The COVID-19 pandemic has led to a shift in healthcare towards telehealth delivery, which presents challenges for exercise physiology services. We aimed to examine the impact of the COVID-19 pandemic on the reach, efficacy, adoption and implementation of telehealth delivery for exercise physiology services by comparing Australian practises before (prior to 25 January 2020) and during the COVID-19 pandemic (after 25 January 2020).
This retrospective audit included 80 accredited exercise physiology clinicians. We examined relevant dimensions of the RE-AIM framework (reach, effectiveness, adoption and implementation) from the clinician perspective.
During the COVID-19 pandemic, 91% ( n = 73/80) of surveyed clinicians offered telehealth delivery service, compared to 25% ( n = 20/80) prior. Mean (SD) telehealth delivery per week doubled from 5 (7) to 10 (8) hours. In-person delivery decreased from 23 (11) to 15 (11) hours per week. Typical reasons for not offering telehealth delivery were client physical/cognitive incapacity ( n = 33/80, 41%) and safety ( n = 24/80, 30%). Clinician-reported reasons for typical clients not adopting telehealth delivery were personal preference ( n = 57/71, 80%), physical capacity ( n = 35/71, 49%) and access to reliable delivery platforms ( n = 27/71, 38%). Zoom ( n = 54/71, 76%) and telephone ( n = 53/71, 75%) were the most commonly used platforms. Of the reasons contributing to incomplete treatment, lack of confidence in delivery mode was sevenfold higher for telehealth compared to in-person delivery. No serious treatment-related adverse events were reported.