OTS 22: Here Comes Telehealth Featuring Tracey Davis, OTR/L (PDUs Available)
- Jayson Davies
- Jan 21, 2019
- 46 min read
Updated: Apr 14
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Welcome to the show notes for Episode 22 of the OT Schoolhouse Podcast.
In this episode, Jayson interviews occupational therapist Tracey Davis, a pioneer in the world of telehealth occupational therapy services. With technology advancing every day and becoming cheaper to access in all forms, it is no longer a matter of if virtual OT services will become prominent. Rather, virtual OT services are already here and are only going to become more prevalent in school-based settings, as well as in other traditional medical roles. In this training, you will understand the necessary tools required and guidelines to follow in order to provide telehealth OT services in a school-based setting.
You can earn 1.25 units of professional development by listening to this podcast and purchasing the episode 22 podcast PD opportunity here
.Objectives for this Professional Development Podcast.
Listeners will:
1. Understand the guidelines placed on service providers looking to provide telehealth OT services.
2. Know what tools, software, and hardware are needed to provide virtual services.
3. Understand the difficulties and limitations associated with provided virtual OT Services.
Links to Show References:
Have a question for Tracey? You can contact her at TDavis@talkpathlive.com
American Occupational Therapy Association (AOTA) - AOTA has a plethora of telehealth-related documents on its page. Use this link to access them. Some are only available to AOTA members.
American Telemedicine Association - The ATA has several resources and puts on an annual conference for telemedicine provides similar to AOTA's conference.
Teletherapy for OTs and SLPs Facebook Group - Join over 700 other service providers that are interested in the same thing you are, TELEHEALTH!
FERPA - Briefly referenced in the show as the "HIPPA for schools," FERPA is indeed a privacy act that schools must abide by. All school-based personnel/OTs should be familiar with the Family Educational Rights and Privacy Act, or FERPA
Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.
Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com
Well,
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Episode Transcript
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Amazing Narrator
Hello and welcome to the OT school house podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.
Jayson Davies
Welcome everyone. My name is Jayson Davies, and this is episode number 22 of the OT schoolhouse podcast today. I am, well, genuinely excited about this one, because we're talking all about telehealth, and this is actually going to be one of our first professional development podcasts in a while. So you will have the chance to earn professional development by listening to this podcast and heading over to OT schoolhouse.com forward slash episode 22 or OT schoolhouse.com forward slash PD and purchasing the opportunity to take a short quiz and earn a certificate of completion for listening to this podcast. It's actually going to be an hour and 15 minutes worth of professional development, which is really cool. And all you have to do is sit back, listen, and then go take a short quiz of about 10 questions, and you'll be on your way with an extra 75 minutes of professional development that you can use for NBC, ot recertification. With that said, let's jump into the objectives for today. Today, you will be able to or at least by the end of listening to this episode, you'll understand the guidelines placed on service providers looking to provide telehealth ot services, you'll know what tools, both software and hardware, that are needed to provide virtual services, and you'll also understand the difficulties and limitations associated with providing virtual ot services. And with us today is Tracy Davies of talk path, live. She's an occupational therapist herself, and she's really been at the forefront of telehealth. In fact, I think she's been doing this. We'll get into it in a minute, but she's been doing this since 2012 I'm not even sure I was using Skype in 2012 so she's really come a long way, and she's helped telehealth come a long way as far as occupational therapy services. Tracy is based in Ohio, but because she does telehealth, she provides services all over the country, that's pretty awesome. She could be providing services in New Mexico a half hour ago, and now she's providing services in New York City, perhaps. So it's a real treat to have her on and share her wisdom about telehealth. Like I said, Tracy is well versed in telehealth, and she regularly provides trainings in telehealth, not only for employees of talk path live, but also for other occupational therapists who are thinking about getting into tele rehabilitation. So now, if you've ever thought about working from a computer in the area of telehealth, this is the podcast. This is the place for you to be right now, obviously you know how to get to access podcasts. So you must be somewhat technologically savvy, and well, we're going to step up the game a little bit and figure out how we can do well therapy over a computer is basically what it is. So sit back, relax. And here is Tracy Davies, hey, Tracy, welcome to the OT school house podcast. How are you doing this evening? Just fine. Thanks, Jayson, great. And remind me again where you're actually located. I am in Ohio. That's awesome because we're doing telehealth, and we're going to jump into I know you don't just, quote, unquote, work in Ohio. No, not at all. You're all over the place, right? Yeah. So I'm super excited specifically for this podcast only because I've kind of looked into telehealth a little bit. It is, in a sense, my dream to work from home, whether it be seeing kids in my backyard, or doing telehealth or or even doing this podcast and blog full time, something like that. It's kind of my dream, mostly because I want to be able to be there for my kids when I had them, but I am excited about telehealth, and I can't wait to get into this. So before we jump into that, why don't you give us a little bit of information about you, where you went to school, maybe, and how you got to where you are now.
Tracey Davis
Sure, Sure. So I went to school in Wisconsin, a small school just north of Milwaukee. I got both my bachelor's in psychology and master of OT there. I've been in OT for long time now. I'm not even sure that luck now, maybe 19 years, something like that. And I've been working with children pretty much that whole time. So pretty much very versed in pediatrics. I've been working in telehealth for a while now as well, about six years maybe or so, and I was one of two OTs when I first started working in telehealth at the company that I worked for, and so we kind of muddled through everything. You know, together. I've worked with kids of all ages and all different settings, but my family moves around a lot, and so telehealth was the answer for me to continue my career, even though we move around a lot. And it i i. Have just really enjoyed it. So now I I'm now the Clinical Director for a telehealth company. Talk path live, and I teach continuing ed courses as well, and talk with people like you about the versatility and all the things that can be done in this with this service delivery model. That's awesome. I mean, you kind of jumped on really quickly into the telehealth role. If you've been doing it for six years, we're 2018 2012 I mean, yeah, as far as you know, when was like the first real telehealth like, hey, someone's doing telehealth, yeah. So it started with speech therapy. They were doing it before us, but not too much longer. Before us, there were, there were a few people who were really doing some research in the, you know, early 2000s but really it wasn't. It wasn't until about, well, a ot a identified it as an emerging niche in 2011 Okay, so you're right, Devon, I was pretty close, and their their first position paper came out in 2013 Okay, so, so, you know, people were doing it before then, for research and things like that, but it really has only been in the last five, six years that it's gotten to be sort of mainstream for occupational therapy. Okay,
Jayson Davies
and I might edit this part out. But have you been in contact with a ot a as all when it comes to telehealth? Are you one of their go to Resources In a way?
