Large-Scale Telemedicine Implementation for Outpatient Clinicians: Results From a Pandemic-Adapted Learning Collaborative.

Learning collaboratives are seldom used outside of health care quality improvement. We describe a condensed, 10-week learning collaborative ("Telemedicine Hack") that facilitated telemedicine implementation for outpatient clinicians early in the COVID-19 pandemic. Live attendance averaged 1688 participants per session. Of 1005 baseline survey respondents, 57% were clinicians with one-third identifying as from a racial/ethnic minoritized group. Practice characteristics included primary care (71%), rural settings (51%), and community health centers (28%). Of three surveys, a high of 438 (81%) of 540 clinicians had billed ≥1 video-based telemedicine visit. Our learning collaborative "sprint" is a promising model for scaling knowledge during emergencies and addressing health inequities.

State Occupational and Physical Therapy Telehealth Laws and Regulations: A 50-State Survey.

The Center for Connected Health Policy conducted a scan of current state policy affecting occupational therapy (OT) and physical therapy (PT) practice, supervision, and additional requirements for using telehealth. While most states have established telehealth policies for other health care professions, this 50-state scan shows that many states made some reference to telehealth practice for OT (37 states) and PT (40 states). The states that adopted these policies also tended to adopt them in either law or regulation, but not both, and showed no discernable patterns favoring either. Additionally, eight states included OT and PT within telehealth laws that concurrently apply to multiple health professions. More commonly, states enacted policy within laws or regulations specific to OT and PT. Most policies including limitations on telehealth practice for OT and PT did not appear to create requirements that are more restrictive than what is generally seen in telehealth across all states.

An analysis of state telehealth laws and regulations for occupational therapy and physical therapy.

This study conducted a scan of telehealth occupational therapy and physical therapy state laws and regulations. The laws and regulations were analyzed to determine the potential effect they could have on occupational therapists' and physical therapists' utilization of telehealth. The results indicate that the majority of occupational therapy and physical therapy boards are silent on telehealth. A handful of physical therapy laws and regulations address "consultation by means of telecommunication," but do not provide any guidance for practitioners seeking to provide direct telehealth-delivered services to patients. Of the few states that do provide guidance, policy had the potential to provide clarity or inhibit adoption. The findings suggest that as state boards consider crafting telehealth regulations, they should do so in a manner that facilitates, rather than hampers adoption, while upholding their providers to a high standard of care.