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Telehealth Sees Success in Therapy

Physical and cognitive therapy programs are using telehealth to connect with patients at home - and demonstrating positive results.

- Telehealth-based therapy programs for stroke survivors have helped increase cognitive and language skills and enabled patients to receive therapy five times more often, according to one company.

The survey of more than 20 million therapy sessions by Boston-based Constant Therapy is in line with reports from mHealth advocates who say home-based physical and cognitive therapy programs can improve outcomes and frequency. The platform is now being considered for everything from post-discharge, remote patient monitoring and PT programs to Veterans Administration programs that help veterans with physical and emotional issues.

Keith Cooper, Constant Therapy’s CEO, says mHealth platforms take advantage of online capabilities and big data analytics engines to custom-design therapy programs. As the patient goes through each therapy session at home, via a tablet, data gathered from the session is used to measure success, and to adjust the next session accordingly.

“Combining big data and mobile technology allows us to collect more and better data throughout the rehabilitation process than was ever possible before,” Cooper said in a press release. “The more data we collect, the better our algorithms become and the more we can recommend and deliver precision medicine. It’s really the dream of personalized healthcare.”

According to Cooper, in analyzing more than 20,000 sessions on Constant Therapy’s NeuroPerformance Engine, the company saw a 15 percent improvement in language and cognitive exercises among patient with severe disabilities who completed 100 exercises; that improvement jumped to 40 percent after 500 exercises. Processing speed in language and cognitive exercises, meanwhile, improved by 20 percent after 100 exercises and a whopping 80 percent after 500 exercises.

Overall, Cooper said, stroke survivors using the mHealth platform received five times more therapy than those who travelled to a clinic or their therapist’s office.

The online therapy and rehabilitation space is filled with mHealth and telehealth companies offering innovative platforms for patients wanting to work out at home. Some make use of gaming technology to boost engagement, while others add in videoconferencing so that the provider can collaborate with the patient and modify sessions (that platform is especially appealing to those with mobility issues and parents with children needing treatment). The primary barrier to provider acceptance, however, is reimbursement.

That may be changing, albeit slowly.

Last November, The Centers for Medicare & Medicaid Services unveiled a new Comprehensive Care for Joint Replacement (CJR) model, enabling bundled payment programs for knee and hip replacements to include telehealth-based rehabilitation as part of the post-discharge routine.  Many saw this as a good step toward improved CMS reimbursement for home-based physical therapy.

Buoyed by that announcement, the American Telemedicine Association lobbied CMS earlier this year to provide more CPT codes for reimbursement.

“(A)dvances in rehabilitation care have been made in the recent decade by relying on using telehealth technologies that include measuring for and generating wheelchair prescriptions; neurological assessments; adaptive equipment prescriptions and home modifications; ergonomic assessments; functional exercise programs; activities of daily living (ADLs) skills training; self-care training; caregiving support; adjustment and clinical support of prosthetic devices; school-based services, including handwriting performance; early intervention (IDEA Part C services); health and wellness programming; and rehabilitation for individuals who have experiences stroke, breast cancer, traumatic brain injury, polytrauma, Parkinson’s disease, and other neurological and orthopedic disorders,” ATA officials said in a letter to CMS.

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