Tracey Davis
I don't speak with a ot a as a, as an organization, but I have, I have spoken with some of the, some of the people who wrote those documents. You know, Janna cayson is, is a big one. She and Ellen Cohen, they co edit the International, International Journal of tele rehabilitation. And Ellen Cohen is a speech therapist, and Jan is an OT and so, you know, they were kind of very much pioneers, and I, I run in those circles a little bit.
Jayson Davies
So good. Hey, I mean, if you've been doing it, I mean, like you said, it's emerging, you were, I mean, you had to be one of the first few 100 people maybe doing it, and if not even sooner than that. So.
Tracey Davis
People to ask.
Jayson Davies
Exactly, right? Well, now it's a little bit more. So, all right, well, I want to hear from you Exactly. How do you define tele health? When someone asks you, like, what do you do for a living? How do you define it?
Tracey Davis
So I tell I mean, if I'm talking to a lay person, I tell them that I provide therapy services to children over a secure internet connection, that I meet with them via video chat, basically, and that we do therapy together, which is kind of exactly what it is, because it's it's considered a service delivery model, so it's one of the tools in our tool chest, essentially. It's not a specialty or anything like that. It's just one of the ways that we can provide services to individuals. Anyone.
Jayson Davies
Yeah, very cool. And so what do you say if an occupational therapist asks you, obviously they know what OT is, and you're telling them it's telehealth. Now, is it a little bit more? What? What questions do you get and what answers are you giving?
Tracey Davis
You know, it's interesting. I have to say that the biggest skeptics are other therapists. And you know, it's just OT is a hands on profession, and it's hard to picture how you can provide those services when you're not in the same room as the person that you're working with, and so I I go into a little bit more detail, of course, but if I were talking to a therapist, I would just tell them that I do exactly the same things that you might do, but I use instead of my hands, I use my Voice to effectively communicate, and we often compare it to a coaching model, which we've found to be highly effective, especially in areas such as early intervention and home health services. We're working with the an entire team of people, caregivers included, and so we utilize coaching techniques in order to communicate what we need, what we need to happen.
Jayson Davies
Yeah, and if anyone wasn't sure what this specific podcast episode was about, that just kind of summarized it all up, and I can't wait to dive more into it. So we talked a little bit about a OTA, kind of the people that kind of do some some telehealth in that community does a ot a specifically define telehealth? Do they have an official definition for you?
Tracey Davis
They do within their within the position paper that they created, they they defined it as the application of evaluative, consultative, preventative and therapeutic services delivered through. Telecommunication and information technologies.
Jayson Davies
Okay and that's in the AOTA position paper you said on telehealth. Yep, perfect. We'll be sure to link to that in the show notes. But so that's a OTs definition. What about other definitions? I know that doctors are doing telehealth. Obviously you said speech therapists are doing telehealth. I mean, is it all pretty similar. And who else even is out there doing telehealth?
Tracey Davis
Yeah, so telehealth has really gotten so much bigger than it than it was. It's still growing, but, but physicians are doing it. A lot of specialty physicians especially are doing it. So let's say that you live in a community that doesn't have a particular specialist, then you might access a specialist through it, via telemedicine and physical therapy. We physical therapists are doing it as well. And so they actually, APTA created a position paper in 2012 so around the same time as a OTA, then we there's also a group called the American Telemedicine Association, and they have a lot of different resources, things like that, but they have a telerehab special interest group, and so they've created a it's an interdisciplinary document for all rehab professions, where they also kind of their original document was called the blueprint for tele rehabilitation guidelines. It's been updated since that time, and it might even have a different title now, but it's, it's just an update of the original position paper. But all of them have very similar definitions, and all of them identify telehealth as a viable service delivery model, meaning that, number one, you don't really need any sort of specialty certification to conduct telehealth services. And number two, research you know, has shown it to be an effective means of delivering services.
Jayson Davies
Perfect. I mean, that's kind of the two things that really you need to know. Obviously, there's a few more, and we'll get into those here in a few minutes. So, so let's dive a little bit deeper into telehealth. What are some examples of telehealth that's being used more specifically to OT and maybe, you know, this is a school based platform that we're talking on here. What are some different ways that telehealth occurs in school based therapy?
Tracey Davis
Yeah, so it actually is a little easier to picture telehealth when you go when you use examples, so specifically in school, in schools, all, all school sites do make use of telehealth. So brick, some brick and mortar schools use telehealth therapists. Virtual Schools use telehealth therapists. The charter school system like in California. So basically, homeschooling families who are accessing Special Education make use of telehealth. So, so all, all different types of schools. There are schools that are using telehealth. And an example could be, you could be doing a direct one on one session with a child using, you know, a pull out sort of scenario, where they come and they sign into your virtual room and they meet with you. We also conduct small groups using telehealth, where there might be two kids sitting at one computer, or there might be two kids from two different school buildings within the same district that are both signing in together for a group session. Okay, so, and they basically just sign into a video, you know, a compliant video software. We use it for, maybe for consultative sessions with teachers. We we use telehealth in order for our therapist to attend IEP meetings. So there's, there are all different, all different areas where it's being utilized, within the schools.
Jayson Davies
I remember one person telling me that there's a difference between, I think it's called synchronous and asynchronous telehealth. What's, what is that? Or what are those? And what's the difference?
Tracey Davis
Yeah. So synchronous technology is basically just real time. So that just means that you're providing a live therapy session or a live any type of session. So you and whoever you are working with are meeting in the in the at the same time in the same place. Asynchronous is store and forward technology, so we don't use it so much in the schools, although there are some scenarios where we use it, but but basically you would make use of some sort of software where the therapist is putting, maybe a home exercise program with into this software, the client then signs into that software, completes the home. Size program, including maybe even recording, you know, video recording themselves doing it, and then the therapist, then signs back in, sees that they've done it. Maybe watches the recording, makes adjustments that would be asynchronous.
Jayson Davies
Okay, so kind of think of it like an email. You know, you send the email now, but maybe the person opens the email later and takes action on it later. Okay, correct. Gotcha perfect. In fact. I mean, does anyone use email as a way to perform telehealth?
Tracey Davis
You know, you can, you can do that. But some states have laws that you know, say that phone calls are not telehealth. Email is not telehealth. In fact, some states go so far as to say that you must be using the synchronous in order for it to be considered telehealth, although there are lots of states that consider asynchronous but, but they do. But a lot of places do require you to use some sort of software or something where you're each logging into the same website, maybe not at the same time, but you're logging into the same place, if that makes sense.
Jayson Davies
Okay? And you kind of touched on that. You know, different states have different things going on. So at what level is telehealth really regulated? In the sense, is it a OTA regulating it. Is it California Board of OT regulating it, or who regulates it? And how are they different from maybe state to state?
