehealth into its practice, you’ll grow immensely in your career. Not only will you spearhead a movement to build a program in your organization (which can look great on the resume if you ever pursue non-traditional OT career paths), you can feel proud that you helped bring your workplace to the forefront of a new horizon (cue sci-fi music)!

 

Platforms for providing telehealth

Of course when you are looking for a telehealth platform privacy is one of your main concerns. 

During Covid-19, certain platforms were approved by HHS in the US for telehealth. For OTs in Canada, Therabyte has this comparison chart about which options meet Canadian data security standards. 

But, in choosing the right platform, you will need to understand the particular privacy laws in your country. You may want to consult with an IT professional and healthcare attorney before you commit to a setup for your teletherapy.

Let’s start with platforms NOT to use: 

  • Facebook Live
  • Twitch
  • TikTok
  • Think: any video that is public-facing

Platforms that have been approved—but do not offer comprehensive solutions like payment and robust scheduling

  • GotoMeeting
    • Plans start at $14/month
    • Recently updated speed to 65% faster
    • HIPAA-ready
  • Skype for Business/ Now Microsoft Teams
    • Plans start at $4/user per month
    • Comes with the MS office suite
    • More advanced plans offer compliance and security
  • Updox
    • Three pricing tiers; must contact company to get a quote
    • Includes document management and storage
    • Enables document signing
  • Zoom for Healthcare
    • Plans starting at $149/user per year
    • Consistent, high-quality video
    • Commonly used in webinars
  • Google G Suite Hangouts Meet
    • Free trial; plans start at $6/month
    • Incorporates with the Google suite of tools
    • Up to 100 participants per call (good for groups)

HIPAA-compliant platforms that provide more comprehensive solutions: 

  • Blink Session
    • Plans start at $29/month; somewhat complex pricing structure
    • Waiting room function
    • Ability to share clients among therapy team
  • BlueJay
    • Many options; must contact them for quote
    • Very robust; some plans come with integrated HEP and patient engagement
    • Some plans come with reporting and compliance features
  • Doxy.me
    • Many options including free for limited services
    • Reviewers on Capterra highlighted the solution’s free option and ease of use
    • These same users mentioned that calls drop if the internet service isn’t strong
  • eVisit
    • Pricing options vary for clinics vs. large systems
    • Robust scheduling option
    • Visit reminders for patients
  • Health Recovery Solutions
    • Numerous product and pricing options for various types of practices
    • Specialized and setting-specific platforms (e.g. home health)
    • Established presence in prestigious healthcare systems
  • HelloNote
    • Rates start at $45/month for EMR; telehealth rates require a quote
    • Integrates well with HelloNote EMR system
    • EMR built by therapists
  • SimplePractice
    • $29/month to start (free trial)
    • Part of a wider practice management platform for small businesses in health and wellness (including EMR)
    • Includes integrated features, such as free appointment reminders (SMS, email, and voice), mobile app, e-claim filing
    • Reviewers report a clean interface
  • Therabyte
    • $36/month to start (free trial)
    • Practice management platform for small private practice OTs, SLPs, BAs, (including EMR)
    • Includes integrated features, such as telehealth, appointment reminders (SMS, email), goal tracking, online intake
    • Built by an OT!
  • thera-LINK
    • $30/month to start (free trial)
    • Focused on mental and behavioral health; geared toward individuals and small organizations
    • Payment integration feature
  • TheraNest
    • $39/month to start
    • Unlimited users, storage, and support
    • Specifically tailored for mental health applications
    • Electronic health record software with Wiley Practice Planners treatment planning solution add-on
  • TheraPlatform
    • $39/month to start
    • Designed to support both in-office and telehealth visits
    • Includes waiting room, group sessions, and appointment reminders
  • VSee
    • $49/month to start
    • Unlimited calls and chats
    • Triage queue options; walk-in waiting room feature
 

How to document for telehealth?

As the list above showcases, your documentation options are built right into many teletherapy platforms. 

One unique consideration you might have in your session and therefore documentation is the assessment portion. We made this post to help you choose assessments that work well via teleheath.

What about the rules—and what about reimbursement?

Telehealth OT is a bit like the Wild West. There’s very little consistency between states in the way of laws. Some states have established laws and regulations regarding telehealth, while others haven’t even touched the subject. The AOTA provided a chart that details information about telehealth and OT on a state-by-state basis. You can also stay up to date on OT telehealth advocacy issues on this page.

We also wrote this post on OT telehealth coverage during the pandemic, and plan to do an update when the OT licensure compact comes to fruition (which will expand the tele-health opportunities for many therapists!)

Can COTAs provide telehealth?

Telehealth legislation is in huge upheaval right now, so this answer may only be found on a state-by-state, provider-by-provider basis. But, in general, if OTs can provide telehealth (per local legislation) there is a good chance COTAs can, as well.

