Agreement between face-to-face and telehealth physical therapy triage decisions in a routine outpatient setting
Zafnat Sharvit, Alon KalronBackground
Telehealth has increasingly been integrated into physiotherapy services to improve access and reduce waiting times. However, evidence regarding agreement between telehealth and face-to-face physiotherapy triage decisions remains limited, particularly in routine outpatient settings.
Methods
A repeated-measures agreement study was conducted to evaluate the use of telehealth for physiotherapy triage in an outpatient clinic. Adults referred for physiotherapy triage due to chronic musculoskeletal conditions underwent two consecutive triage assessments, face-to-face and telehealth, performed by five independent physiotherapists. Agreement in treatment recommendations and in urgency classification was assessed using percentage agreement and Cohen's kappa or weighted kappa. Patient and physiotherapist satisfaction with telehealth triage was evaluated using visual analog scale questionnaires.
Results
Thirty participants completed both triage assessments. Agreement between face-to-face and telehealth triage was moderate for treatment recommendations (70.0%, Kappa = 0.44) and lower for urgency classification (56.7%, weighted Kappa = 0.22), with variability across musculoskeletal conditions. Both patients and physiotherapists reported high levels of satisfaction with telehealth triage.
Conclusions
Telehealth physiotherapy triage demonstrated moderate agreement with face-to-face assessments for treatment recommendations but limited agreement for urgency classification. While telehealth appears feasible for supporting treatment allocation, caution is warranted when using it to determine clinical urgency, and further standardization of urgency assessment is needed.