What I Learned at HIMSS: PTs Are Health Care’s Forgotten Provider

Out of sight; out of mind. You’ve probably heard that saying before. Maybe you’ve even repeated it to yourself when you’re trying to ignore something—you know, to keep it from distracting or upsetting you. After attending the 2017 Healthcare Information and Management Systems Society (HIMSS) Conference & Exhibition in Orlando, Florida, however, I’ve started to see that seemingly harmless adage in a whole new—and much more ominous—light.

Why? Because even though 40,000-plus healthcare IT professionals, clinicians, executives, and vendors were present at this year’s HIMSS event, there was virtually zero rehab therapy representation—in either the attendance list or the material presented during the educational sessions. Granted, I couldn’t go to every single presentation—after all, for comparison, this conference was about four times larger than the APTA Combined Sections Meeting (CSM), which I’m betting many of you have experienced at some point in your career—but rehab therapists definitely should not have been out of sight or out of mind during the presentations I did attend.

Now, this was not my first HIMSS rodeo; I’ve been to this conference three times in the past five years. Each year, a few overarching themes tend to emerge. Three years ago, for example, the buzz was all about ICD-10—the codes themselves, how to use them effectively, and what the transition meant for the future of health care. This year, interoperability, value-based care, and artificial intelligence (AI) surfaced as the recurring topics of discussion. And those topics—the first two in particular—only underscored our profession’s obvious lack of representation.

For instance, it was extremely disappointing—more like maddening, actually—to sit through an entire presentation on low back pain without hearing a single mention of physical therapy. This discussion specifically delved into the role interoperability plays in ensuring patients achieve optimal outcomes. Sure, several speakers from hospitals and other large health organizations talked about using some of the same outcome measurement tools (e.g., the Oswestry Low Back Pain Questionnaire and Neck Disability Index) that PTs use every day. But PTs—and our hands-on, non-invasive, patient-centric approach—were left out of the equation completely. And that’s not okay—not only because it means we, as a profession, are nowhere near achieving the level of respect and recognition we deserve in the greater healthcare community, but also because it means there are thousands of low back pain patients out there who are paying way too much for dangerous treatments (e.g., surgery and prescription painkillers) that could actually threaten their long-term health and wellbeing.

Physical therapists should’ve been at the forefront of this conversation. After all, low back pain is one of our most-seen diagnoses. Even more disheartening: After raising my hand and questioning the speaker’s glaring omission of physical therapy in his presentation, he paused, scratched his head, and said, “That’s a really good point—I’m not sure why or how we would get PTs involved.” Talk about a huge slap in the face to our entire profession. PT wasn’t even on his radar—and that should be a major wake-up call for all of us.

During another presentation, an orthopaedic surgeon explained how his well known teaching and research hospital routinely publishes patient outcomes data in medical journals as well as openly on the hospital’s website. Now, making that kind of data available to the public is something I’m sure many rehab therapists would shudder at; after all, historically, we’ve been fairly resistant to the idea of collecting that sort of data in the first place—and downright terrified of sharing it beyond our individual practices. But, that’s not the way the rest of the healthcare crowd sees things—especially at the hospital level. In fact, many large health organizations not only view their outcomes as a differentiator, but also believe patients have a right to know what kind of results to expect—and I think it’s high time rehab therapists started embracing that mindset.

In other words, we shouldn’t be collecting this data solely for our own purposes—to better market ourselves to referring providers and consumers, negotiate higher reimbursement rates, and improve our and our staffs’ clinical performance. If we truly want to paint ourselves as the patient-centered caregivers we are, then we should be empowering those patients to make the best, most informed care choices they possibly can. But, we can’t do that without putting ourselves—and our data—out there.

Furthermore, we must continue looking for ways to get that data in the hands of health care’s biggest decision-makers—especially those in the hospital, insurance, and government spaces. Because as it stands, that data simply isn’t there. And the relationships necessary to capitalize on that data aren’t there, either. We, as outpatient therapy providers, haven’t taken the initiative to collaborate with other practitioners—like surgeons—in an effort to create organized data-collection programs with defined sets of measurement tools. As a result, many of our peers in the neuromusculoskeletal field—including orthopaedic surgeons, who represent one of our biggest referral sources—have little to no knowledge of the immense benefit we provide in postsurgical (and sometimes even pre-surgical) cases. That lack of understanding was never more apparent than when the presenting surgeon admitted—completely unsolicited by me—that he and his colleagues “have almost no training on [the value of physical therapy] during our training at all.”

Of course, hindsight is 20/20, but I can’t help but think that the PT profession would be in a very different place right now had we been more proactive in partnering with providers outside of our own space to standardize, exchange, and cross-analyze patient outcomes data. Perhaps we’d be the ones presenting low back pain research at one of the world’s largest and most respected healthcare conferences. At the very least, I’d like to think that we’d be considered a universal value-add in most neuromusculoskeletal care episodes—and thus, that we would be included in the clinical curricula for medical professionals in all related areas of practice.

In the rehab therapy space—and even right here on the EIM blog—we talk a lot about “the PT branding problem.” We urge one another to get out there and educate the world about who we are, what we do, and the value we provide. But honestly, I don’t think that’s enough anymore. At this point, we have to do more than effectively market ourselves. Yes, that’s still important—especially in light of the move to a value-based payment paradigm in which patients will continue to shoulder a greater and greater portion of their healthcare costs. But, as the healthcare powers that be continue pushing all of us to simultaneously improve care quality, reduce spending, and increase patient satisfaction, we’re going to have to work together—there’s simply no way around it. Like our government leaders, we’re going to have to reach across the aisle if we want to truly move the needle in the right direction. No single provider—or type of provider—can achieve the triple aim alone. And that is precisely why we—and, by extension, our software and technology systems—must speak the same language.