Several years ago, I did some research about companies that hired COTAs for teletherapy. I found that while some companies only hire OTs, a few do hire OTAs to perform teletherapy.

Here are some of the teletherapy companies that historically have hired OTAs:

 

The research base has already been rapidly growing.

Before diving into telehealth, we of course, have a professional duty to understand whether research backs its use.

And the good news for OTs at this time is that telehealth is not some completely unknown, desperate second option for use to just “try out” in crisis. Telehealth OT has been studied for years, and you will likely even find research that correlates closely to your practice.

As I’ve been reading this research myself, I have found it to be very promising. I hope you check it out for yourself: Research Articles about Telehealth OT.

 

Telehealth activities and skills?

As therapists quickly found out when they tried telehealth over the pandemic, this mode of therapy requires us to learn new skills. Some of the go-to therapy activities you may be accustomed to just may not work in this context.

Here are some resources that may help you:  

Telehealth, Parent Alliance, and OT with Adam Griffin

Would you like to earn an AOTA-approved CEU while listening to a podcast about telehealth OT? You can by listening to this episode of the OT Potential Podcast!

What’s next for OT and telehealth?

Only time will tell where telehealth will take us, but we do know one thing: telemedicine is the future.

I am so excited for the opportunities telehealth is going to bring for our clients. They’ll be able to find the exact right therapist, right when they need them. This is certainly a game changer for our clients—and our profession! 

What are your questions/thoughts about telehealth? Share them in the comments and I will do my best to address them in future updates to this article! 

66 replies on “Telehealth Occupational Therapy Guide”

Great article! Very informative. Thanks for your hard work. I have been thinking about this for awhile now.

I’ve been interested in this topic for some time now and it was so fun to compile the information in one place! Thanks for reading 🙂

Ok. Someone from Global Teletherapy told me that hypothetically they COTAs can, but that her company only hires OTR/Ls. That isn’t particularly helpful. If you were feeling really motivated to find a position, you could just reach out to the individual companies listed above.

Thank you so much for taking the time to let me know! I swear the AOTA site is always shifting on me! I just found a new way to access the chart and included it.

Hi Sarah,
I am very interested in Telehealth with hand therapy patients.
I am a CHT and think this would be a wonderful way to help patients who are not able to get to therapy as often as the doctor prescribes. What are your thoughts? Also do you know of any other CHT’s that are working in Telehealth?
Anne

Hi Anne! I follow Virtual Hand Care on Instagram. I don’t know the exact logistics of her business model, but it definitely seems worth looking into! I agree that hand therapy seems like a great telehealth opportunity! http://virtualhandcare.com/

Absolutely! I love following what you are doing via Instagram! I’m ready for you to disrupt hand therapy 🙂

Thanks Sarah,
I just checked out her website and I am going to contact her.
Thanks for all the info. I appreciate you!
Anne

Thank you for the informative article! Teletherapy is definitely here to stay.

Enable My Child provides teletherapy services exclusively to children. We serve students with IEP needs through school contracts and we also work directly with parents. EMC is expanding to Early Intervention and hospital settings.

Our company is growing quickly and there are therapist jobs being posted almost daily in our Facebook jobs group: https://www.facebook.com/groups/emcjobs/about/

I encourage anyone who loves working with children to learn more about this option!

Can telehealth be strictly cash based. Do we have to bill insurance? I would like to consider looking at this for private practice but would rather it be cash based instead of insurance based. Thanks L

Hi Sarah- What information have you found about providing telehealth outside of the state you are licensed in, ie live in MA but provide consultation to a client in WI

It’s my first visit to this blog, it seems that you are fond of writing since so long because the selection of topics is so nice also the information which you have mentioned here is real and impressive. Really appreciate.

Thank you for sharing your information. Any chance to share some specific mental health treatments being carried out?

Great Article! As an OT in Massachusetts this would be a refreshing change from Home Health. I did look into telehealth back in the fall but without OT Pediatric experience its hard to break into this shell. I did see a few select companies that service Adults and hope it continues! Thanks for the information.

Does anyone know what supervision for a COTA would look like in this area/if there are any laws about COTA’s providing these services?

Very interested in possibly starting a new journey into telehealth, more now then ever, given the current situation with social distancing. Can you talk a little about how this will work with a COTA ? Supervision, evaluations, etc. Thanks! Great information on your blog!

What happens when your home health company asks you to make phone visits (telehealth) in place of actual visits but can’t answer how they will reimburse me for my prep/phone conversation /documentation as a per diem OT? What is the correct way to address this?

Oh man, I think many practitioners are facing tough ethical decisions like this. I don’t think there is a "correct" answer to many of the questions we all have right now. My take is to try to communicate the best you can with your company, but then it will probably come down to a personal decision on your part.

