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Secondary care

Capio Centre occupational treatment and rehabilitation clinic: Recreating value from physical appointments

Åsa Söderlund

We spoke with Catarina Stenmark, Operations Manager at the occupational treatment and rehabilitation clinic at Capio Centre, to evaluate how the first year-and-a-half of online consultations has gone. We asked Catarina, about the lessons they have learned and how the staff and patients have responded to the new digital pathways.

The Capio Centre occupational treatment and rehabilitation clinic began working with online consultations in Visiba Care during the summer of 2019, as a complement to physical meetings. But, like so many other organisations, their entire operations plan needed to switch to remote meetings with the pandemic in the spring of 2020. Even the employees who were previously reluctant were now propelled to throw themselves out and test with predominantly positive results.

I have to admit we have accumulated a lot of experience with online consultations now. We were among those who switched to online consultations very early this spring and it was a challenge. Our reception does not only have the standard individual therapy or individual visits that most receptions have; We have multimodal rehabilitation, group therapy, and patients who need to do physical exercises – and we managed to do that with video.

Staff discovered new solutions

With the push of research and the creativity of the employees, the reception has managed to bridge some of the gaps between physical and digital consultations, to ensure that they do not lose in quality of care.

We have thought extensively about how to formulate digitally certain practices that take place in a physical meeting. You can – you just have to use your imagination.

How does it happen digitally?

The fact that patients do not have to travel and physically be at the reception can be positive or negative, depending on the stage of treatment they are in. In cases where a walk to the clinic is a positive addition to the consultation, the patients were encouraged to replace it with another walk before the meeting. The notification for the meeting simply includes a suggestion for the patient to get ready, put on a jacket and walk 15-30 minutes ‘to the appointment’.

Another example of reformulating some of the feelings of contact one gets in physical group therapy is digital coffee breaks. In these cases, the therapist removes herself from the consultation during the break, to create a more casual atmosphere where the participants get the opportunity to socialise and get to know each other.

The fact that the therapist only sees the face or half of the patient’s body and misses part of the body language can be a challenge. Sometimes additional questions need to be asked, and in other cases, the patient is asked to put their phone on a tripod, stand up, and do an exercise. It can also be a challenge to distribute the floor with a gaze as is often done organically in physical group therapy. Therapists need to be more alert and proactive in distributing the floor and picking up signals that a participant wants to have the floor.

By meeting the patient in their home environment, therapists are gaining more insight into what the patient’s everyday life looks like and what options there are. It is easier to propose a sustainable rehabilitation plan and see things in the home that the patient can use as a prop in exercises.

Missed appointments can become online consultations

A major advantage Catarina sees in offering video consultations is the reduction in DNA rates. An appointment that would have previously been cancelled due to a mild cold or caring for a sick child can now take place in video. It is often the case the patient is simply feeling too overwhelmed to even get to the appointment.

Having the video consultation option is really helpful when the person is feeling so overwhelmed and the travel to the clinic itself can drain all the energy out of him or her. In these cases, it’s better to have a video consultation.

Actualising the appointment schedule as initially planned is a great financial gain for the business, as well as a gain for the patient who does not have to interrupt the treatment or rehabilitation plan. Cancellations have dropped by approximately 10% since the reception started offering online consultations.

Collaboration made easy

The clinic works with multimodal rehabilitation and some treatment series contain multiple meetings with several specialists. Staff also in close contact with employers and sometimes relatives.

If we can cut travel time in half by moving certain meetings digitally, it is easier to get everyone together. The patients also remark that: ’It’s nice not having to travel to the clinic that day’. Care is becoming more flexible.

Patients’ attitude is very positive

Patients have been very positive about the option to meet online and Catarina believes that this demand will continue to grow even after the pandemic restrictions.

Our patients have become used to this and today, many of them actively choose video consultations instead of physical appointments. I think it is here to stay. This situation has been an eye-opener for patients and therapists alike, and patients will definitely expect this in the future.

Rapid internal development

The reception staff have really rolled up their sleeves and embraced the new technology, and during this year, it has transformed from an emergency solution to an organic tool to work with. Catarina shares feelings of pride for the scale everyone has evolved with online consultations.

When we were getting started, one of my psychologists was very reluctant about video consultations and wanted to continue with physical appointments as much as possible. Now he is the one who tells me: let’s have an online appointment instead, it’s better! He has become confident that he can do a great job even via video.

Research is valuable help

The Capio Centre occupational treatment and rehabilitation clinic collaborates with Uppsala University via a doctoral student who works with them. They have had the option to get academic support in asking the right questions and compensate for what happens in a physical environment.

There are quite a few studies and good evidence about online consultations in CBT and digi-physical care for the treatment of burnout, pain, and trauma.

With the help and guidance from Uppsala University, insights from this year, and the patients’ experiences, Catarina is looking forward to getting the time to reflect on how the clinic will continue to use the technology in the best way possible.