Chief Clinical and Product Officer Mary O’Donoghue shares why a consultation with an on-staff physical therapist prior to treatment is a critical component of MedRisk’s Platinum Grade Program for Managed Physical Medicine.
It’s a well-known fact that physical therapy as first-line treatment can improve patient outcomes, but what about a consultation with a physical therapist? Can a simple conversation between patient and provider in advance of treatment affect outcomes?
Research says yes. A 2018 study from the University of Utah found that a discussion between patient and provider about the severity of pain and prognosis can reduce the chance of opioid prescription by up to 65%. And according to MedRisk Chief Clinical and Product Officer Mary O’Donoghue, the benefits don’t stop there. In this article, we take a closer look at what physical therapy (PT) consultation entails at MedRisk and three ways this important touchpoint can benefit injured workers.
1. Educate the Patient
Patients directed to the MedRisk network for physical rehabilitation receive a clinical phone consultation with one of MedRisk’s on-staff physical therapists prior to scheduling and before the start of treatment. One of the objectives of the call is to educate the injured worker on why physical therapy is valuable, what to expect and the importance of active engagement and compliance with the treatment plan. Individualized coaching is also provided for the specific diagnosis, such as low back pain or shoulder injury, to reassure patients that in most cases, conservative care (including PT) will relieve.
Altogether, the consultation is intended to support a reduction in appointment no-shows and cancellations, better compliance with at-home exercise, a lower rate of opioid prescription and a decrease in medical costs.
“We’re finding with the level of patient engagement that can be cultivated during these calls,” O’Donoghue said.
2. Address Psychosocial Factors
According to O’Donoghue patient education can mitigate the fear and anxiety that often comes with a work-related injury. But the PT consult goes a step further to address catastrophic thinking and other negative factors that may also be at play following an occupational injury.
MedRisk’s physical therapists use the opportunity to help allay worry and set expectations.
“The patient may have a run-of-the-mill diagnosis, but if during the consultation the patient indicates that she is afraid of re-injury then it might be an opportunity to apply additional resources to the case, such as a nurse case manager to potentially avoid delayed recovery down the road,” O’Donoghue said.
3. Introduce Telerehabilitation
During the consultation, MedRisk physical therapists have an opportunity to better understand a patient’s unique needs. For instance, do they travel for work? How far are they from the closest clinic? If the patient is identified as clinically eligible for telerehabilitation, it is discussed as an option during the consultation.
MedRisk’s telerehabilitation program takes a blended approach to treatment consisting of telerehabilitation, traditional clinic delivery and fluidity between these two service delivery options. Using advanced HIPAA-compliant technology, a US-based MedRisk clinician can connect instantly with the patient for face-to-face evaluations and coaching. Treatment may also be supported by MedRisk’s dynamic library of instructional videos and “store-and-forward” materials to facilitate patient education and improve satisfaction. Remote patient monitoring for guided home exercises is also available to capture and summarize clinical data on performance, progress and compliance to maximize care management.
“Sometimes it’s the people you least expect who are eager to try it. One of our first telerehab patients back in 2017 was 62 years old,” O’Donoghue said. “Many travel for work, and we ask them if there’s a hotel room or conference room available to them. As long as the injured worker has a private, appropriate place to participate in therapy and they are comfortable with the technology available, we can be successful in delivering PT.”
When a worker gets injured on the job, they may not know much about the road ahead of them, especially if it is their first injury. Connecting with a physical therapist before visiting the clinic can help patients gain a sense of understanding and control in what can initially seem like a hopeless situation.
“You just never know how a patient is feeling. If they are disengaged or have already made up their mind that are not going to get better, treatment will be an uphill battle. This could end up being the most important appointment they have,” O’Donoghue said.