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===== Facilitating Knowledge and Education through Physiotherapist communication =====
===== Facilitating Knowledge and Education through Physiotherapist communication =====
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Another strong predictor on patient participation in healthcare is effective patient knowledge about their condition and course of action. Patient education is extremely important to enhance therapeutic compliance and healthcare providers should supply patients with adequate education about their treatment and disease <ref name="Jin et al." />. All of the smartphone applications discussed provide additional resources relevant to the patient's condition. PhysioTrack is partnered with the University of Dublin and SportEx to keep up to date with relevant research protocols. Additionally, PhysioTrack allows physiotherapists to send their patient relevant information and research about their condition <ref name="PhysioTrack" />. Similarly, MyPhysioapp allows physiotherapists to provide their patients with relevant health topics like diagnosis, self-management concepts and general health literacy <ref name="Myphysioapp" />. PT Pal is partnered with various hospitals to stay up to date on clinical protocols and has recently appointed a clinical advisor, Dr. Russel Carter to their team <ref name="PT Pal" />. This allows the application to communicate up to date research with their clients. Lastly, PhysioAdvisor incorporates additional information through an injury profile library to help inform and educate patients <ref name="Physioadvisor" />. Education for patients is important as many patients describe not attending appointments because they perceived that their appointment was unnecessary. Providing clear information to patients is important since many patients appear to lack understanding over their own healthcare <ref name="Collins et al." />. Communicating relevant information about the patient's condition can further engage the patient in his or her own treatment concerns and builds a greater understanding and partnership with the physiotherapist.<br>
+
Another strong predictor on patient participation in healthcare is effective patient knowledge about their condition and course of action. Patient education is extremely important to enhance therapeutic compliance and healthcare providers should supply patients with adequate education about their treatment and disease <ref name="Jin et al." />. All of the smartphone applications discussed provide additional resources relevant to the patient's condition. PhysioTrack is partnered with the University of Dublin and SportEx to keep up to date with relevant research protocols. Additionally, PhysioTrack allows physiotherapists to send their patient relevant information and research about their condition <ref name="PhysioTrack" />. Similarly, MyPhysioapp allows physiotherapists to provide their patients with relevant health topics like diagnosis, self-management concepts and general health literacy <ref name="Myphysioapp" />. PT Pal is partnered with various hospitals to stay up to date on clinical protocols and has recently appointed a clinical advisor, Dr. Russel Carter to their team <ref name="PT Pal" />. This allows the application to communicate up to date research with their clients. Lastly, PhysioAdvisor incorporates additional information through an injury profile library to help inform and educate patients <ref name="Physioadvisor"
>PhysioAdvisor. PhysioAdvisor.com "Take control of your injury": home page. http:
/
/www.physioadvisor.com.au/ (accessed 4 Nov 2015)</ref
>. Education for patients is important as many patients describe not attending appointments because they perceived that their appointment was unnecessary. Providing clear information to patients is important since many patients appear to lack understanding over their own healthcare <ref name="Collins et al." />. Communicating relevant information about the patient's condition can further engage the patient in his or her own treatment concerns and builds a greater understanding and partnership with the physiotherapist.<br>
===== Communicating the right exercise prescription =====
===== Communicating the right exercise prescription =====
-
Finally, the importance of communicating the appropriate exercise prescription in an interactive manner is discussed. mHealth applications creates new opportunities for patients to strengthen their relationship with their therapist, reinforce standing of the plan of care, confirm home exercise techniques and proactively address relevant concerns <ref name="Dicianno et al." />. <br> <br> PT Pal is arguably the most interactive device of them all as the exercise programs offers an audio option to count sets and reps as well as overall duration of the program. In addition to this, pop-up motivational notifications can inform a patient when they are almost done their exercises <ref name="PT Pal" />. Importantly, PT Pal has the feature to collect pain and difficulty feedback from patients to help tailor exercise prescriptions and adapt programs in real time. When asked how physiotherapists have responded to using the app, Naveen Khan has stated the following: (Catenazzi, Oriana. Conversation with: Naveen Khan. 2015 Nov 16).<br> <br>'''''[[Image:
