Determining Gaps in Current Physiatric Tele-Physical Assessments (TelePA) via a Needs Assessment Survey.

OBJECTIVES: Physical examinations are essential for in-person patient visits but remain difficult to replicate during virtual encounters. This work aims to identify gaps in the current state of telemedicine-based physical assessments (TelePA) by surveying physical medicine and rehabilitation (PM&R) physicians who perform physical examinations.

DESIGN: A survey of 29 Likert-scale questions and 5 open-ended questions was distributed to practicing PM&R physicians. The Likert-scale questions covered remote physical assessment, access, perception/engagement, implementation/effectiveness, and administrative concerns.

RESULTS: 53 participants completed the survey. Over 80% of respondents suggested that while telemedicine was universally well accepted, they could not effectively perform TelePA, especially the musculoskeletal and neurological components. Remote assessment of upper and lower extremity strength, reflexes and sensation were examples of key unmet needs. Responses to open-ended questions suggested that TelePA can reduce the burden of travel and increase adherence to follow-up visits, but complex technology setup can pose difficulty for older patients and patients with cognitive deficits.

CONCLUSIONS: These findings suggest that current telemedicine technology is insufficient to meet PM&R physicians' TelePA needs. Despite high levels of provider and patient engagement with telemedicine, numerous deficits remain in performing musculoskeletal and neurological examinations. These results can inform future technology developments that address these identified TelePA gaps.