- Healthcare providers are turning to telehealth to bridge the gap between primary care and health and wellness.
In many cases, solo doctors and small clinics are partnering with local physical therapists. Patients are referred to a PT clinic after a visit to the doctor, then are introduced to a home-based exercise program that connects digitally to the PT clinic and sends data back to the doctor.
“Exercise if the fifth vital sign,” says Scott Lutch, MD, a Milton, Mass.-based cardiologist and member of the Beth Israel Deaconess health system. “But we can’t really measure it [in the doctor’s office or clinic], so we have to find new vehicles to reach patients.”
To get his patients interested in physical therapy, Lutch turned to TrainerMD, a Braintree, Mass.-based startup that has introduced body-scanning technology and wearables to the mix. Lutch is one of roughly 50 doctors who refers patients to TrainerMD. Those patients undergo a digital health assessment that is used to tailor a home-based program that tracks physiological data through Jabra Sport Pulse wireless earbuds.
“Doctors don’t have the time or training for this,” says Joe Hawley, TrainerMD’s founder and CEO, who sees his company as “filling in the gaps” between the hospital and the gym. “We’re educations the doctors and the patients at the same time, giving [patients] health intelligence they don’t normally get from their doctors” and giving those doctors a link to home-based physical therapy that fits into their remote monitoring plans.
The idea of doctors using telehealth to connect with physical therapists isn’t just to help patients reduce their waistlines.
With the shift in the healthcare landscape to value-based care, accountable care networks and bundled payments, providers are using telehealth to extend the care management arc into the home. They’re developing plans that monitor patients after they’ve been discharged from the hospital and making sure patients meet activity requirements – fitness goals that are written for everyone from heart failure and COPD patients to those recovering from surgery.
Last November, with The Centers for Medicare & Medicaid Services touting the success of a bundled payment model for knee and hip replacement surgeries, Duke University’s Clinical Research Institute launched a study to determine whether patients could benefit from a telehealth-based PT platform post-surgery.
“Physical therapy is often a critical component of care for patients who have TKR (total knee replacement) surgery,” Janet Prvu Bettger, ScD, an associate professor with the Duke Department of Orthopaedic Surgery and principal investigator for the study, said in a press release announcing the study. “Digital health technology, including virtual and telehealth options, may increase access, improve quality and lower healthcare costs.”
The Duke study is using the VERA virtual exercise rehabilitation platform designed by San Diego-based Reflexion Health. In a blog at the time the study was announced, Reflexion Health’s Ben Torres said much of the cost variability in joint replacement surgery comes during post-acute care – and that’s where telehealth can make the biggest impact.
“(P)hysicians will look to develop strategic partnerships with ‘preferred providers’ who will be able to optimize both clinical outcomes and healthcare costs,” he wrote. “These ideal providers will likely be those who have been able to leverage certain remote monitoring and tele-rehabilitation technologies and have been able to transition to value based care models. Post-acute care facilities that have implemented these new practices could be very attractive to physicians, who will be having an even greater influence on how post-acute care is delivered.”
At TrainerMD, Hawley says doctors are referring their patients to him for everything from obesity to cancer and diabetes. He has a half-dozen pilots planed as well with physician groups and practices, and is looking to create more programs that bridge primary care and wellness.
He expects healthcare providers will be paying a lot more attention to the PT field as they look to make value-based care a standard of care.
“With 400,000 trainers in the U.S., we can be right in the middle,” he says. “Personally, I like being in the middle. There’s a lot of red tape in healthcare.”