Telehealth can be defined as “the application of telecommunication and information technologies for the delivery of rehabilitation services (American Occupational Therapy Association [AOTA], 2013, p. 69). It can be used in client evaluation, treatment intervention and monitoring, consultation, education, and training (Russell, 2009).

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Other Terms for Telehealth (WFOT, 2014):
Tele-occupational therapy
Telerehabilitation
Teletherapy
Telecare
Telemedicine
Telepractice

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Forms of Delivery (Pramuka & van Roosmalen, 2009):
Voice over Internet Protocol (VoIP)
Mobile videoconferencing
Consumer HDTV videoconferencing
Text-based (e.g. e-mail or text messaging)
Audio-based (e.g. teleconferencing)
Virtual reality (e.g. videogames)
Web-based (e.g. real-time chat rooms)
Wireless (e.g. personal digital assistants (PDAs))

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An advantage of telehealth is that it increases access to services for clients who live in rural areas or who have difficulty traveling.  Without the use of telehealth delivery, some may not receive services at all (AOTA, 2013).

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Although telehealth can be advantageous, there are many considerations to be aware of in order to provide the best care. Some considerations include: 

• Extenders (e.g. family or support staff) may need to assist during the session and be comfortable using technology (Estes, 2017). However, the presence of a third party may result in client discomfort or privacy and confidentiality issues (AOTA, 2013; Estes, 2017). 

• Sensory loss due to normal aging (e.g. diminished hearing and vision) or cognitive, motor, language, or vocal impairments can impede clients’ ability to operate the technology or benefit from services delivered from a distance (Brennan et al., 2010).

• There is a potential for equipment malfunction. Lapses in sound/picture transmission can negatively impact the therapeutic encounter (Denton, 2003; Estes, 2017).

• Clients should be informed of the risks and benefits, their rights (including the right to refuse treatment) and responsibilities, and organizational policies for the retention and storage of audio and video recordings and electronic medical records (Grosch et al., 2011). 

• Therapists should use clinical reasoning to determine the appropriateness of telehealth use based on individual client situations (e.g. client’s diagnosis and impairments, nature of the occupational therapy interventions to be provided, client’s ability to access technologies, etc.) (WFOT, 2014).