For years I practiced physical therapy and managed a successful PT orthopedic clinic outside of Los Angeles. Times were good- schedules were full, referrals were abundant, and I had developed into a seasoned clinician. However, like many other physical therapists, I was frustrated by the day-to-day inefficiencies of the clinic. Decreasing reimbursements and the need to see patients multiple times per week were making it difficult to deliver the quality care I felt patients deserved. I knew something had to be done and I felt I was not going to be able to do that in my position. My love for physical therapy and helping patients was still as strong as ever, but I saw a need to rethink the way we care for patients in this new healthcare environment. So, against the recommendation of some of my colleagues, I made the decision to try something new. I packed my bags for a digital health startup in San Diego.
Here are four reasons I left my booming practice for a digital physical therapy startup:
1) Extending our reach to the patient
PTs are passionate and genuinely care for their patients. In fact, I would argue that we cultivate the deepest relationships with them because of how dedicated we are to getting patients back to doing the things they love. But we can’t deny the frustrating inefficiencies that remain inside the system and often de-motivate us from doing what we do best. I believe digital health that combines remote monitoring and telerehabilitation can help our profession get back to treating patients the way we are supposed to.
Some are hesitant to embrace new technology, but if implemented correctly, I believe PTs will find that digital health can maximize the power of innovation in healthcare delivery. This will give patients the care they need where and when they need it, while also allowing clinicians insight to what the patient is doing away from the clinic.
Studies consistently show that the quality of healthcare services delivered via telemedicine are as good as those given in traditional in-person consultations. For example, a recent study in the Journal of Telemedicine and Telecare revealed that clinical outcomes for postoperative tele-rehabilitation was equivalent to traditional care and demonstrated lower outpatient utilization following total knee arthroplasty (TKA) patients.
As therapists, we’re taught to focus on the patient’s individual goals. We ask them what their goals are and what they ultimately want to do again. Their responses can vary between wanting to be able to take walks around the block, or completing an Ironman. Yet, we only treat them when we see them and base our clinical judgments on roughly 2 percent of their whole week. Sure, patients may say they are adhering to the paper HEP handout you’ve provided. But the question really is, are they adhering to it the way you want them to? Are they doing their exercises correctly? It’s hard to tell.
If we can use digital health, we can extend our reach beyond the traditional in clinic setting and into the patient’s home. This would empower the patient to do more at home when they are not in front of you; thereby maximizing their recovery time.
2) Improve access to Physical Therapy
Therapists are very busy; patients are scheduled back-to-back for 45-minute sessions and booked two months in advance, but this doesn’t necessarily equal efficiency.
This lack of productivity frustrates me. Why can’t we define a system to assist with the exercises that are repetitive and straightforward to leave time for PTs to elevate their face time with patients who really need the hands on care and their attention?
Not only does digital health improve access to patients in distant locations, but it also allows physicians and health facilities to expand their reach, beyond their own offices. Given the provider shortages throughout the world–in both rural and urban areas—digital health as an industry has a unique capacity to increase service to millions of new patients.
Of course, there should still be an element of one-on-one interaction to help develop the confidence to complete the rehab program. Outside of self-assurance and safety, technology can be a vital tool in their healing process that is convenient, gathers data, provides feedback in real time, and allows the therapist access to review the ongoing success of rehabilitation. This will enable the clinician to have more data / information to assist with clinical decision-making when an in person visits is necessary.
This current time structure inefficiency makes our profession look bad and makes clinicians not well organized. There is an easy fix by implementing innovative technology into our practice.
3) To create a more robust industry standard
Another common concern of PTs is not having the time to get creative with their practice. Seeing patients on a fee-for-service model creates a sense of hustle because the grading scale is on productivity-not on outcomes. The incentive is in the wrong place.
Our knowledge and skill sets are valuable, but due to time constraints, we give a rudimentary exercise rather than taking the time to educate patients about why they’re doing the prescribed movements and how it will ultimately lead to their successful rehabilitation. If we can leverage remote monitoring and telerehab tools that help patients perform their exercises at home, I think we can further that experience by empowering them with information to know how the exercise helps their recovery overall. This type of robust practice will be what thrives in the value-based payment model.
Practicing at a higher level is key to achieving patient goals, but also creates a practice that is results driven and forward thinking.
4) To explore, and meet patient demand
Reducing or containing the cost of healthcare is one of the most important reasons for funding and adopting digital health technologies. It’s been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.
With the April implementation of CMS’s bundled payments, it is important to understand how this will affect clinicians and their practice. We all need to shift our thinking and consider a few things:
How are you going to continue to make a living in this profession and what new opportunities are available now?
As a clinic, you need to strategize how you’re going to partner with hospitals that are now responsible for managing your patient’s costs.
How are you going to evaluate your staff now?
You will no longer be able to evaluate on productivity alone, but will need to evaluate on population management.
In the fee-for-service world, we were always worried about coverage and cost. But looking forward, we’ll be able to get back to the basics, making it imperative we focus on empowering the patient and setting specific goals for them.
The greatest impact of digital health and telerehab, in my view is on the patient, their family and their community. Digital health reduces travel time and related stresses for the patient. Over the past 15 years, study after study has documented patient satisfaction and support for telehealth services.
With all of the new opportunity in front of us and the incredible benefits it brings to our patients, I strongly believe PT’s should implement digital health and redefine post acute care. Let’s face it, healthcare is changing. But the more we engage and leverage these new technologies into our practice, the better our care delivery will be. And in the end, that is something we can all get excited about.