Our Telehealth service is an award winning, innovative, over the phone or videophone treatment solution from Physio Med, designed to empower patients to self-manage their condition. It won the prestigious Chartered Society of Physiotherapy Service Excellence Award ( Self-Management ). It combines all the advantages of expert Physiotherapy intervention with state of the art technology.

Our customer surveys report high patient satisfaction and additional feedback indicates that this intervention is both effective in resolving the symptoms and preventing people taking time off even if they are working from home.

Essentially there is no difference between the over the phone and the face to face assessment. We have taken the face to face assessment and simply delivered it over the phone using Skype, Facetime, Google Duo etc. We use the same set of questions, we use the same Senior Chartered Physiotherapists and we use the same clinical reasoning skills, the phone and video facility is simply used as a quick and effective method of contacting the patient. We also allocate the same amount of time to undertake the assessment as we strongly feel that this service is to be of the same quality as our face to face approach.

90% of the diagnosis is made by a Physio in the question and answering part of the assessment. Then we ask the patient to do some simple movements to assess how far the patient can move the cervical spine, lumbar spine, shoulder, knee etc. and where they feel the pain. The Physio may even ask the patient to press certain areas arround the injury to esablish the most panful area to gather the remaining information they need.

The Senior Physiotherapist then takes the subjective and objective part of the assessment and uses this information to compile the clinical reasoning, the treatment and advice, including any reasonable work-place modifications that may be required to facilitate recovery.

As a result of an injury, inflammation and scar tissue formation, you may experience pain, reduced movement and reduced strength. Your assessing Senior Physiotherapist will identify where your pain is coming from, which of your movements are restricted and which of your muscles are weak. Your Physiotherapist will then create a tailored exercise programme to meet your specific needs and address this. The exercises will be graded dependent on the age of your condition, i.e. gentle in the first few weeks and then increasing as the condition progresses. These exercises aimed at reducing your pain, improving your movement and improving your strength will have a direct effect on improving your condition.

Exercises are most often prescribed to have a cumulative effect over a period of time. This effect can be diminished if the exercises are not carried out regularly. Some forms of exercise need to be performed several times per day whilst others only 1-3 times per week, the intensity of the exercise and it's desired effects dictate the frequency and amount it needs to be performed.

Let us look at some of the clinical skills that a Chartered Physiotherapist uses to facilitate and promote recovery in injured tissues

• Advice and Education on the condition
• Workplace modifications
• Home and lifestyle modifications
• Exercises to reduce pain
• Exercises to improve movement
• Exercises to increase strength
• Exercises to improvement balance and co ordination
• Advice on the use of ice / heat
• Advice on the use of strapping and supports
• Referral to other professionals for further investigations
• And finally the use of our hands to mobilise the joints and the soft tissues

As you can see the Physiotherapists hands are only a part of the many skills that are used to facilitate and promote recovery in injured tissues. In some cases the Physiotherapist does need to uses their hands to promote recovery however in some cases they do not.

Not only do different injuries have different healing rates, individuals will recover at different rates and in fact an individual with the same problem twice may recover at different rates which can be attributed to age, diet, lifestyle choices and many other factors.

Telehealth answers an inherent problem with any medical intervention. There is always a gap between the patient asking for help and being able to provide a clinician to assess and treat the problem. Physio Med realised that many patients wanted immediate advice often in relation to straight forward questions about exercises ,use of heat, rest etc. We decided this information needed to be given by a clinician and be in direct relation to the problem. As our Physio's can't be available all day to answer patient calls directly we decided to get a fully qualified physio to call the patient back at a booked appointment time, to offer clinical advice as quickly as possible. However, as all of our Physio's are registered and chartered we have a professional responsibility to ensure we ask the right questions and produce the correct paperwork. Meeting these two needs as fast as possible; direct contact with a real physio and the physio being able to complete their professional requirements, led to the development of our remote Telehealth service. In running a trial (of over a year) we realised that the majority of our patients who rang within the first few days of a problem actually got better with the correct advice on exercises, workplace modifications, tablets and whether to rest or not. However, we know it does not work for everyone in every case so we follow everyone up and make sure if you need to see a physio face to face you will.

We have to follow up patients to ensure the advice given is working, this is consistent with our face to face service. If not then it needs to be changed or a different route taken. We understand all patients are different and what works for one patient may not be effective for another. Follow up allows us to see how the problem is changing and then change our advice if necessary.

In essence it continues to be used because it actually works for the majority of people. We know this because of the huge effort that went into its development. Initially we ran a trial to see how well advice over the phone would work which ran for over a year using real Physio's Med's real patients and monitoring real results. During this time the service changed to the current version of Telehealth which now involves a comprehensive structured over the phone assessment about the problem, advice and follow up. We checked the results of both the improvements in patients conditions and actual patient satisfaction surveys and both were extremely high. Higher than we initially anticipated, so high we even won a professional award. In fact the results have remained as high ever since. However, we understand Telehealth does not work for everyone which is why we keep our original face to face service with over 780 clinics in the UK for patients who PAL won't be, or hasn't been, effective for. Please remember a large portion of our patients ring within the first few days of getting a problem and for the majority of them advice often cures the problem without the need to send them to a clinic to see a physio.

When a patient sustains an early or what we call an acute injury the Senior Physio may prescribe stretching exercises to restore the normal range of motion. The exercises chosen are normally described as early rehabilitation exercises and in their nature are designed to be simple to follow and gentle. These are delivered as video files to allow the patient to follow the exercises. We use the latest multimedia video package for our Telehealth service. This includes a full explanation and demonstration of all of the exercises in video, picture and word formats. Each set of exercises explain that the exercises should not be painful to perform and if they are the patient should contact Physio Med for further advice. This is considered to be the best technology currently available and is a proven effective way of exercise delivery.

Telehealth exists because of patients. Most people who ring Physio Med actually ask for advice over the phone straight away. Our admin staff who answer the phones are not in a position to answer clinical questions even ones as simple as should I rest or keep going? Should I use ice or heat? will this tablet help? We can't have Physio's answering the phone for enquiries their time is too valuable and they are a limited resource. Coupled to this our Physio's won't give advice on a problem until they have at least talked to a patient about the problem first. So a patient rings and quite rightly wants advice to get them heading down the right path straight away. We get our Physio's to call you back at a pre booked and agreed appointment time and give that advice. Our Physio's have a professional responsibility to follow up on that advice which we give. If the advice works great, if not we change it. Without Telehealth it may be days before a patient receives any actual advice from a health care professional (Google doesn't count!) Those days without the right advice would be at best a waste of time and at worst a time where the patient actually made their problem worse. We don't see Telehealth as a waste of time we see it as early intervention.

Your assessing Senior Chartered Physiotherapist asks in-depth questions about your problem followed by some general health questions
You will then be asked to do a few easy movements to assess mobility and pain
You will finally be asked questions regarding the effect of your condition on your job.
After this, the Physiotherapist will make a decision regarding the most appropriate management for you condition.
a. 10 day exercise program with follow up
b. Referral for face to face Physio
c. Referral to GP or back to Occupational Health

You will be e-mailed with full instructions and a direct link to your individually personalised exercise programme.
These can be printed out for easy reference and each exercise also has a video link that you can watch to make sure you do your exercises correctly.
The e-mail also contains access to the Educational Zone of our website which gives you further information and advice about your condition