Tracey Davis
Yeah, so it's not federally regulated by a OTA or NBC OT or anyone like that. Rather, a OTA provides guidelines for its use, its ethical use, and, you know, its effective use, and things like that. But state boards are who tend to regulate it. There is some there are some possibilities for there to be a little bit broader regulation. Because the problem with each state regulating is that each state's laws are different, of course. So one of the great things about telehealth is that you can, you know, you can work anywhere, yeah? But because different state laws are different, it's sometimes difficult if you took to be crossing state lines? Yeah. So there are, you know, there are some possibilities in the future for that to become a little bit more level across the board, but, but the first place, if you had any questions at all about the regulatory laws within your state, would be to contact the state licensure board, because it makes sense. There's, they're the ones who, if there are any specific regulations for telehealth, they will know, and they will be able to tell you.
Jayson Davies
Gotcha so the board of occupational therapy in that state, right? Yep, exactly. I think everyone should know how to they should know that website for your state, and you should maybe have them on speed dial every now and then. But you mentioned some platforms. What do you mean by a platform?
Tracey Davis
So by a platform, I mean just basically whatever it is that you're using to to as a virtual meeting space. So if it's an asynchronous platform, then it'd be, you know, one of those software programs I mentioned, or something, or if it's synchronous, then, then some sort of video, video based meeting space. But it needs to be HIPAA or FERPA compliant, so they're, you know, not just anything.
Jayson Davies
Yes, and HIPAA and FERPA complaint, that's a whole nother. We won't dive too much into that. But yes, yes, and for anyone, just really quickly, for anyone who doesn't know, fairpa is kind of like the school based version of HIPAA and it regards, it talks about educational documents that need to be secure, as well as any sort of telehealth documents or telehealth videos that would need to be secure. Correct, correct. Okay. So, for instance, right now, we're recording this on Skype that would be considered a platform, but not necessarily a platform that would be okay for telehealth. Is that right?
Tracey Davis
That is correct. So the short answer here is that whatever you're using, you need to, you need to be able to get what's called a BAA certificate from them, meaning a business associate agreement. And if, if what you're using can supply you with that basically, that is the software that you're using, the platform that you're using basically says we're encrypted and we follow, we follow these rules. So that's what your BAA certificate does for you. And if you aren't using if you. Don't have one of those, then it's not you. It's not HIPAA or for compliant. Now, I will say we're on Skype right now, yes, and there are free versions of Skype and there are paid versions of Skype, just like there are free versions of zoom and paid versions of zoom. Yeah, yes. It's a lot of times the same thing. It's the same connection, yes, but you need you know, using the free version doesn't necessarily mean that you're being HIPAA or FERPA compliant. Does that make sense?
Jayson Davies
Yeah. And from my experience, too, and I think at my previous district, we were looking into even using Google Docs within a school district, and we had the same type of conversation about the BAA, because Google Docs is not technically HIPAA, fairpa compliant. However, you can get that Baa, but in order to get the BAA, you have to basically upgrade to Google suite, and you have to do all this application process. The school district has to talk to Google. They have to set up their entire IT department has to reorganize everything to make it set up. And so I know just from that small experience how difficult it can be for a school district to get set up with a BAA with a company, it might be a little simpler if it's just you and you know, I'm sure Google has an entire team that you can contact, and it's probably not too difficult. But when you're looking at, you know, a school district that has 1000s of computers and an IT department and all that good stuff can be a little crazy. I'm sure.
Tracey Davis
It can get that way. But what some places do, and the company that I work for does, is we use, we use a FERPA compliant platform for our video sessions, but then we have proprietary software for all of our documentation and everything like that. So it doesn't have to be an all in one solution. And if there are some reasonable video, video platforms that you can that are not very expensive, and that you can, that you can get, that are HIPAA FERPA compliant, so I typically use Zoom, that's just what I use, because I have found it to be pretty user friendly for new clients who are signing in and things like that. It's just pretty easy to use. And I have, I have a paid version of zoom, and it is, it's pretty reasonable and wasn't very hard. So, so there are options out there, but, yeah, that's just kind of a whole, I feel like that's a whole nother discussion. You know, with all of that, it's important for the listener to know that, you know, just signing on to FaceTime or something with someone doesn't necessarily mean that you're following the guidelines that you should be following.
Jayson Davies
Exactly. I mean, and it's hard because technology, I mean, it's so accessible now. I mean, I want to say even, like, three years ago, it was harder to do what we're doing right now, talking with video over Skype. I mean, it's amazing how fast technology is going. And, I mean, we've already talked about laws and regulation a little bit, but you know, it's trying to keep up with, with with telehealth. I mean, so and all the technology.
Tracey Davis
And it's in the hands of a lot more people now too. So you know, when I start a session with someone, I mean everybody, like, it's not that difficult for people to, you know, to click a link to sign into my therapy room anymore, because everyone has access. Most people have access to something, and a lot of the platforms these days have, like, app versions, smartphones or tablets. And, you know, we don't really recommend telehealth on smartphones just because the screen so small. But, you know, the access doesn't necessarily have to be from a computer. So. Yeah, it's, it's amazing what we can do. It just, it just really is. It is. So I think that's a good segue. Now, like, what do you see? You've been doing it for a while. What do you see as the benefits of telehealth that maybe even more so than regular occupational therapy in a school? Yeah. So, you know, it's interesting. Our out, like research wise, our outcomes measures are showing outcomes equal to and in some cases, greater than, in person services, which is very interesting to me. I have my own theories about that, but I think one of the biggest benefits is I work with a lot of very remote school districts that literally can. Not find a therapist. Yeah, and these kids who hadn't had therapy all school year long now are making progress on their IEP goals, you know, on their ot goals, on their IEP because, because we're able to meet with them, you know, over an internet connection. And it's not only remote areas. But we have found, even in some very urban areas where maybe it's hard to retain a therapist, maybe it's an area of town that isn't quite as safe, or maybe, you know, there's just, they're just other barriers to getting into those environments that make it very difficult. We you know, I can give you an example too, of we are working with a school district that has a lot of children who have ASL needs, and they don't have any therapists on staff who know ASL, but we are able to provide them with an ASL fluent therapist. Oh, okay, believe it or not, you know, she doesn't, she doesn't live anywhere close to them, but we're able to hook them up via telehealth, yeah, so, so those kids are accessing service too. So it's not just geographic barriers that we're talking about, but it could be language barriers or cultural barriers that you know, or even even just travel restrictions, you know, we we do some work with kids. We do work with kids who are in, like a home, hospital based school kind of thing, and so, you know, they don't have to miss out on any therapy there, either. So I think that's probably the biggest benefit that I see, is just getting kids access therapy,
Jayson Davies
yeah. What about for the the team, the other players on the IEP team, you know, maybe the speech therapist, the teacher, the administrator. Do you see a benefit for them as far as you being part of the team?
