Telehealth has become a core component of modern healthcare delivery, particularly in geographically dispersed countries such as Australia. For Occupational Therapy (OT), telehealth offers a powerful mechanism to address long-standing inequities in access, timeliness, and continuity of care, particularly for people with disability, chronic conditions, and those living in rural and remote communities. The COVID-19 pandemic accelerated the adoption of telehealth globally; however, the sustained integration of telehealth into occupational therapy practice reflects not temporary necessity but a paradigm shift toward more flexible, patient-centred and cost-effective models of care (World Health Organization [WHO], 2022). This paper examines the theoretical, clinical and policy foundations of telehealth occupational therapy, explores its effectiveness and limitations, and considers its role within Australia’s NDIS and broader healthcare system.

Telehealth occupational therapy refers to the delivery of OT services using digital communication technologies, including videoconferencing, secure messaging platforms, remote monitoring tools and digital therapy resources (Australian Occupational Therapy Association [OTA], 2023). These services may include functional assessments, therapy sessions, caregiver coaching, goal setting, progress monitoring and report writing. Telehealth can be synchronous (real-time video consultations) or asynchronous (recorded videos, digital activity tracking and messaging), allowing flexibility in how services are delivered.

Unlike traditional clinic-based models, telehealth OT occurs within the client’s natural environment, which is often their home, school or workplace. This allows therapists to observe real-world performance rather than simulated behaviour in clinical settings, supporting more ecologically valid assessment and intervention (Cason, 2015).

Telehealth aligns strongly with core occupational therapy theory. The Person–Environment–Occupation (PEO) model emphasises that occupational performance arises from the interaction between the individual, their environment and the tasks they must perform (Law et al., 1996). Telehealth uniquely enables therapists to assess and intervene within the client’s actual environment rather than an artificial clinic context, thereby improving the accuracy and relevance of intervention planning.

Similarly, client-centred practice, a foundational principle of occupational therapy, is strengthened through telehealth. Clients retain greater control over session timing, location and involvement of family members, increasing autonomy, engagement and adherence to therapy (AOTA, 2020).

A growing body of evidence demonstrates that telehealth occupational therapy achieves outcomes comparable to in-person services across multiple populations. Systematic reviews have shown strong evidence for telehealth OT in paediatric developmental delay, autism, stroke rehabilitation, mental health, and functional capacity building (Tenforde et al., 2017; Cason et al., 2018).

Because therapy occurs in the natural environment, skills generalise more easily into daily life, which is a critical determinant of long-term functional improvement (Rogers et al., 2021).

The National Disability Insurance Scheme (NDIS) prioritises participant choice, control, capacity building and community participation. Telehealth OT strongly supports these principles by reducing geographic, financial and physical barriers to accessing services (NDIS, 2023).

NDIS practice standards explicitly permit telehealth for therapy, functional assessments and reporting when clinically appropriate, recognising its role in improving system efficiency and equity (NDIS Quality and Safeguards Commission, 2023).

Telehealth OT contributes to health system sustainability by reducing overhead costs, travel reimbursements, missed appointments and clinician downtime (WHO, 2022). For regional and remote Australia, telehealth mitigates workforce shortages and allows specialist services to be distributed more efficiently.

These benefits align with broader health system goals of value-based care and sustainability (Productivity Commission, 2023).

Despite its benefits, telehealth OT is not suitable for all situations. Some clients require hands-on assessment, physical handling or assistive technology fitting that cannot be delivered remotely. Clinical risk management frameworks require therapists to assess appropriateness, consent, privacy and safety before delivering telehealth (OTA, 2023).

However, when integrated into a hybrid model—combining telehealth with in-person visits when required—telehealth enhances rather than replaces high-quality care.

Telehealth OT will continue to expand as digital literacy increases, broadband improves, and NDIS demand grows. Emerging technologies such as remote sensing, artificial intelligence-supported assessments and virtual reality-based therapy are likely to further strengthen telehealth delivery (WHO, 2022). For Australia, telehealth represents one of the most effective strategies for closing access gaps between metropolitan and rural disability services.

Telehealth Occupational Therapy is a clinically effective, economically sound and ethically aligned model of care that supports equitable access, client-centred practice and real-world functional outcomes. Within Australia’s NDIS and health system, telehealth OT enables people with disability, families and carers to receive timely, high-quality therapy regardless of geography or mobility. As healthcare continues to evolve toward flexible and digital-first models, telehealth OT will remain a cornerstone of modern occupational therapy practice.

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