Determining a capability framework and training requirements to support provision of physiotherapy via telehealth in an Australian public tertiary health setting: a multi-methods study.

Background: Inadequate clinician training and support is a primary challenge to physiotherapists' adopting telehealth. Training must be underpinned by relevant capability frameworks and co-developed to meet the needs and preferences of the existing physiotherapy workforce.

Objective: Establish a capability framework for delivery of care via telehealth and understand training requirements to achieve competency specifically for the publicly funded physiotherapy workforce.

Methods: Sequential multi-methods study design. Phase 1: Physiotherapists with telehealth experience participated in a 2-round e-Delphi process to establish consensus on core capability framework domains (Round 1, n = 29; Round 2, n = 26). Phase 2: Physiotherapists (n = 35) subsequently rated their current knowledge and confidence for each capability item. Phase 3: Participatory focus groups, involving physiotherapists (n = 37) from six facilities, identified theoretical and practical domains most relevant to local contexts via thematic analysis.

Results: Fifty-three capability items were produced across eight domains (Compliance, Patient privacy and confidentiality, Patient safety, Technology Skills, Telehealth Delivery, Assessment and Diagnosis, Care Planning and Management, Access and Equity). Knowledge and confidence were ranked lowest within the Technology Skills domain (% respondents reporting high levels of confidence = 28.6%-42.9%), and highest in Telehealth Delivery (% respondents reporting high levels of confidence = 54.2% -80%). Focus groups identified technology skills, risk management (patient safety) and superuser support as priority areas for training.

Conclusion: Physiotherapists identified additional local training competencies to compliment the 53-item capability framework. Adopting a sequential multi-methods and participatory approach successfully produced a training package framework suitable for implementation in a public outpatient setting.