Tracey Davis
Yeah? So, you know, sometimes it's a little bit of a learning curve for people, you know, trying to get used to the idea of a therapist not actually being in the building, but ultimately, we have had some very great relationships with the team. You know, I don't know what kind of district you work in, but when I worked in this in a brick and mortar school, I did a lot of traveling, and I had to supervise some CODAs, and we hardly ever crossed paths, because we were all traveling everywhere, all week long. And this way, you know, we we are able to connect via email and phone, and even sometimes, you know, in in our virtual meeting spaces, and it doesn't, we don't have to worry about the travel pieces and things like that. So that's been really beneficial to to team members, for you know that we don't have to all get into the same place at the same time.
Jayson Davies
Yeah, and you mentioned two big things there. I'll ask you one at a time. CODAs are there? CODAs working as telehealth.
Tracey Davis
There are some CODAs working as telehealth. You have to check with your specific state, because some states allow it and some states don't. So when
Jayson Davies
you say allow it, do you mean the billing of it, or just even the practice of it,
Tracey Davis
the practice of it only because of the supervision piece. Um, so, but honestly, I have found supervision to be almost easier, because if, if we're providing telehealth services, I can just literally sign into the session as supervisor. So, and just, I usually just don't turn on my video or my audio, yeah, and just watch. And if I need to, I will, but you have
Jayson Davies
no idea. I would have loved that when I was supervising a Cody, you know, just to be able to kind of pop in and be a fly on the wall and just check in. And then you don't even have to do anything at that moment, like you said. You can leave everything off. But then after that session is over, after School's out, and you have time you can, you know, give your Coda a quick call. Or the coda can call you and say, Hey, I had difficulty with this dude in and boom, they Yeah. I mean, that way sounds even better. I could imagine my COTA saying, Hey, I'm having difficulty with so and so. Can you attach into my phone call this time, at this day when I'm working with them, exactly right, versus me having to travel across the district, yeah,
Tracey Davis
exactly. I mean, it really, it really, truly is easier. And I think, in fact, I know that speech therapy tends to be using it a little bit more in that way. I think we have some catching up to do there. But I just see that as just another great, great benefit of telehealth, yeah, is being able to use CODAs and provide that kind of that level, the level of supervision that we need.
Jayson Davies
Wow, yeah, all right. The other thing that I wanted to ask again, kind of looking at the benefits, is the benefit for the clinician. And one thing that I wrote down real quick, as you mentioned, class. Collaboration. What about collaboration with other OTs? Do you get that as a telehealth provider,
Tracey Davis
you need to be very intentional about it, because we're all working from home, and so it's easy to kind of get isolated, but there are a lot of really easy things you can do to connect with other people. There's some great Facebook groups that are specifically for telehealth therapists. So I would encourage you to to just, you know, even just do a search, because everybody has has Facebook. But it's funny, because
Jayson Davies
I think that's actually how I found you, right? It was, I think it was the telehealth group, yeah. So,
Tracey Davis
so there are some great groups there. There are some that are interdisciplinary and some that are, you know, just for OTs. But there are always people. I mean, I get, I get emails every single week from people who are saying, you know, I want to add telehealth. You know, what can you tell me? Can you, can we collaborate a little? Can you tell me what you know, basically, so, but you do have to be a little intentional about it. Just be, about it, just because it's easy to get isolated.
Jayson Davies
Yeah, I believe you got to make time, you know, for listening to podcasts like this one, going to conferences and stuff like that. You know, just like any other ot does exactly all right. One more last, I guess person or entity that I feel might have been a benefit from is the payer in school based that's obviously different than what it would be like in a hospital. But how does billing work when it comes to Medicaid and providing telehealth? Yes,
Tracey Davis
so there are some states that do reimburse as Medicaid for telehealth services. Not every state does currently, but each time I check it's more states have been added as as allowing telehealth for Medicaid. So, you know, basically within the schools, I mean, it just, it's kind of the same thing. You just when I provide, when I provide Bill, you know, I when I work privately and I provide, like, a super bill or something like that, then I usually put there is a location code of OT to is for telehealth. So, you know, there's a specific location code that you put in there when you're billing, but it works the same as everything else, if you're in a state that Medicaid reimburses for telehealth. Now, if you're not in a state that that reimburses for telehealth, Medicaid, I mean, then telehealth is being used a lot less by schools, but there are still a lot of schools that use it anyway, because ultimately it is a cost savings. We were talking about traveling between locations and with without. The Traveling therapists are more productive. You know, when you don't have to, you can see more kids in a day and things like that. So there are some cost savings. So there are schools that, you know, even schools that can't bill for Medicaid for telehealth services, are still utilizing it, just, you know, with their special ed funding, gotcha,
Jayson Davies
that's very cool. What do you see now, the opposite side of all this, what do you see as some of the challenges, some of the things that I'm thinking of is, like you said, working in a completely different state, if you will. You just kind of mentioned scheduling a little bit and traveling, that's kind of a benefit, but also, I'm sure it's also a challenge, yeah, so, so what are some of the challenges? So
Tracey Davis
personally, you have to be very organized. You have to you have to keep track of your schedule, and so you don't have random kids popping into your virtual therapy space, you know, on not right times and things like that, and you have to be a very good communicator via email and phone, and even just during the therapy sessions, you have to be able to communicate what you want to see happen. You have to be able to show it right and so. So personally, those are kind of some of the challenges that I found when I started doing telehealth. And I found that to be a pretty steep learning curve at first. So that was, that was a little hard, nothing that you can't overcome, but, you know, it's, it's definitely a challenge. The Medicaid piece, where not every state is, is, reimbursing, is, is definitely a challenge. Licensure is also a challenge, because currently you need to be licensed in your state of residence and whatever state you practice in. So PT is a little bit ahead of us on this. They've actually joined physicians and nurses to sign a telehealth compact. I don't know if you're familiar with that, but they it went active recently. I'm not exactly sure when, a couple months ago, maybe, but basically, several states have signed this compact. I think current. Currently, maybe eight of them are live and but there are a whole lot more that are going to be live. So what this compact means for PTS is that if you are a resident in one of the states that has signed the compact, and you are licensed there, you may practice telehealth in any of the other states that have signed the compact. So I hope that ot follows that trend because it will make the licensure piece easier, because you can get Christ cross license, you can get licensed in a state where you're not living, but it gets a little expensive, complicated. Yes, it's expensive for all those licenses, and it's complicated because each state might have different regulations as far as continuing ed go and when your license expires. I mean, when I had, when I was holding six state licenses, I just had to make a spreadsheet of the state and what it expired, any special continuing ed classes that needed to happen and things like that. And it just, it was, it was hard to keep track of
Jayson Davies
I can imagine. I mean, yeah, I know I get a lot of continuing, continuing education units in every year, but still, even just remembering where I put the certificates or making Excel spreadsheets so that when it's time to turn them in, just for one state and NBC, OT is enough. I mean, I can only imagine doing it for 346, states,
Tracey Davis
and this state needs, once, an ethics course, and this state wants an HIV course, and this state wants a, you know, I don't know, some sort of, like, safe handling course, so you have to keep track all of that. So that's, that's kind of a challenge as well. Gotcha
Jayson Davies
All right. Well, I think this is where we're going to kind of transition a little bit into, what does a day look like for you when you, you know, you get in front of your computer, what does that kind of look like for you at a school based model, um,
Tracey Davis
so, you know, in a school based model, you you have some
Jayson Davies
Hold on one second. Tracy, give me one second. Say, you you there? Can you hear me? Let's start that over a you. Internet went bad. So, so, okay, no, I'll just ask you the question again. So that way it's a natural transition. So, so transitioning a little bit now to kind of what the day to day looks like. You know, I think a lot of therapists are a little scared about what it would look like for them. What does that look like for you and your work day when you're working in a school based model through telehealth?
