Managed Physical Medicine

Identifying the Ideal Telerehab Patient

As virtual PT services make their way into workers’ comp, which patients stand to benefit most?

There’s no doubt telemedicine is a key element of next generation health services. Seventy-four percent of group health consumers say they would use telehealth options. Before strategizing how to attract and convert patients to use telehealth services, however, the baseline needs of the patient must first be considered.

Research shows that telerehabilitation is effective and comparable to conventional in-clinic care, yet telerehabilitation hasn’t yet entered the mainstream when it comes to the workers’ comp industry. During this transitional phase, as telerehabilitation gains steam as an accepted complement to traditional, in-clinic care, it is imperative that payers work with managed care organizations who focus on identifying the patients who can benefit most from virtual PT services.

As a part of this process, both the requirements for a successful telemedicine engagement and the motivators that will drive patients to see telerehab as a viable healthcare alternative need to be defined.

Prerequisites for Telerehab Success

Not every case can be appropriately treated through virtual services. Even if an injury is found to be appropriate for telerehabilitation, the patient must also have the technology required to remotely connect with their provider. For this reason, a managed care organization need to offer a data-driven screening program to identify ideal telerehab candidates and take into account the following:

Injury/Treatment Plan: Is telerehab clinically appropriate – and if so, when? The severity, nature of the injury and any complicating factors will be the first consideration of any screening program. Some treatment plans will not translate well to telepractice, such as monitored patient with unusual or heavy work demands; s/he may need specialized equipment or in-person supervision. In other instances, in-clinic PT sessions can be supplemented with valuable remote offerings including online education, virtual home exercise supervision and online discharge planning appointments, to create a hybrid treatment plan.

Technology Access: At a minimum, telerehab patients will need a computer, smartphone or other device that is compatible with the HIPAA secure telehealth software. The device must be connected to the internet, either through a dependable wireless or wired connection, or a mobile network. Most telerehab treatment plans necessitate the use of a microphone and camera, which are built-in to most computers and mobile devices but can be purchased as external hardware if needed. Speeds of 15Mbps download and 5Mbps upload are best to ensure a smooth video streaming experience.

Reasons Patients Say ‘Yes’ to Telehealth

Although many patients may meet the requirements outlined above, not all will be interested in using telerehabilitation services. There are many reasons that patients might feel motivated to engage with their provider in a virtual fashion. Here are some of the more common drivers of enthusiastic telerehab adopters:

Location
: Healthcare services in rural areas have taken a hit in recent years. According to the National Rural Health Association, 75 rural hospitals have closed and 673 more are in danger of closing. The shortage of clinicians working in remote areas and absence of specialty services like physical therapy often means increased travel times for rural patients. Telerehab services offer these patients a fast and convenient option to get the care they need. In a 2012 report by the Institute of Medicine for the National Academies, it was found that telehealth increases quality of care and reduces costs in rural communities.

Demographic: While interest in technology cannot be dictated strictly by age, conventional wisdom would tell us that telehealth may find more traction among younger patients. After all, research has shown that millennials are 5 times more likely to adopt technology than any other age group. And in a recent survey, 71% of millennial patients indicated they would like to engage with their provider via a mobile app. While younger patients may be more eager to adopt telerehab, older patients should not be excluded from such services. Although little research has been done within virtual PT for workers’ comp, high patient satisfaction among older adults has been reported for telerehab services in home health applications after stroke, fall, etc.

Lifestyle: For some patients, the appeal of telehealth really boils down to convenience. In the workers’ comp arena, convenience may have added weight for frequent business travelers who find it difficult to establish a consistent schedule at a physical “home base” provider or others who have family obligations that make it more difficult to travel to appointments. A survey conducted by the American Telemedicine Association found convenience to be the top motivator for active healthcare users interested in complementing or replacing their in-person care with telehealth services.

Conclusion

Be it the severity of injury, a complex treatment plan or a lack of technology, there will always be instances when telehealth is not a suitable solution. However, in many cases, it represents a more direct route to recovery. As the practice of telerehabilitation becomes more prevalent, buy-in from injured workers and their employers will only increase. Now is the time for payers to establish a standard of care and a foundation of interest as we anticipate increased user growth, advancing technologies and expanded clinical capabilities in the years to come.