A Proposed Decision-Making Framework for the Translation of In-Person Clinical Care to Digital Care: Tutorial

The continued demand for digital health requires that providers adapt thought processes to enable sound clinical decision making in digital settings. Providers report that lack of training is a barrier to providing digital healthcare. Physical exam techniques and hands-on interventions must be adjusted in safe, reliable and feasible ways to digital care and decision making may be impacted by modifications made to these techniques. We have proposed a framework for determining if a procedure can be modified to obtain a comparable result in a digital environment or if a referral to in-person care is required. The decision making framework developed using program outcomes of a digital physical therapy platform, and aims to alleviate provider barriers to providing digital care. This paper describes the unique considerations a provider must make when collecting background information, selecting procedures, executing procedures, assessing results, and determining if they can proceed with clinical care in digital settings.