Tracey Davis
Yeah, so if I were working in the schools and I had several students to see. I will have already prepared a little bit beforehand, because, let's say I need to work on cutting with some of my kids, and I want to do a cutting worksheet, I will have probably emailed that to whoever is bringing the student to therapy, which I need to make this point is that in the schools, when we're working with kids in the schools, we there is, there's always an adult who is bringing the child to therapy, and usually it's up to you as therapist to decide what role they will play. You know, are they just available if needed? You know, is this a middle schooler you're working with and they're fairly self sufficient, or is this a kindergartner and you need that adult to provide assistance throughout the entire session. So, but regardless, there will be someone, so I will have probably, you know, sent a little bit of preparation to the to that person, you know, and if it's some sort of worksheet or something, they will have printed it out, or something like that. So you have to kind of plan ahead of time a little bit, yeah,
Jayson Davies
and I'll speak to that just a second. In a district that I used to work at, they did go ahead. We couldn't find enough speech therapists in our area, and so they did do speech for telehealth, and even just setting up that, trying to manipulate the AIDS within the district, because obviously they didn't want to hire one aide at every school just for telehealth, and so they really had to be, I mean, they had to be efficient with the way that they worked with the aid, so that someone was always in that room, and also just to find a computer even At some at some of the schools,
Tracey Davis
then that has been a challenge at some schools. And we try and be very creative with, you know, the fact that we need an adult present, you know, because we don't, obviously we don't need the school doesn't want to be having to hire a person just to bring the kids to therapy plus pay the therapist, right? So we try and be very creative there, but it a lot of times it's someone like, maybe a pair of professional or someone like that, and sometimes it's, you know, we've even set the computer up in the back of a classroom, you know, not necessarily in a separate space, yeah, all right, so. Sorry, go ahead and continue. No, that's fine. So then I would, I would sit down, and I usually don't bother with creating, you know, all of these schedule and meeting invites and things like that. It gets very complicated. And I like to, I like to have one link for all the time so, so I have it set. You know, some of the some of the platforms have this quote, unquote waiting room feature. So basically, when someone tries to come into my virtual meeting space, they're put in this other space, and then I'm alerted that they're there, and I have to let them in, if that makes sense. So, um, so I sit down and I wait for my student to come. And what you need to know about telehealth is that it looks very, very similar to what you're already doing. You know, it's not a bunch of just high tech games and this and that. I'm an OT so I still do a lot with Play Doh. I still do yoga. I still, I still do dance to YouTube videos and things like that. So I might sit down and they might come in, but I'm not necessarily going to stay seated. You know, we're gonna we're gonna get up and we're gonna move around, which, which brings me to another point, is that you really need an external webcam if you're going to provide telehealth services, because your built in laptop camera, if you want to point it at the table, then you're closing your laptop. So, so you need to, you need to not only have one which they're very inexpensive, I mean, like 20 bucks, you know, nothing, nothing huge, but you need to have that, and you need to make use of it. So if you're doing something fine motor wise, then you want to point the camera not at your face, but at your hands. If you want to, if you're doing something gross motor wise, then you need to point the camera at your body. You need to stand up, and you need to move and so, so you need to be very aware of what your camera is pointed at, what is it that the student is seeing? And so they're going to come in and I'm going to, we're going to do some warm up movements, and then we're going to maybe do some tabletop, you know, origami, or play doh or something like that. And maybe we'll do some handwriting or cutting or something, but all the same activities,
Jayson Davies
and how much so when I think of it, this is, as occupational therapists, we're allowed to use CODAs as a either aid in our own treatment or as an aid to do their own treatment, but under our supervision. But that person that's in there, if it is a paraprofessional, how much can they help you?
Tracey Davis
So it'd be, it'd be a little better if you thought of that person more in that early intervention or home health kind of scenario, where it might be a caregiver, but not necessarily a skilled therapy assistant, if that makes sense. So you're still going to make use of them. You're still going to instruct them to, you know, help you with, maybe making sure that the student is has nice posture, or their chair is facing the table, or something like that. But I wouldn't ever ask them to do something that you know would be considered skilled therapy, gotcha. But we use people like that all the time. We instruct caregivers in home exercises, and we get their feedback when they come back to therapy. And so we can use, we can use the the aid who comes with the student in much the same way. So they might help me get out materials. They might toss the ball back and forth with the with the student, or maybe even, I mean, even, you know, I have, I have given input to, you know, oh, I'm noticing that their shoulder, the one side of their shoulders up just a little bit. Can you just put your hand just gently on their shoulder? You know, nothing, nothing that's outside of what their scopes might be, but just providing that little bit of cues? Great.
Jayson Davies
Yeah, I think that makes sense. Because originally going to school and doing a level one or level two field work. I remember being in more an acute rehab setting, or something like that, where they had therapy aids, and we were kind of taught that this therapy aid is not to have any sort of contact, or at least in like California, this is what we were learned, or we're taught, you know. But when we come to thinking of a special education classroom at a school district. It's so so often you see either an aide or teacher providing that hand over hand assistant. You don't have to be you don't have to be a ot to provide hand over hand instruction. So I think that that fits in from what I see. Okay, so
Tracey Davis
yeah, and if they're working at the school, then they're already authorized to be working with the children. So exactly,
Jayson Davies
perfect. All right, so I think this is going to be a big question that everyone has those that is listening evaluations, yeah, how do you do an evaluation? Are you limited in your assessment tools that you can use? Or how does that work? Yeah.
