Telerehabilitation perceptions and experiences of physiatrists in a lower-middle-income country during the COVID-19 pandemic

Background The COVID-19 pandemic catalyzed the adoption of telerehabilitation in various health care settings. However, there was neither a preexisting national guideline in the Philippines nor an internationally agreed upon standard for telerehabilitation. The literature lacks nationwide studies documenting how physiatrists perceived and experienced telerehabilitation during the pandemic. Objective To determine the perceptions and experiences of physiatrists in the Philippines regarding telerehabilitation. Design Online survey originally developed by the authors with inputs from local experts in telehealth or telerehabilitation. Setting Nationwide, involving board-certified physiatrists practicing in the Philippines. Participants Fellows of the Philippine Academy of Rehabilitation Medicine (PARM) (N = 259) with Internet access. Main Outcome Measures Self-reported telerehabilitation knowledge, skills, and experience; key concerns; preferred clients, service offerings, and methods (technology, duration, charging). Results The respondents (n = 161; 62.2% response rate) had a mean age of 48.1 +/- 9.6 years, were mostly female (57.8%), and mostly practiced in private hospitals and urban settings. The majority reported inadequate telerehabilitation knowledge (61.5%), skills (58.4%), and experience (72.1%). The most common sources of telerehabilitation knowledge were colleagues (52.8%), PARM (51.6%), and telemedicine-related websites (41.6%). Most of the respondents preferred to conduct telerehabilitation with former patients over new ones and prescribe telerehabilitation programs for physical, occupational, psychological, and speech-language therapy but not for swallowing therapy. Videoconferencing was the most common telerehabilitation method. More than half of the respondents charged lesser fees for telerehabilitation compared to in-person consultations. Although the majority recognized the need for telerehabilitation, their key concerns included the lack of thorough patient examination and medicolegal liability issues. Conclusion Despite their limited baseline knowledge, skills, and experience regarding telerehabilitation, many physiatrists in the Philippines learned to adopt this service delivery method during the pandemic. Their perceptions and experiences could be used in formulating practice-based guidelines and strategies to improve the conduct of telerehabilitation in the country.