The ever-growing healthcare demands have prompted countries globally to adopt telehealth and Ireland is no exception. Ireland has embraced telehealth as a transformative force which has reshaped how healthcare is delivered in Ireland. However, fragmentations within the Ireland’s healthcare systems, combined with regulatory complexities, underdeveloped infrastructure and gaps in policy implementation has decelerated the uptake of telehealth among the healthcare workers and the public likewise. The introduced of eHealth strategy to integrate Information and Communication Technology into the Irish health system, especially the Health Service Executive (HSE) which is Ireland’s Public Healthcare provider has revolutionised the delivery of healthcare service, especially during Covid-19 lockdown where HSE has massively invested in telehealth for provision of safe and timely healthcare. Like other healthcare professionals in Ireland, Physiotherapist were also using telehealth modalities like, video conferencing, telephone consultations, exercise prescription software, online digital exercise videos etc. It would be interesting to explore the use of telehealth among the Physiotherapist in Ireland following the ease of Covid 19 restrictions to see if the practice of telehealth has sustained and what were the barriers and enablers for the use telehealth.

Background

The swift integration of telehealth solutions by the Physiotherapist in Ireland which was accelerated by Covid-19 pandemic has led to the need to for understanding the nuanced experiences and adaptations made by the Physiotherapists for the future delivery of healthcare services.

The gap in existing research regarding the specific adoption patterns of physiotherapists, the challenges they face, and the enablers that facilitate sustained telehealth utilisation in Ireland creates an indispensable avenue for exploration. Furthermore, Ireland’s investment in healthcare infrastructure, including telehealth, emphasizes the need to comprehensively assess the extent to which telehealth has been adopted in delivery of physiotherapy services. This study aims to investigate into the telehealth dependency trends, the telehealth modalities used, challenges and  opportunities concerning telehealth solutions among physiotherapists in Ireland during the pandemic and post Covid -19 restrictions ease, offering valuable insights for healthcare providers, policymakers, and scholars. Through this research, we aim to bridge the knowledge gap, providing insights into the sustainability of telehealth contributing to the ongoing discourse on the future of healthcare delivery in Ireland for reasons other than Covid-19.  A cross-sectional survey research design was employed to collect the data from physiotherapists working in Ireland during the COVID-19 pandemic and 118 Physiotherapists participated in the survey. The data was collected through Qualtrics using a self-developed questionnaire. The validity and reliability of the questionnaire were examined through content validity, Kuder-Richardson (.73) and Cronbach’s coefficient alpha (.76).

Results

The methodology involved quantitative measures like percentages and mean score and also thematic analysis was used to gain in-depth facts and participant’s perceptions on use of telehealth. There were 33% male and 67 % female participants and over half of the participants had IT literacy to use telehealth solutions at good levels. It is identified from the study that a vast majority of participants used video consultation followed by telephone consultation as telehealth means during the Covid-19. On the contrary, the number of video consultations usage decreased, however some physiotherapists are still using the telephone as a telehealth solution after the Covid-19 restrictions lifted.

It was clear from the study that, 45% of the participants are not practising telehealth after the Covid-19 restrictions lifted with the major barrier being the practicality of use of telehealth in the field of Physiotherapy which is a hands-on practice. Majority of the participants believe that telehealth is not practical or appropriate for some or all aspects of their assessment or treatment as Physiotherapist. The second large barrier is the patient’s preference for face-to-face contact. However, there are mixed responses for the same as participants suggestions for enabler of telehealth advocates that there is growing familiarity and acceptance of telehealth solutions by the public. A maximum number of participants stated that improved access to patients and reduced travel is one of the biggest enablers for telehealth.  This cross-sectional survey explored that a significant majority of respondents, 70% hold optimism about the prospects of telehealth besides challenges and barriers. 19% of respondents are found with pessimistic perceptions of telehealth sustainability for good, while 11% of participants remained undecided over this statement.

Thematic analysis revealed that majority of the participants reported the lack of infrastructure, resources and funding for purchase of equipment, especially the lack of high speed broadband services in rural areas was a major barrier. Other barriers included the fact that the participants believe, Physiotherapy practice is hands on and practical approach and telehealth can influence the treatment outcomes. Few participants recommended eHealth and Irish government on promoting awareness to improve the engagement and use of telehealth for the public by advertising campaigns in television and social media.

Future research

The study highlights the gap between the acceptance and limited adaptation of telehealth by the Physiotherapists post Covid-19 restrictions eased. It advocates for further research in complex clinical settings, telehealth compliance, hybrid healthcare models and patient’s acceptance and further studies are suggested for a wider evaluation using mixed-method research approaches, considering not only Physiotherapist’s perceptive but also patient’s views. This study aims to contribute valuable insights for telehealth policies, particularly related to Physiotherapist profession in Ireland.

This article is based on Vivek Bhaskaran’s thesis “THE USE OF TELEHEALTH DURING AND AFTER COVID 19 AMONG PHYSIOTHERAPISTS IN IRELAND” (2023). https://urn.fi/URN:NBN:fi:amk-2023110728741 The references are available fron the first writer.

Vivek Bhaskaran, Master of Digital Health (Student)

Liisa Klemola, Lecturer, PhD, Savonia University of Applied Sciences, Unit of Continuous Learning, Kuopio, Finland

Elisa Snicker, Lecturer, CBC, MSc (Econ and Bus Admin), MSc (Health Sci.), Savonia University of Applied Sciences, Unit of Continuous Learning, Kuopio, Finland