Paving new roads in physiotherapy

It was relatively early in Cloe Benz’s physiotherapy career, before the pandemic came along and forced the swift rise of telemedicine, that she became aware of the potential of digital healthcare.

While working for Hospital in the Home, the Sydney Children’s Hospitals Network service that enables children requiring acute care to be treated at home rather than in hospital, she became frustrated by the time wasted on the road in city traffic.

“When you’re in a big metropolitan centre like Sydney, visiting and treating kids in their homes, there’s a lot of time spent in the car while driving to see them,” says Cloe, 29, who worked as a senior physiotherapist for the service until March 2020. 

“There was this balancing act of trying to make sure we could provide high-quality care for these kids, but also putting our service in a position where we could treat as many kids as possible, especially during those times in the day that were really challenging to do home visits.”

Conscious of the pressure on the service to provide quality care to an increasingly large cohort of patients, Cloe began to look for solutions. She explored the literature on the effectiveness of virtual physiotherapy, and found some evidence showing it could be as effective as in-person treatment.

For years, telemedicine has been touted as the next big thing in healthcare, but before the pandemic, it still played a very minor role in the health industry.  

Cloe, however, was convinced that virtual treatment could improve the Hospital in the Home service, so she approached her managers with a proposal to trial a telehealth program for physical therapy.

The benefits of a telehealth program would be multi-fold, she argued. Skipping traffic jams would give physiotherapists more time on the job, attending to patients. They’d even have enough time to see their regular patients twice a day – once through online video, and once in person. And virtual treatment could have practical and educational benefits, too, engaging patients in their own recovery journey.

“It has many different benefits, but it also has drawbacks,” says Cloe, who completed her Bachelor of Physiotherapy at ACU in 2014, and specialises in respiratory physiotherapy. 

“There are children who I would never consider appropriate for telehealth because you need to be there in person. We might need to physically be able to see the patient, to touch them and move them and all of those kinds of things. So virtual treatment isn’t always the answer.”

Alongside that, there were ethical and risk considerations, all of which had to be weighed up against the potential benefits.  
 
“It certainly was a challenge to convince the medical teams to trust us and let us trial it,” Cloe adds. “So we started small and slowly worked our way up as we became more confident with the setup.”

‘Prove that it works’ 

At the outset, the medical team overseeing the Hospital in the Home service was adamant that the telehealth program had to be evidence-based. 

“When I went to them and said, ‘Hey, I’ve got this great idea’, they very rightly replied, ‘Okay, but you need to prove that it works’,” Cloe says. 

It was all the encouragement that Cloe needed to embark on a research career. She went on to pursue a master’s degree exploring the effectiveness of telehealth in paediatric physiotherapy, while simultaneously implementing the pilot program at Hospital in the Home. 

Her goal was to expand on the research exploring the use of telehealth to treat young patients.  

“Sometimes that’s the best push to create an evidence base,” says Cloe, whose research has found that combining telehealth with home visits improves efficiency and capacity without added risk.

“If you’ve got a passionate person who really sees a need for something, they’ll work to get it done. Seeing the benefits and improvements and the positive feedback we got from our pilot study, it was really motivating and it prompted us to move forward and do something on a bigger scale.”

Cloe Benz

At the completion of her master’s degree in late 2019, Cloe felt positive about the promises of digital healthcare. 

“I went merrily on my way and thought, ‘Yeah, things are going to happen in this space’,” she says. “Then, two months later, bam! The pandemic hits, and everything I’d worked on became way more relevant than it ever had been before.” 

Having moved to Western Australia in early 2020 and taken on a role as a senior respiratory physiotherapist at the Perth Children’s Hospital, she was soon put into contact with researchers at Curtin University, who were working in digital health. 

“With the emergence of the pandemic, there was suddenly a real need for people who had tried telehealth-based platforms and had implemented models of care, and I happened to be one of those people,” says Cloe, who is currently pursuing her PhD on the implementation of a telehealth model of care in the disability sector. 

Her new focus on disability is a direct response to a need that arose as a result of the COVID-19 pandemic. 

“In the disability sector, there are a lot of allied health therapists, and they’ve essentially had telehealth thrusted upon them during the pandemic with no previous experience of it,” she says. 

“There are a lot of nuances that need to be taken into consideration, especially when their patients are often accessing different types of therapy and seeing physios, OTs, a speech person, someone doing their equipment fitting … it gets really busy, and I can see how telehealth can improve efficiency and access to care in the same way that it does in the paediatric sector.” 

A passion for treating kids

Cloe has found it fun being a “novice” in the disability sector because she’s learning new things, and being exposed to new problems. 

At the same time, she continues to have a passion for paediatric physiotherapy, combining her research work with her respiratory physio role at the Perth Children’s Hospital. 

“If the pandemic hadn’t come along when it did, I probably would have happily gone back to being a physio for a little while before I pursued research again,” she says. 

“It was just the way of the world, life happened and there was an interest in my area of expertise in digital health, which was completely unexpected. I still love being a kids’ physio, I still enjoy being in the hospital, seeing the kids and being part of their journey to getting better.” 

Working with younger patients is satisfying, Cloe says, because of their sense of innocence and positivity. 

“Even through really tough situations and really traumatic experiences, or when treating children who might have an uncertain future, there’s always an opportunity with kids to be glass half-full, to find the good things in the way that something’s happened, or even just the simplicity of blowing up a balloon or playing with bubbles or having a sticker as a reward for something,” she says. 

“There’s so many opportunities to find the brighter part of life, and to help them and support them to see that brightness as well, and I think that’s one of the most rewarding parts of the work that I do in physiotherapy.”

As for her interest in telehealth and virtual therapy, it all comes back to the pursuit of providing the highest quality care that is possible in the circumstances. 

“There is so much potential in telehealth to provide efficient and effective care, reaching patients who we may not have reached in the past and making sure they have access to expert advice,” Cloe says. 

“It’s all about getting better health outcomes, and I think more people are starting to realise that this is great way to deliver care to lots of different types of people.”

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