Tracey Davis
So we do an evaluation in much the same way I meet together with the students. I do think that there are some things that are harder to see. Number one, it's, I think it's very hard to really, truly assess ocular motor movements over the over the computer, even with a great internet connection, if you're looking at some subtle jerkiness, you know, the smooth pursuits and things like that, it's kind of hard to see. So, you know, I'll just lay that out there. And I'm the first to say, you know, sometimes there are things that we have to problem solve around. But I will also say that, when we're working in the schools, what are we doing? We're determining if the student is eligible for services, yeah. And so, you know, you might not need that level of detail in order to determine their eligibility. So for an evaluation, a lot of times, if I'm doing maybe standardized testing, it might involve a paper booklet, like, you know, the beer VMI or TVMs or something. Yes, exactly. So we physically mail those booklets to the school, and then the adult who's helping. Some people call them e helpers. Some people call them learning coaches, whatever. Then, you know, we instruct them in how to place that booklet in front of the student. Don't tilt it, you know, please place it right in front of them. Give them a pencil. Don't, please, don't, you know, prompt them in any way, that kind of thing. And then they either mail them back or they scan in the in the the booklet, and email them back exactly. So, you know, there are several assessments, and there are even some companies, some publishers of some assessments, that have been working to make them more accessible for us by digitizing the manual, the examiner's manuals, or are the test plates, you know, if it's a visual perception test or something like that.
Jayson Davies
Honestly, I'm surprised that there's not already, like Pearson or something working on a lot of iPad based assessment tools. I'm sure there might be in the work by now, but I
Tracey Davis
mean, it kind of is, it kind of is, but I'm surprised that it's going a little slower than than it is now, sensory sensory testing, very easy to do because both the sensory processing measure and the sensory profile are online, so they can be done easily. We can do visual motor testing, there's some and visual perceptual testing, we can do those, and we can do most things of the bot. The hard part is, anything that has specialized equipment is a challenge. You know what I mean. So any testing material, like, you know, the blocks, the string of the Yeah, okay, you know that kind of thing. So do you ever send
Jayson Davies
those materials, or do you kind of just try to use alternative methods to get the information that you need?
Tracey Davis
Yeah, we usually just try and use alternative methods, just because it gets really difficult. Now, if you're only working with one district, or, you know, yeah, like you're working independently, then that wouldn't be so difficult. But I work with a company that provides services to so many districts that that it's just, we can't, we can't send those materials to everyone. Gotcha?
Jayson Davies
No, that makes sense. All right. Well, I kind of, oh, we're talking about evaluation still. So moving forward now, do you do a classroom observation sometimes or Uh huh, yeah. So they just set you up in the back of the classroom somewhere, something with the computer, and boom, you're in,
Tracey Davis
yeah, making sure that, making sure that I, as therapist, can see the person I'm evaluating, and, you know, some other peers, to see how some of that interaction goes. And then we're just, we talk in great detail with the teacher, either via email or phone or or whatever. And if we need to take something like a handwriting sample, then typically, I'll just have them, you know, scan it and send it back to me so that I can take a look at that. And, you know, I'm going to also prompt them to be moving their camera down to the table top if I'm looking if I'm looking at fine motor movements or whatever that is, yeah. So some states do require something like informed consent, we call it, and so I just as best practice, always include a statement in my evaluation that you know this was conducted via telehealth. And that, you know, the school was informed and are in agreement with this service delivery model.
Jayson Davies
Okay? And speaking to that real quick, is there any sort of extra paperwork, I guess you have to say, I mean, we have to get an assessment plan, you know, for any student who's going to be assessed. But is there any sort of form that has to go home to the parents saying that you're being your child is going to be assessed and or treated via telehealth, or is that state to state? Yeah,
Tracey Davis
it's state to state. But as best practice, we just try and we, we make sure that that parents are informed of that before we start services. That makes sense. So they and if, if we're, you know, doing an evaluation, we send home a consent to evaluate, and they sign it and and give it back to us. Just, it's just for our records. It's just kind of what we what I think is good practice to do, definitely.
Jayson Davies
All right, you've mentioned a lot of things that people already need, or already start that over. All right, so you've mentioned a lot of things throughout this, you know, 45 minutes or so that we've been on about what someone might need, a platform, the hardware that they need. They need a external camera. They obviously need to have a computer that works. And we're already having some technical difficulties tonight, so people need to make sure they have some some fast internet, you know. But what else might they need if someone wanted to do telehealth,
Tracey Davis
you know, that's kind of those are kind of the big ones that and what I consider to be necessary pieces of equipment, a couple just luxury items that you don't necessarily think about. It's really nice to have a second monitor, because you can put the student on one screen, and you can pull up their goals on the other screen, and then you can keep them nice and big. I
Jayson Davies
wish I had that just like every day, like for all my treatments, my
Tracey Davis
second monitor wasn't working the other day, and I just felt lost without it, because I'm so used to it now. It makes me so much more productive. And I actually, I did telehealth for probably a year before I invested in a second monitor, and it cost me, I think, $100 and I don't know, like, as soon as I got it, I had no idea why I just didn't do it from the beginning, because for the for the level, the improvement in my efficiency and my productivity, it was just so worth the investment. Um, so and then you just need to have a secure way to be sending documents. You know, at the bare minimum, you need to be password protecting. You know, if you've written a report and you have to send it to the school,
Jayson Davies
speaking of that, okay, so report, we kind of skipped that part of the evaluation. What does that look like when you are doing a report, you're presenting a report. I mean,
Tracey Davis
it looks pretty much the same as any other, as any other piece, though, the one thing that I also include is when I the standardized tests aren't necessarily standardized for telehealth use, and so I usually put a statement in there, just saying that, saying that, but then I say, but with clinical observation, these skills are thought to be representative of current of the level of function. Yeah, just to make sure, to cover all my bases, but it's, it's pretty much just the same report that everybody else does. And I
Jayson Davies
know with the company that we were using, the speech therapist would call in. Is that pretty typical a call, versus having to screen time or whatever you want to call it in video. Or do you do video? We
Tracey Davis
usually do video, okay, but it just depends if you know, if it's a brick and mortar school, it's just a little easier with video, because typically everyone's sitting around the table, and then for you to be there too, like being seen is nice, but if we're talking about a virtual school scenario, then probably everybody's calling in, yeah, that's true, so it just depends on the setting.
Jayson Davies
Gotcha, yeah? Because, I mean, and that's the same thing, whether or not you're on telehealth or in just an everyday brick and mortar. IEP, I mean, for instance, yesterday we actually had a face to face in the school IEP, and it was a part two to a meeting that had been over the phone. And because the meeting that had been over the phone, because it was over the phone, everyone just so much communication was lost. And that has nothing to do with telehealth. I was a high school that I work at, brick and mortar, and just the communication just wasn't there over the phone. And, you know, as OTs, you know, we know, we understand, as most people do, facial expressions matter, body language matters. All that good stuff is, you know, 90% communication is not what is spoken, as they like to say. So it's important to be present.