PT
Speech.png|center|
400x300px
]]<br>''''' <br><br>Rehabilitation professionals can utilize this information to better understand any relevant environmental factors affecting exercise adherence as well as utilizing this real time data to receive patient feedback that is less subjective to recall bias in future appointments <ref name="Dicianno et al." />. Physiotherapists' who use PT Pal can monitor patient progress remotely and send reminders or follow up notes to patients who may not be completing their program or appear to be having difficulty
(PT Pal 2015)
. The patient confirms (with a click of the box) once an exercise is completed, allowing the patient to keep track themselves
. Additionally, the physiotherapist is notified with highlighted coloured button of red, yellow or green informing the physiotherapist of the patient’s status with the HEP (Catenazzi 2015)
. Additionally, the patient who uses PT Pal has their program stored in the application which they can share with other health professionals. In this way, it keeps all health professionals informed on the quality of care and they can work together remotely
(Catenazzi 2015)
. PT Pal is continually evolving and targeting the application to more health professionals
(PT Pal 2015)
<br> <br>[[Image:Myphysio symptoms.png|left|
200x300px
|Myphysio app symptom rating (Myphysioapp 2015)]]Similarly, MyPhysioapp also requests the patient's current symptom using a VAS scale (1-5) once they start their program. The application incorporates timed sets, reps and rest intervals. Upon completion of the program, the patient has the option to write any relevant notes or comments on their personal progress. The patient can then use this information to track progress and monitor their symptoms over the duration of their physiotherapy program
(MyPhysioapp 2015)
. In comparison,
Physiotrak
stores the patient's exercise prescription history and offers a 'compliance button' for the patient to track when they complete their exercises
(Physiotrak 2014)
. This information is sent directly to the physiotherapist's portal where they can monitor patient's progress. Physiotherapists have the option to track the patient's progress with a reporting feature on their account. As we have evaluated, PhysioAdvisor does not offer any reporting option or tracking program to monitor patient compliance with the program.<br> <br> An important feature for patient participation in healthcare is accessibility and satisfaction with the healthcare facilities <ref name="Jin et al." />. These physiotherapy applications helps to promote healthcare facilities remotely in the patient's own environment. An important feature of the application is that is must be useful and usable, and this may link with adoption and frequent use of mobile application <ref name="Monroe et al." />. If the physiotherapist is able to communicate effectively with the patient about their condition, treatment and home exercise options using any of these applications, there will likely be improved patient participation and engagement with their rehabilitation process.<br>
+
Finally, the importance of communicating the appropriate exercise prescription in an interactive manner is discussed. mHealth applications creates new opportunities for patients to strengthen their relationship with their therapist, reinforce standing of the plan of care, confirm home exercise techniques and proactively address relevant concerns <ref name="Dicianno et al." />. <br> <br> PT Pal is arguably the most interactive device of them all as the exercise programs offers an audio option to count sets and reps as well as overall duration of the program. In addition to this, pop-up motivational notifications can inform a patient when they are almost done their exercises <ref name="PT Pal" />. Importantly, PT Pal has the feature to collect pain and difficulty feedback from patients to help tailor exercise prescriptions and adapt programs in real time. When asked how physiotherapists have responded to using the app, Naveen Khan has stated the following: (Catenazzi, Oriana. Conversation with: Naveen Khan. 2015 Nov 16).<br> <br>'''''[[Image:Speech
Bubble 2
.png|center|
475x300px
]]<br>''''' <br><br>Rehabilitation professionals can utilize this information to better understand any relevant environmental factors affecting exercise adherence as well as utilizing this real time data to receive patient feedback that is less subjective to recall bias in future appointments <ref name="Dicianno et al." />. Physiotherapists' who use PT Pal can monitor patient progress remotely and send reminders or follow up notes to patients who may not be completing their program or appear to be having difficulty. The patient confirms (with a click of the box) once an exercise is completed, allowing the patient to keep track themselves. Additionally, the patient who uses PT Pal has their program stored in the application which they can share with other health professionals. In this way, it keeps all health professionals informed on the quality of care and they can work together remotely. PT Pal is continually evolving and targeting the application to more health professionals
.