For screen sharing interactive games and websites, what are some of your favorites? I’ve seen abcya and pbskids.

Highlights is amazing, Sesame Street has a section for games AND they have a section for parents related to coronavirus, cookie.com has learning games, learninggamesforkids.com has learning games, the Kidz page has games and puzzles

I am heading up the change to telehealth for our OT pediatric group. Does anybody have any good resources for treatment planning these session for pediatric clients?

Pediatric OT groups on Facebook have posted a lot about telehealth, including some treatment ideas. This is a link to a closed group so you’ll have to request access if you’re not already in but they’re generally pretty quick to respond. https://www.facebook.com/groups/80351866792/
I’ve also been compiling resources (mostly treatment ideas and free printables) on my OT Pinterest board. https://www.pinterest.com/farmindarlin/occupational-therapy/telehealth

A general search for OT telehealth may be helpful too. I just started doing that so I don’t know for sure yet if it’s useful.

This is a link to a webinar about parent coaching https://youtu.be/vgByunNA5sU

This is a link to a video example of a pediatric telehealth session https://youtu.be/vgByunNA5sU

We heard that a payer (Primera) was allowing telemedicine for OT right now, so we called to check. The support person confirmed that they were covering those services, but then told us she wasn’t allowed to tell us HOW to bill correctly for such services. So how are we supposed to figure it out and get our clients confident enough to do these services?

Thank you for the hard work you put into this article. I have been thinking about starting a telehealth practice in behavioral health but I don’t know where to begin. I’ll continue to follow your posts to see of anything turns up.

Thanks for this information article. Do you have any advice for a therapist whose manager says "we don’t have time or infrastructure to deal with it" in regards to making telehealth an option during COVID 19?

Hi Jennifer, the US Dept of Education clearly states that if a school district is providing education to the general education population during Covid-19, then the school must provide equal access "to the greatest extend possible" to students in special education. Here is the link to the document from the US Dept of Edu: https://www2.ed.gov/policy/speced/guid/idea/memosdcltrs/qa-covid-19-03-12-2020.pdf https://www2.ed.gov/policy/speced/guid/idea/memosdcltrs/qa-covid-19-03-12-2020.pdf

Great resource article! My school district is asking me which Teletherapy platforms offer the most flexible and cost-effective options for OT services (whiteboard, PDF uploads, and mark-up, apps, etc…
I would love to know what school districts have begun to use for the immediate and emergent moment in time?

Hi Laura, my school district is using Zoom and Google classroom. So far, I have used Zoom for meetings with my colleagues and have not yet used it for any teletherapy as the district is still figuring out how to best roll this service out. Zoom is free and does give you the option of a whiteboard and ability to share your screen. Not sure what state you practice in but I would also remind you that related services need to be working in concert with your instructional team and not a stand-alone.

Hi Sarah, Thank you so much for this amazing article. I have been strongly thinking of attempting to start a private practice in the area of Hand therapy via telehealth…for people that do not have the time to get to the clinic and especially now during this horrible pandemic. However I am not planning to bill insurance… I would like to just be paid privately. My understanding from your article is that I can only practice with patients in my own state? Just want to ask you to clarify if that law applies to private pay as well? or only if you are billing insurance? Thank you in advance. I have a few other questions but will hold until I receive this answer. By the way my maiden name was Lyons. Thank you Sarah!

Judy, I just saw your question, and after taking an online course on telehealth, thought I could answer it for you. The location of service is the state that the patient resides in. So if you are licensed in Ohio, but you patient lives in Georgia, you would need to hold a Georgia state OT license. This could really get pricey if you have patients all over the US. Good luck with this new venture, and I pray you and your family are well.

Hello, I was wondering if we can shadow an OT who practises teletherapy – there is some time freed up in my weekly schedule due to school being online now.

Hi, thank you so much for this article. The school district I currently work for is transitioning to tele-practice due to the covid-19 closures. Our department is in the process of creating a set of guidelines for parents and staff. We have been attempting to find more information regarding regulations in relation to virtual assessments (either initial or triennial). We haven’t had much luck finding concrete rules, most articles mention it is up to the therapist discretion. Do you have any further information regarding completing OT assessments using a virtual platform? Thank you in advance!

Hello all! I am a little late to the party getting Telehealth options started. I am planning to be working with neuro populations, PD, CVA, TBI , FSH-MD, and possibly some ortho.
I am curious if anyone has found any of templates required to for consent to treat/ HIPPA forms. I believe that they vary state by state . Are there specific guidelines for what needs to be in those? Hoping to use something out there and refine as necessary for OR. Many thanks!
Kelly B. ( Portland, OR)

Hi Kelly,
I’m happy to talk more about this as I have some experience with telehealth with those populations – depending on the platform you use, some have templates (like Simple Practice) have their own templates built in (and the ability to have patients sign in real time). Some states (like California) require consent and typically you can get an initial consent and then document a verbal consent in your note in individual sessions.

