Q and A: Telehealth
Q. What is telehealth?
"Telehealth" is defined as the use of interactive
audio and video, in real time telecommunication technology or store-and-forward
technology, to deliver health care services when the occupational therapist and
patient/client are not at the same physical location. Its uses include
diagnosis, consultation, treatment, prevention, transfer of health or medical
data, and continuing education.
Q. What are the Standards of Practice for Telehealth?
An occupational therapist or occupational therapy assistant
providing occupational therapy services via telehealth must exercise the same
standard of care when providing occupational therapy services via telehealth as
with any other mode of delivery of occupational therapy services and provide
services consistent the AOTA Code of Ethics and Ethical Standards of Practice;
and comply with provisions of the Occupational Therapy Practice Act and its
Q. What is required to provide occupational therapy services via
telehealth in Oregon?
An occupational therapist or occupational therapy
assistant providing occupational therapy services via teleheath to a client in
Oregon must have a valid and current license issued by the Oregon Occupational
Therapy Licensing Board.
Q. I am from out-of-state. Do I need an Oregon license to
provide Occupational Therapy services to a client in Oregon?
A. Yes, a license by the Oregon Occupational Therapy
Licensing Board is required.
Q. Do I need to reside within the state of Oregon in order to
provide telehealth services to a client who resides in Oregon?
A. No, you are not required to reside in Oregon but you
are required to have an Oregon license and follow all the provisions of laws
and regulations governing occupational therapy.
Q. What is consent?
A. Consent is the process (and document) by which an
occupational therapist discloses appropriate information to a competent client
so that the client may make a voluntary choice to accept or refuse treatment.
It originates from the legal and ethical right the patient has to direct what
happens to his or her body and from the ethical duty of the occupational
therapist to involve the patient in his or her health care.
Q. What else must be considered before providing occupational
therapy services via telehealth?
A. OAR 339-010-0006 (6)(a) of the regulations requires the
occupational therapist to determine whether an in-person evaluation is
necessary and make every attempt to ensure that a therapist be available if an
onsite visit is required. (7) requires an occupational therapist should
consider at a minimum the criteria set forth in (7) (a)-(f) when determining
whether an in-person evaluation or intervention are necessary.
Q. How does an occupational therapist determine if an in-person
evaluation or in-person interventions are necessary?
A. OAR 339-010-0006 (7) (a)-(f) requires the occupational
therapist to consider at a minimum the following factors: (a) the complexity of
the patient's/client's condition;
(b) his or her own knowledge skills and abilities;
(c) the patient's/client's context and environment;
(d) the nature and complexity of the intervention;
(e) the pragmatic requirements of the practice setting; and
(f) the capacity and quality of the technological interface.
Q. Do evaluations and interventions have to take place in
A. No. OAR 339-010-0006 does not require an
occupational therapist to be present, with the client, unless a determination
is made that an in-person evaluation or interventions are warranted and
necessary. OAR 339-010-0006 requires the occupational therapist consider the
factors set forth in OAR 339-010-0006 (7) (a)-(f) to determine whether
services, including the evaluation or interventions can be (safely and
appropriately) delivered via telehealth or whether the evaluation or
interventions should be provided in-person. The occupational therapist that is
considering rendering services, including providing an evaluation or
interventions via telehealth, must make the determination whether services must
be provided in-person or services can be safely delivered via telehealth.
After consideration of the criteria in OAR 339-010-0006 (7) (a)-(f) what if a
therapist is not available to perform an onsite evaluation or intervention?
services via telehealth may increase access to care, however, that care cannot
be at the risk of a patient’s safety. The occupational therapist must determine
whether the evaluation or interventions can be (safely and appropriately)
delivered via telehealth or whether services, the evaluation or interventions
must be provided in-person. If an "on-site" occupational therapist is
not available, alternative options may be provided, such as referring the
patient to an out-patient rehabilitation clinic, another local occupational
therapist, home health services, etc.
telehealth be used for supervision of an occupational therapy assistant?
A. Supervision of Occupational Therapy Assistant under
339-010-0035 for routine and general supervision, can be done through
telehealth, but cannot be done when close supervision as defined in
339-010-0005 is required. The same considerations in (7) (A) through (F) must
be considered in determining whether telehealth should be used.