<br> <br>[[Image:Myphysio symptoms.png|left|
200x275px
|Myphysio app symptom rating (Myphysioapp 2015)]]Similarly, MyPhysioapp also requests the patient's current symptom using a VAS scale (1-5) once they start their program
(figure featured to the left)
. The application incorporates timed sets, reps and rest intervals. Upon completion of the program, the patient has the option to write any relevant notes or comments on their personal progress. The patient can then use this information to track progress and monitor their symptoms over the duration of their physiotherapy program. In comparison,
PhysioTrack
stores the patient's exercise prescription history and offers a 'compliance button' for the patient to track when they complete their exercises. This information is sent directly to the physiotherapist's portal where they can monitor patient's progress. Physiotherapists have the option to track the patient's progress with a reporting feature on their account. As we have evaluated, PhysioAdvisor does not offer any reporting option or tracking program to monitor patient compliance with the program.<br> <br> An important feature for patient participation in healthcare is accessibility and satisfaction with the healthcare facilities <ref name="Jin et al." />. These physiotherapy applications helps to promote healthcare facilities remotely in the patient's own environment. An important feature of the application is that is must be useful and usable, and this may link with adoption and frequent use of mobile application <ref name="Monroe et al." />. If the physiotherapist is able to communicate effectively with the patient about their condition, treatment and home exercise options using any of these applications, there will likely be improved patient participation and engagement with their rehabilitation process.<br>
-
===== Key Points
:
=====
+
===== Key Points =====
-
[[Image:Key points.png|center|
600x200px
]]
+
[[Image:Key points.png|center|
700x300px
]]
== Further considerations: Facilitating behaviour change ==
== Further considerations: Facilitating behaviour change ==
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===== Data Protection =====
===== Data Protection =====
-
With the increasing number of smartphone applications and rapid progression of telerehabilitation services, it is important the the physiotherapist is aware of the quality and protection that the software offers. In the UK, compliance with the [http://www.legislation.gov.uk/ukpga/1998/29/contents Data Protection Act ]is a minimum standard to protect your information and rights. The following table describes key rules so that information is:[[Image:Data protection .png|center|400x300px]]<br>The applications that we have discussed provide a global sample of physiotherapy home exercise programs available through smartphone applications. Under the ‘terms and conditions’ and ‘privacy policy’ section of each application, they specifically describe data protection as well as liability concerns for using their software. Importantly, they all describe that the information provided on the applications
do
not replace consultation with a physiotherapist / physician and clearly state not to use the applications for medical advice. This is extremely important for the all applications, but specifically PhysioAdvisor as the patient can utilize resources to assist with self-diagnosis and control over creating their own exercise program. Physiotherapists must ensure they are protected for liability and insurance purposes. It is important for both patients and physiotherapists to make themselves aware of the terms and conditions when using external applications. If the reader would like to read specific terms and conditions for each company, please follow the links below.
+
With the increasing number of smartphone applications and rapid progression of telerehabilitation services, it is important the the physiotherapist is aware of the quality and protection that the software offers. In the UK, compliance with the [http://www.legislation.gov.uk/ukpga/1998/29/contents Data Protection Act ]is a minimum standard to protect your information and rights. The following table describes key rules so that information is:[[Image:Data protection .png|center|400x300px
|(Scottish Government 2015)
]]<br>The applications that we have discussed provide a global sample of physiotherapy home exercise programs available through smartphone applications. Under the ‘terms and conditions’ and ‘privacy policy’ section of each application, they specifically describe data protection as well as liability concerns for using their software. Importantly, they all describe that the information provided on the applications
does
not replace consultation with a physiotherapist / physician and clearly state not to use the applications for medical advice. This is extremely important for the all applications, but specifically PhysioAdvisor as the patient can utilize resources to assist with self-diagnosis and control over creating their own exercise program. Physiotherapists must ensure they are protected for liability and insurance purposes. It is important for both patients and physiotherapists to make themselves aware of the terms and conditions when using external applications. If the reader would like to read specific terms and conditions for each company, please follow the links below.
<u>'''PT Pal'''</u><br>[http://www.ptpal.com/#!terms-of-use/cira Terms and condition and privacy policy]
<u>'''PT Pal'''</u><br>[http://www.ptpal.com/#!terms-of-use/cira Terms and condition and privacy policy]
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<u>'''MyPhysio App'''</u><br>[http://www.myphysioapp.com.au/wordpress/wp-content/uploads/2012/12/MyPhysio-App-Licence-Agreement.pdf Terms and conditions and privacy policy]
<u>'''MyPhysio App'''</u><br>[http://www.myphysioapp.com.au/wordpress/wp-content/uploads/2012/12/MyPhysio-App-Licence-Agreement.pdf Terms and conditions and privacy policy]
-
<br><u>'''PhysioAdvisor'''</u><br>[http://www.physioadvisor.com.au/7649650/physioadvisor-terms-conditions.htm Terms and conditions]<br>[http://www.physioadvisor.com.au/7651050/physioadvisor-privacy-policy.htm Privacy Policy]<br>
+
<br><u>'''PhysioAdvisor'''</u><br>[http://www.physioadvisor.com.au/7649650/physioadvisor-terms-conditions.htm Terms and conditions]<br>[http://www.physioadvisor.com.au/7651050/physioadvisor-privacy-policy.htm Privacy Policy]<br>
== Concluding Remarks ==
== Concluding Remarks ==
-
With the ever enhancing realm of technology and mHeath applications, the future generation of physiotherapists must be aware of the evolving changes in technology to make physiotherapy an interactive environment with the patient. This will support an increase in motivation and facilitate participation in a home exercise program. As one review discovered, non-compliance remains a major issue in improving healthcare outcomes despite many studies highlighting this ongoing issue over the years
(
Jin et al.