Lauren S. (San Francisco, CA)

Hi Everyone,
My school district is also moving to telehealth. I would also love to see a template for a consent form that other school districts are using. I am in the state of CA, but if someone is willing to share, I am sure that my district will be able to alter it to our needs. Thanks so much in advance! Best, Grace L.

I am a COTA working in a SNF. My director is using an OTR through Telehealth. My fellow COTAs and I have not had any interaction with her since this began last week nor do I have an understanding of how her evaluations are being done. What is the protocol for such a format?

Thank you for all of this great information. Has anyone in this post every created a telehealth business and hire therapists to provide service. Question #2: Is anyone doing telehealth in health promotion and mental health? If so, what does that look like as far as assessment? Thank you so very much. Lisa

Hi Sarah, This is a great in-depth post about telehealth! Such great information. I have linked it to the "Start here" post on my site. TheVirtualPediatricOT.com. I worked for Presence Learning before most people had heard of telehealth!

Do you have any resources on how to communicate with parents regarding their new role as an "e-helper" for teletherapy sessions? Along with tips we can pass along to them on how to set up and get ready for teletherapy? Thanks!

Hi Sarah,
I am so elated that I came across this article. This is great information! I am an OT student(only 8months into my studies) studying in the UK. Our dissertation module has been pushed up due to Covid-19. A suggestion topic was telehealth and I got interested and started surfing online and came across your article. At the moment I am unsure as to what question I should formulate around teletherapy. However, my interest has been sparked towards the relevancy of telehealth and future pandemic(s). I’d welcome any suggestion(s) in the right direction. Keep up the good work and I’ll be keeping an eye out for future articles.

With thanks,

Gordon

Currently working in telehealth, one of the biggest difficulties we run into is administering standardized assessments (such as MoCA, MVPT, etc.). Does anyone have any resources or recommendations for administering standardized assessments virtually?

Hi Sarah, and thank you so much for this informative article. I have a question, which I’m having a tough time finding an answer to on my own.
As a Canadian based therapist, am I able to obtain work with a US based telehealth company? (I’m working on obtaining license to practice in the US) It seems the only option for Canadian therapists is TinyEYE.

Thanks in advance!

Hello!
I am a senior Pre-OT student hoping to gain additional observation hours via remote means during this time. I already have shadowed in two different settings, but hope to gain more experience to better prepare for graduate school and my future career. I was wondering if any OTs here would be willing to allow me to shadow them remotely. I am always attentive and respectful when I shadow, only making myself seen and heard if specifically requested. I would greatly appreciate any OT who would be willing to let me shadow remotely, even just for a day or two! Thank you so much! My email is AD891042@wcupa.edu

Hi
I am an OTR in NY state with mainly skilled nsg facility/long-term (general) rehab experience. Would like to move into telehealth area. Could you recommend what CEU courses to focus on to be better equipped to provide telehealth for adults? (My best guess would be along the lines of ortho, ergonomics, yoga, stroke recovery etc ) TY 🙂

Hello my name is Ena-Lynnette !
I am applying to OT school and hoping to gain observation hours via remote means during this time for my admissions requirements. I am very agar and passionate about the field and the different setting OT work in. If there are any any OT who would be willing to let me shadow remotely, even just for a day or two! Thank you so much! My email is enalynnbolling@gmail.com

Hi there!!!!

Great article and great resources. I am going to review some of the podcasts listed above and will look into the OT Potential Club.
My name is Rosie and I am an OT working in the school district in Texas. Can you tell me if we need to document each time that we obtained verbal consent when working with parents/school children (I’ve have had to see some of my more involved students with the parents, sometimes with the spec ed and/or resource teacher, depending on the student)? Can we just use a general telehealth consent form?? Any thoughts?? Please email me at
rleblanc1@saisd.net

Do we know whether OT assessments for school aged kids can be done virtually? Concerns about standardisation and challenges related to services

My name is Matthew. I am currently applying to Occupational Therapy programs in Texas. I have observed at many different facilities, but for both PT and OT. For my application, I need more hours of OT observation. However, due to the COVID-19 pandemic, I am struggling to find shadowing opportunities. I have reached out to hospitals and local school districts. I have been told that due to the circumstances and to liability issues, I am unable to observe them at this time. Therefore, if there is anybody who could allow me to remotely observe a minimum of 20 hours, I would be very appreciative. My email is mepallini13@gmail.com.

Are there performance reviews available for OT’s who have shifted to remote work that take into account the different set up?

This is very informative. Telehealth in the United Kingdom in now beginning to be considered in OT services. Still a bit of a way to go but the NHS is now coming around. Important to consider barriers though, like lack of social cues, a narrower view of a patient’s occupational environment.

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