Tracey Davis
I mean, I. Go to a lot of meetings, because I'm a clinical director for this company, and I, I go to a lot of meetings that you know, where schools are coming on board and things like that. And I really prefer this format, I mean, you and I are looking at each other right now. And I really prefer this format as opposed to just a phone call, because I think, I think it just sets everything off on the right foot. And one thing is that, you know, sometimes we get, I don't want to say resistance, but just questions about how it's all going to work, and things like that. And so maybe I'll go into a school and I'll do a meet and greet, where my I'll leave my therapy room open, and parents can, you know, classroom 101, has my is logged into my therapy room. And when they go to pick up their kids, they can stop and say hi and ask any questions. And it, it tends to diffuse a lot of that anxiety surrounding what telehealth is. When you guys, you can actually see it in person, and you can understand, you know, I had a teacher say, once she she actually said to me, I just don't know how I'm going to get my my students to interact with a computer. And my answer was, you don't have to. I'm a person. They're interacting with me. It just happens to be over the computer, yeah. But the interaction is with me, a person, the same as if I were in the room. And you can tell she never even considered that. So you know, just actually having this format and being able to see what it looks like really tends to dispel a lot of that, those fears absolutely
Jayson Davies
and I know when we again, we had the speech therapist coming in for our it was about half of our district because we couldn't find enough speech therapist. And yeah, there was, I mean, that five to 10, maybe 15% of parents that were skeptical about it, and they didn't want their child being seen by a computer, quote, unquote, you know, yeah. And so, yeah, they were resistant. And so I can imagine, you know, you do get that 10% or so that are like, whoa, what's going on? But for the most part, I heard good things about it for speech, and it sounds like you're doing great with OT and you love it. Yeah, we do. You know, I never got to I didn't ask you this at the beginning, what drew you into telehealth? Well,
Tracey Davis
you know, I had read some research on it. I had read some interesting articles on it, but ultimately I decided to give it a try, just because my family moved around so much, and I was tired of starting over every time. But I stuck with it, just because of, number one, the flexibility. I just love the flexibility. I make my own schedule. I you know, I decide I took my daughter to the Nutcracker today, and so, you know, and then I came home and I worked. So that is really nice. I love the collaboration aspect, because, because I'm not physically present, I'm kind of relying on the adult who's with the student. And so it's more than just me saying, Oh, we worked on this today in therapy. You know, the that adult helper is is kind of an active participant in a lot of what I'm doing, which I think aids that collaboration, I think, is what's helping our outcomes measures. Because I think people are getting a greater understanding of what we're doing and why we're doing it, and I think that is leading to better carryover throughout the week. Yeah. So I love that collaboration piece, and I like the problem solving as well. We tend to, we tend to attract a lot of therapists who are maybe secure in their therapy skills. They've been doing therapy for a while, but they want kind of a little bit of a different challenge and and this is it, because it's a lot of problem solving. How can I accomplish this goal when I'm not in the room?
Jayson Davies
Yeah, that's super cool. I again, I'm already thinking about how I would probably do this at some point. And I think a lot of OTs don't even realize, but I think a lot of OTs are going to be doing this in the future at
Tracey Davis
some point, because it's only going to grow. Yeah. I mean, really, I'm
Jayson Davies
right there with you. I think so. But at the same time, I kind of want to, I want to push you a little bit on that where, where, what's the next step in telehealth? Or where do you see telehealth going? I
Tracey Davis
think, I think number one, we need to kind of rally and really push for clear guidelines, not guidelines from you know, a OTA has really done some good guidelines. The World Federation of occupational therapists has some great guidelines. But as far as just like different state regulations, there's just so much out there that has actually hindered the progress. At one point Texas required, and they've since rescinded this. But it's only recently that this happened, that they rescinded. But they, they were requiring an in person evaluation followed by an in person therapist signing off on the telehealth sessions and the whole, it just defeats the purpose of telehealth, because you can find an in person therapist. Why would you, I mean, like, then just use the in person therapist, you know? So, so I think there, there is some regulation going on in states that is kind of hindering our progress. And so I think we need to get, we need to rally, and we also need to, as therapists, not hinder each other either. Yeah, we need to, we need to be more supportive, yes, and open to it, yep.
Jayson Davies
I mean, I just think about, you know, nowadays I have a, well, I shouldn't say A, I have three Google homes in my house. I don't have, you know, like the Facebook portal one now, or anything yet. But we are all just getting so much more used to technology in our house, in our daily lives, listening to us, watching us doing I mean, I did make fun of my speech therapist yesterday because she had us she had a piece of tape over her camera on her computer, like, are you scared of people watching you? And she's like, Yeah, but, but for the most part, you know, people are becoming more familiar and more understanding of technology. I really do think of the portal as the new thing, and I could see eventually pieces of technology like that being used for telehealth, especially more of the medical model and nurses checking in on patients and stuff like that. Yeah, absolutely. I think the portal, the Facebook portal, now, is the first one that can actually follow you when you move. So the camera actually looks at you as you move across the room, which is correct. I mean, only amazing for telehealth reasons, you know, right,
Tracey Davis
right? And so the potential is, is huge, exactly.
Jayson Davies
So I want to ask you two more questions before you go, can you share a time where telehealth, just like was the perfect opportunity to be used in a school based setting?
Tracey Davis
Yes, I do have a great, fantastic story I had. I had a child with autism who transferred to a virtual school and so from a brick and mortar school. So he came to me for virtual therapy. And his dad was his learning coach, so to speak. He when he first came to me, he just his attention was all over the place, you know. So I knew that we and his IEP that came with him from the brick and mortar school, said, 245, minute sessions a week, and his attention was not great. And I thought, oh, so we just developed this plan. We had this I had this YouTube video that I used every single time to mark the start of therapy and another one to mark the end of therapy. I mean, I could sing those songs in my sleep crazy. And then I used the whiteboard feature of the virtual space to make just basically a schedule of what we were doing, and I would let him mark it off each time. And we were doing a lot of sensory breaks and things like that. And in Ohio, when they come in on transfer IEPs, and we have 30 days to kind of assess how things are, and then we have an IEP to create a new IEP so by the fifth session. So he has therapy twice a week. So that'd be by the beginning of his third week, he was going through his 45 minute sessions. No problem. His attention was appropriate. He was doing everything. He was loving it. You know, great. So when we got to the time to recommend, make our recommendations. I He didn't even need 245 minute sessions anymore, but he had two highly educated parents, and you know how parents can get kind of attached to therapy? So I thought, I don't know. So I called them to tell them, I'm not, I'm going to recommend a decrease in services. And immediately his parents said, absolutely fine. And so we actually ended up cutting it in half to 145 minute session. And so I asked, I said, out of curiosity, you know, why were you so quick to agree? And they said, Well, he loves therapy, and we love therapy too. Ot also, but because dad was his learning coach and he was participating in therapy every day, they said, for the first time ever, we know what he does an OT. We know why he does it. We know what it's working on. And so he gets ot every day. We do that. We do the activities that you know, the things that you do during therapy. We do it every single day. We follow through. So that was just a huge success story for what we could accomplish, and that, that collaboration piece, yeah. So that was one of my, one of my brighter moments. It was, it was great.
