This is part one in a series of blog posts. This installment provides an overview on the use of telemedicine for acupuncture practitioners.
COVID-19. After a year of navigating this pandemic there is not a single aspect of life untouched, including the practice of acupuncture and Traditional East Asian Medicine (TEAM). While many clinics have re-opened, some patients and providers have opted to stay home. For many, the inability to receive in-person care presents challenges; for patients with chronic pain, being caught amid a collision of the opioid and COVID-19 pandemics is particularly arduous.
While acupuncture is not possible via telemedicine, it is paramount to remember that as providers of a complex multicomponent intervention, acupuncturists can offer so much MORE than just needles. The late researcher-practitioner Hugh MacPherson documented this in a 2019 commentary, “…the practice of acupuncture comprises a range of non-needle-related components, including…explanation of a TEAM-based diagnosis, advice about lifestyle and self-care, [to elicit] the active involvement of the patient in their recovery, and supporting behavior change.”1MacPherson H. Why Acupuncture Is More Than Just Needling, and the Implications for Research. J Altern Complement Med. 2019;25(9):872-73. An axiom of TEAM is to treat the whole person (mind, body and spirit), and this emphasizes the role providers play amid the current collision of pandemics. To this point, recent publications from an international pain management experts suggest that a multidisciplinary approach to chronic pain management is needed during the pandemic.2Shanthanna H, et al. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia. 2020;75(7):935-44.,3Gill JS, et al. Pain Management Best Practices from Multispecialty Organizations During the COVID-19 Pandemic and Public Health Crises-Evaluating the Risk of Infection Associated with Corticosteroid Injections. Pain Med. 2020;21(8):1730-31. Specifically, they call for telemedicine options that focus on exercise, sleep hygiene, pacing, mindfulness therapy and healthy lifestyle techniques.
Telemedicine and telehealth are often used interchangeably. For the purposes of this article, telemedicine is a branch of telehealth; it refers to practice of medicine using technology to deliver remote care. Telehealth is the full umbrella; encompassing all electronic & telecommunications technologies used to provide remote care.
Although many providers and patients may not have considered acupuncture telemedicine for chronic pain management, TEAM is well equipped to help via this technology. What can TEAM practitioners offer? Think of what happens in a typical in-person treatment and remember that pain management requires more than just needles. Providers often focus on lifestyle and the foundations of TEAM: rest, diet, exercise, mental health, and, if needed, other TEAM modalities such as self-acupressure and breath work. Future blog posts will delve deeper into these evidence-based treatment options.
When working with patients who experience chronic pain, providers should emphasize COVID-19 precautionary measures (e.g. masks, distancing, hand washing) as well as assess the general well-being of patients with chronic pain. Research suggest this population has a higher prevalence of: anxiety, depression, catastrophizing and suicidal ideation and may be more susceptible to COVID-19.4Shanthanna H, et al. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia. 2020;75(7):935-44.
General Reminders for Telemedicine Visits
- The patient and acupuncturist must be located in same state
- The acupuncturist must maintain an Active status license (in same state as patient)
- Telemedicine must meet the standard of care for the particular patient and condition being treated
- Chart documentation is same as in-person services; note that consent was obtained
- Verbal consent OK, so long as costs are discussed
State Specific Information
- Oregon Medical Board Telemedicine Page: https://www.oregon.gov/omb/Topics-of-Interest/Pages/Telemedicine.aspx
- New regulations in Washington require telemedicine training for providers as of 01/01/2021
- For more info and links to free training see our January 6th Blog post at https://www.chpgroup.com/evidence-in-ih/washington-state-telemedicine-mandatory-training/
- New state laws in enacted in June 2020 loosened regulations for telehealth services
- See the Idaho Department of Health & Welfare’s Telehealth page at https://healthandwelfare.idaho.gov/providers/rural-health-and-underserved-areas/telehealth for more information
- The Department of Occupational & Professional Licensing has information about telehealth in Utah on their page at https://dopl.utah.gov/covid19.html – click on Telehealth in the left-hand column
- The Colorado Department of Public Health & Environment maintains telehealth information for providers at https://covid19.colorado.gov/telehealth-for-providers
- Telehealth information for Alaska providers is available from the Alaska Department of Health and Social Services, Division of Public Health at http://dhss.alaska.gov/dph/HealthPlanning/Pages/telehealth/default.aspx