2008)
. The new face of physiotherapy applications can facilitate patient adherence by creating an interactive exercise environment that promotes self-efficacy and behavior change through enhanced communication, goal setting and progress reporting means. As this wiki has highlighted, there are many links that can be made between the models of behavior change and some of the smartphone applications discussed here, however due to wide variation in terms of study designs and applications, it is difficult to pinpoint potential influences of mobile-phone based strategies on physical activity behavior
(
Monroe et al.
2015)
. Additionally, the effectiveness of smartphone applications to improve health behaviours is an emerging field of research
(
Kirwan et al.
2012)
. As the Scottish Government highlights for our way forward, we need to improve sustainability and value by establishing a baseline, and developing consistent outcome measures and indicators to track the impact of telehealth and telecare on working practices, productivity and resource use (The Scottish Government 2014). Future research is necessary to focus on these novel physiotherapy applications and the effect on patient behavior change and patient experience. Research should also target physiotherapy programs administered via these applications to identify any advances in rehabilitation and home exercise programs. As the Scottish Government identifies, we need to raise awareness, publish and promote innovative approaches, good practice and illustrate user/patient experiences to further develop good practice (The Scottish Government 2014). The physiotherapy smartphone applications discussed in this wiki page have identified a new and emerging area in physiotherapy to better our practice and further facilitate the patient-physiotherapist relationship. The list of smartphone physiotherapist applications is not exhaustive, and many other applications currently exist and will be created in the future. The information presented here should allow the reader to identify key features provided in smartphone applications that may enhance the physiotherapist-patient relationship. Physiotherapists need to be aware of the expanding significance of telerehabilitation as new technology might offer further support to our patients.<br><br>
+
With the ever enhancing realm of technology and mHeath applications, the future generation of physiotherapists must be aware of the evolving changes in technology to make physiotherapy an interactive environment with the patient. This will support an increase in motivation and facilitate participation in a home exercise program. As one review discovered, non-compliance remains a major issue in improving healthcare outcomes despite many studies highlighting this ongoing issue over the years
<ref name="
Jin et al.
" />
. The new face of physiotherapy applications can facilitate patient adherence by creating an interactive exercise environment that promotes self-efficacy and behavior change through enhanced communication, goal setting and progress reporting means. As this wiki has highlighted, there are many links that can be made between the models of behavior change and some of the smartphone applications discussed here, however due to wide variation in terms of study designs and applications, it is difficult to pinpoint potential influences of mobile-phone based strategies on physical activity behavior
<ref name="
Monroe et al.
" />
. Additionally, the effectiveness of smartphone applications to improve health behaviours is an emerging field of research
<ref name="
Kirwan et al.
" />
. As the Scottish Government highlights for our way forward, we need to improve sustainability and value by establishing a baseline, and developing consistent outcome measures and indicators to track the impact of telehealth and telecare on working practices, productivity and resource use (The Scottish Government 2014). Future research is necessary to focus on these novel physiotherapy applications and the effect on patient behavior change and patient experience. Research should also target physiotherapy programs administered via these applications to identify any advances in rehabilitation and home exercise programs. As the Scottish Government identifies, we need to raise awareness, publish and promote innovative approaches, good practice and illustrate user/patient experiences to further develop good practice (The Scottish Government 2014). The physiotherapy smartphone applications discussed in this wiki page have identified a new and emerging area in physiotherapy to better our practice and further facilitate the patient-physiotherapist relationship. The list of smartphone physiotherapist applications is not exhaustive, and many other applications currently exist and will be created in the future. The information presented here should allow the reader to identify key features provided in smartphone applications that may enhance the physiotherapist-patient relationship. Physiotherapists need to be aware of the expanding significance of telerehabilitation as new technology might offer further support to our patients.<br><br>
-
==
CPD Test
your knowledge ==
+
==
Further
your knowledge ==
-
add appropriate resources here
+
To test your knowledge on the information presented in this wiki, please take this test.
+
+
+
+
<u>'''Further Resources'''</u>:<br>Follow this [http://www.nhs.uk/pages/healthappslibrary.aspx link] to the NHS Health Apps Library page. The site is currently being upgraded, however information is still available to the reader to find interactive tools, apps and podcasts to manage health as well as links to the project roadmap to understand how patient-focused health apps can be recommended. <br>
== <span style="font-size: 19.92px; line-height: 1.5em; background-color: initial;">References</span> ==
== <span style="font-size: 19.92px; line-height: 1.5em; background-color: initial;">References</span> ==
<br> <references />.
<br> <references />.