Jayson Davies
Yeah. And on the other end of that, I mean, even if the kid wasn't a homeschool kid, if you want to call that, but if the kid was in brick or mortar and you were providing this treatment in the back of the. Classroom or with potentially an aide that spends half of their time in the classroom and half of their or one day a week helping those kids with you well now that aid is seeing what you're doing and getting that all that is going right back into the classroom.
Tracey Davis
That's exactly right. And we see that at brick and mortar schools as well. We see that same thing going on? Yep, cool.
Jayson Davies
All right, this is the opposite side of that question. What? I'm sure there has been a time where you kind of felt that maybe you can't help this kid potentially, or if there's just another challenge. But what has been one instance when you had a big challenge with a case? Sure,
Tracey Davis
you know, there haven't been a whole lot of times where I've recommended in person services, but there, there have been a few, and I'm happy to recommend in person services if needed, because I, you know, ultimately I want, I don't want telehealth to succeed. I do, but only because I want the child to succeed.
Jayson Davies
Can I stop there real quick? What do you mean when you recommend? You just said I will recommend, or I will do in person therapy.
Tracey Davis
No, I will recommend a transfer from telehealth to in person if needed. You know, I'm happy to do that, if that, if that needs to happen, and it hasn't, hasn't happened a whole lot, where I felt like, you know, they really, you know, the child I'm working with doesn't really needs an in person therapist as opposed to telehealth, but it has happened a few times, and you know, I want the child to succeed. And there was one, there was one case in particular where the boy had had more profound autism, and he honestly didn't even know I was there. He was constantly being prompted to to look at the screen, to look at me, but he just really didn't have that awareness. And we tried everything. I mean, I went all the way down to I had the aide make boxes, you know, yeah, and we're just going through box number one, there's the activity, box number two, box number three, but it's still, it was just such a challenge, because he just had no awareness that there was a therapist even in the space. And so that was just a huge challenge for me, and we made it work for a while, but ultimately, ultimately, we found him, we found a therapist to come in and see him. Gotcha okay? So we had to turn it off, because if, if you, you have to be able to connect with absolutely on some level, and I just, I couldn't, I couldn't make that connection without being in the world, yeah, physically, okay, yeah, I lied.
Jayson Davies
I have one more question only, because what you said kind of makes me wonder some of those more like you said, mod, severe type of kids, maybe, or even the kids who have low, maybe an intellectual disability, and maybe they're in high school and they're functioning at that really, much Lower mentality. Does that get a little difficult with over over the web?
Tracey Davis
It can but ultimately, if, if you can make a connection with them, if you can connect, you know your person, with that person, then you can probably do therapy. Okay? I see that as a bigger challenge. But there are definitely, there are definitely challenges with that. Like, some of the life skills are hard. Not not life skills, but like, like, ADL type, yeah, things you know, if they're in a life skills program or something, it's hard to work on, on, you know, bathroom stuff or something like that, or or kitchen stuff. But we, we sometimes do what we need to do. We create simulations as best we can, especially if it's a case of them not getting services.
Jayson Davies
Definitely, you know, and I it's hard, I think, for any occupational therapist sometimes, to be in those life skills classes. I'm in a high school life skills class, and it takes a lot of energy. It takes a ton of collaboration, communication, all that good stuff I do.
Tracey Davis
Then you're already well suited for telling, oh, man, you're collaborating, you're communicating,
Jayson Davies
but, but here's one thing that I do with them, and maybe I mean I could again, being, as you said, in order to be a telehealth you have to be a problem solver. One of the things I love doing with that classroom is every now and then I attend the community outing. But again, now. I can see it already, you know, kind of working through it. Those teachers have iPhones. Those teachers have stuff that they take with them. And I heck, most of the kids have iPhones or tablets or whatever, you know, and it could happen with the right collaboration potentially, so they could so, yeah, that's super cool, alrighty. Well, that was like the quickest hour I've ever had in my life. Thank you so much for all that information. I love it. Oh, good. Is there anything you felt like we forgot to say?
Tracey Davis
I don't think so. I think we covered I think we covered pretty much everything that I wanted to make sure that we covered. So well done.
Jayson Davies
Awesome. Well done us. Thank you so much for coming on. I appreciate it. It's awesome that we're able to do this on the podcast. Yeah, where can people reach out to you if they have questions? Or is that okay?
Tracey Davis
Yeah, no problem at all. I can be reached. And you might want to, you might want to, you know, put this in print too, but I can definitely be reached at t, as in Tracy Davies T Davies at talk path, live.com.
Jayson Davies
Awesome. And yes, that will be on the episode show notes, which will probably, I might have to edit this, but ot schoolhouse.com, forward slash, episode 22 and so that will be the show notes where you will be able to not only listen to this episode, well, you've already got that far. You're already listening right now, so you've already got that part, but also any of the resources that Tracy has sent me that we can put up onto that site, so that maybe some links to, like the A OTA document she was referencing earlier. We'll have a link to that on there, as well as a link.
Tracey Davis
And also the international I'm sorry, I don't know.
Jayson Davies
You're fine. Go ahead.
Tracey Davis
but I was just gonna say that the the International Journal of tele rehabilitation is actually a free publication. So so that's a really great resource. Has a lot of research in it. So great.
Jayson Davies
Well, yes, thank you, Tracey. I appreciate you so much for coming on here. All your information was fantastic, and you made me like, I know you can't see me all you out there, but like, I'm putting my fingers together, like you made me that much closer to doing telehealth in the near future. So um, right. So anyone out there, if you have any questions about telehealth, be sure to reach out to Tracy, she's also active in, like she said, some of those Facebook groups. So there is telehealth Facebook groups out there. Be sure to join those. And if you have any other questions and you're not sure, feel free to reach out to me or her, and we will point you in the right direction. So thank you so much for listening. Thank you, Tracy, and we'll see you all next time. All right. Well, that wraps up. Today's episode number 22 all about telehealth. Be sure to head over to OT schoolhouse.com. Forward slash episode 22 for all the different links that we talked about in the show on our website, you'll also have the opportunity to earn professional development for listening to this podcast. All you have to do is purchase episode 22 professional development opportunity, and you'll take a short quiz, and once you pass that quiz, we will send you a certificate of completion that you can use for NBC OT and some state professional development requirements. And with that, I just want to say thank you for listening, and we'll see you next time on the OT school house podcast. Take care.
Amazing Narrator
Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otsoolhouse.com Until next time class is dismissed.
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