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ABSTRACT PRESENTATION 

 

62 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                        Volume 4 – Issue 1 – February 2021 
 

Telehealth Optimization – Role of Clinical Athletic Trainers In 
Orthopedic/Sports Medicine Practice 
Katie Harbacheck, ATC; Laura Grambo, MS, ATC; Shaun Keefer, MHA; Eric Klein, MSc, MHA; Christine 
Boyd, MD; Carolyn Ford-Hemann, MHA; Cameron D’Alpe, MSPH; Steve Frick, MD; Kevin Shea, MD  
Stanford Children’s Health, Palo Alto, CA 
 

 
 
Full Citation 
Harbacheck K, Grambo L, Keefer S, Klein E, Boyd C, 
Ford-Hemann C, d’Alpe C, Frick S. Telehealth 
optimization – Role of clinical ATCs in 
orthopedic/sports medicine practice. Clin Pract Athl 
Train. 2021;4(1):62-63. 
https://doi.org/10.31622/2021/0004.1.9.    
 
Presented at the 4rd Annual Athletic Trainers in the 
Physician Practice Society Meeting and Conference, 
February 26-27, 2021.  

 

ABSTRACT 

Background: Prior to COVID-19, telehealth (TH) 
implementation in most health systems was 
minimal. The transition to high rates of TH was 
dramatic in response to COVID-19, and many 
health systems struggled to develop optimal, 
efficient TH workflows. 
 
Hypothesis/Purpose: The primary purpose of this 
study was to evaluate the role of clinically 
integrated athletic trainers (ATs) into the TH 
transition of a major orthopedic academic center 
through growth of TH visits as well as physician 
satisfaction. 
 
Methods: Workflows and tip sheets were 
designed to include considerations of TH visit 
increases, adoption of appropriate technology 
platforms and optimal staff models. The rapid 
rate of TH adoption by orthopedic providers as 
well as the rates of TH visits were monitored. 
Growth of TH and in person (IP) visits was 
reviewed over a 4 month period. The percentage 
of TH visits compared to total visits was calculated. 
These results were then subjectively reviewed by 
physician leadership for satisfaction and 
effectiveness of the TH clinic. 

 
Results:  TH became common practice in March due 
to COVID-19 social distancing measures. In mid-
May, the organization lifted restrictions to allow 
for greater IP visits. March – June, TH visits were 
291, 702, 408 and 193, respectively. IP visits 
were 862, 393, 730 and 788 for months March – 
June, respectively.  Percentage of TH visits was 
highest in April, accounting for 64% of all visits 
(Figure 1). At the beginning of TH implementation 
(March), the organizational electronic medical 
record platform was used for virtual visits. There 
was a high drop-rate, inability to share images 
and overall patient dissatisfaction. TH visits were 
transitioned to a 3rd party platform in April. Initial 
concerns were that it required more man-power to 
run: families had to be emailed a link, patients 
were manually checked-in/out, and 
documentation had to be collected. ATs were used 
exclusively to coordinate and execute the visits.  
Physician satisfaction for TH visits resulted in 
compliance and increased desire to continue a 
virtual-based clinic. 
 
Discussion/Conclusion: While the future of TH is not 
clear health systems will increasingly rely on this 
modality. Developing optimal workflows will be 
critical for further acceptance, effectiveness, and 
managing the financial costs/returns of providing 
this service. A clinically integrated athletic training 
team can be utilized to develop, monitor and 
maintain a TH system, both for sports medicine 
and general orthopedic practices. 
 
Correspondence 
Laura Grambo, 5000 Pleasanton Ave, Suite 200, 
Pleasantonm CA, 94566. 
Email: laura.grambo@gmail.com  
 
   

 

 

https://doi.org/10.31622/2021/0004.1.9
mailto:laura.grambo@gmail.com


ABSTRACT PRESENTATION 
 

 

63 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                        Volume 4 – Issue 1 – February 2021  

 

Figure 1. Telehealth Utilization in Orthopedics 

 

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Telehealth Utilization in Orthopedics

In Person Visits Telehealth Visits

Percentage of Telehealth Linear (Percentage of Telehealth)


