Response to “Standardization of osteopathic manipulative treatment in telehealth settings to maximize patient outcomes and minimize adverse effects”

We appreciate the authors’ interest [1] and enthusiasm for osteopathic interventions via telehealth and agree with their call for standardized guidelines to help improve the delivery of virtual osteopathic care. When these visits began [2], we were pivoting quickly from in-person to telehealth visits and trying to determine if osteopathic interventions via telehealth would be feasible. Given our early results, we absolutely recognize the need for more study of standardization and quality tools to assist patients and families with such visits. This need is highlighted by a systematic review conducted by Mani et al. [3] which revealed discrepancies in validity for certain musculoskeletal assessments conducted over telehealth. Cottrell and Russell [4] suggest several considerations for standardizing musculoskeletal therapy via telehealth including the use of frameworks and theories, clinical factors like physical location, clinician skill and experience, and systematic evaluations of the treatments. The study and development of such standardized protocols could allow for a better understanding of the efficacy of osteopathic interventions for specific musculoskeletal complaints. Additionally, consistent methods would lead to broader and safer application of osteopathic principles through a telehealth platform. We would be eager to collaborate in the future with any osteopathic leaders who might be interested in developing these tools.