I recognized the importance of interoperability before HIMSS; now, I’ve never been more sure that it is mission-critical—especially for constantly overlooked providers like PTs. After all, anecdotes are ancient history. These days, data is the only story healthcare leaders are interested in—and if our data isn’t there, we might as well write ourselves out of that story. And I don’t know about you, but I’m not ready for PTs to fade off the edge of the page—to be out of sight or out of mind. I’m not ready to be forgotten—and for the sake of our and our patients’ future, I hope you’re not, either.

About the Author

Heidi Jannenga PT, DPT, ATC/L is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has since guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.

An active member of the sports and private practice sections of the APTA, Heidi advocates for independent rehab therapy businesses, speaks as a subject-matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. In 2014, Heidi was appointed to the PT-PAC Board of Trustees. She also serves as a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice rehab therapy professionals.

Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a bachelor’s degree in biological sciences and exercise physiology, went on to earn her master’s degree in physical therapy at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her doctorate of physical therapy through Evidence in Motion. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.

8 responses to “What I Learned at HIMSS: PTs Are Health Care’s Forgotten Provider

  1. Heidi,
    You make some great points, and a lot of us share your frustration, but I think in most cases, we need to simply “follow the money” and realize that we have a sickcare system that could care less about minimizing surgeries. Also, hospital systems, at least in California view outpatient PT as a cost center, not a profit center. This is good for private practice PTs since we can compete with hospital- based outpatient PT easier.
    Love the 800 mile ArizonaTrail(Mexican border to Utah)!

    1. I agree on the competition side- we are seeing this more and more with private practice PTs being given the contracts to add to the top line. It is currently a sick care system for sure; but I’m not giving up on minimizing surgeries and getting PTs a more prominent place. The money train is slowing up and when we can get more to hear how we can save the system potentially millions – PTs will rise. But we have to believe and come together as an industry to make it happen.

  2. John Ware, PT says:

    If orthopedic surgeons were so concerned about providing “value-based care” they’d stop doing most knee arthroscopies and lumbar fusions tomorrow.

    Like James said, our “sick care” system has little to do with providing value for patients. It’s about identifying an illness with the “right” code and then squeezing every last cent out of the patient and their third party payer by doing as many interventions as possible, regardless of their value.

    Our system is broke in every sense of the word.

  3. Al Amato says:

    FOTO exhibited at HIMSS recently. our experience was the same as Heidi’s. Content and exhibit hall focus was on interoperability, population management and revenue management. All big concept topics, so Rehab Outcomes with FOTO was not on anyone’s radar. Our take away was a need to expand our offering across the continuum of care and into adjacent providers to allow Rehab providers a path to be included in reporting team management of care like what is happening with CJR.

    Second take away was: Rehab is a small part of health care in terms of dollars spent. Therefore, people and products were focused on big ticket items like enterprise wide EMR’s. As Jim pointed out, “follow the money”, and there the focus will be.

    1. That is fantastic that FOTO exhibited – must have missed you as the tradeshow floor was huge and I didn’t see you in the program listing. Nevertheless, I give FOTO all the credit in the world for seeing the need for outcomes when very few were even talking about it. However, in my opinion, in the current times, proprietary outcomes are not going to get any interest or traction because it must span multiple providers and specialties. CJR is a prime example – they went with the HOOS and KOOS – which we didn’t have much if any input in the decision I have heard – but they are more universally used with Orthopedic surgeons and in hospital systems. Following the money also means that we must be willing to mold our blend our practice methods with what others are doing so that we have a more unified data stream – with the PATIENT at the center of the program.

  4. Taylor Kurtz says:

    Al, John, James, greatly appreciate the insight into where our profession needs to be directed. Noting that we practice “sick care” and “Our system is broke in every sense of the word,” should we believe following the money, trailing behind this broken system will land the field of PT in the right spot?

    Al, thank you for representing our profession at the HIMSS conference. On Dr. Flynn’s ‘Pain Reframed’ podcast, Dr. Louw noted several non-PT clinicians had recently attended his weekend pain conference. Dr. Louw recommended for every PT conference we attend (CSM for example) we should alternate and attend a non-PT conference the next time.

    At HIMSS Dr. Jannenga mentioned healthcare leaders being sold on objective data and Al noticed the interest in population management. Does anyone think the emerging field of population health physical therapy could play a role?

  5. I think that our professional organizations could help bridge these gaps with educational programs.
    I have to note that OT was not mentioned in any of the above links.
    Similarly to how PT wasn’t mentioned….just saying.
    But to the question at hand, I return back to my first sentence. I know that AOTA goes to DC and presents there….they are also involved with some other medical organizations. It sounds like a multilevel problem that is a comprised of our :
    a) Corporate health care system that has us all as cogs in a big wheel , fast turning,
    b) The size of our country, our health care system and the vast amount of schools and providers that there are.
    c) The vast amount of information that there is for any one professions. Physicians do not know what we can do and I suspect we do not know all of their training either.
    I agree with Heidi that more therapy ( please all disciplines) need to insert, infuse and bridge themselves into the medical mainstream. As a new private practice practitioner, I am again finding that most folks don’t know the breadth of our skills and services.

  6. I just saw the post above from FOTA.

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