Telehealth PT | A Hybrid World Lies Ahead
Telehealth in physical therapy (PT) has been on an upward trajectory during the pandemic and beyond. A pilot study conducted by Intermountain Healthcare found that telehealth could potentially replace in-person visits for post-operative physical therapy. The VA Phoenix Medical Center launched a new telehealth physical therapy (PT) clinic as part of Veterans? post-op care plans after total knee replacements.
Going MainstreamIn the broader healthcare space, the adoption of telehealth has been more dramatic, per an article by McKinsey. As stated in this article, telehealth utilization has stabilized at a level 38x higher than what it was pre-pandemic. In April 2020, over 32% of office and outpatient visits were happening via telehealth. Since then, utilization levels have stabilized at about 13% to 17% across specialties. Coming back to PT, telehealth is emerging as a widely accepted solution for patients for whom getting to an in-person physical therapy session would be a challenge. It also helps therapists provide valuable guidance to patients to be able to continue therapy at home. For a physical therapy clinic, offering both telehealth and in-person sessions provides a complete solution for all patients. There is no denying the fact that manual therapy would continue to be vital. But telehealth could help reduce the dependence that some patients have on their manual therapy routines and make them more independent. This blog refers to telehealth delivered as live video in a synchronous format with live, real-time interaction between the therapist and the patient. There is also the option of delivering text and pictures through the patient portal or a two-way messaging system, but that is not in the scope of this post.
Making It HappenThe next step would be to make sure that the telehealth PT software is set up right:
- A telehealth platform that is seamlessly integrated with the EMR and Practice Management system would be the way to go.
- We would need the telehealth platform and EMR/Practice Management to smoothly work in concert for scheduling, conducting, documenting, and billing telehealth appointments.
- That should ensure that the entire workflow happens in one system all the way from the initial patient appointment to getting paid.
- Ensure that the facility has the correct time zone established.
- Code payer rules for telehealth into the software.
- Establish automated invitations and reminders for telehealth appointments.
- Messages would typically be sent using both email and SMS channels.
- Embed the meeting URL into telehealth templates used in the platform.
- Get the telehealth appointment on the calendar, marking it as telehealth.
- Ensure controls are in place that only permit patients from joining the meeting at their pre-determined times.
- If necessary, resend the invitation to the patient via SMS or email.
- Start the telehealth session, an action performed by the therapist.
- Ensure that the clinical documentation (SOAP notes / flowsheet) is readily accessible for making updates while in session.
- Document the telehealth meeting to meet coding/billing requirements and conduct the video meeting.
- Track when the meeting starts and ends to meet payer billing requirements.
- Ensure use of a timer to prevent the telehealth meeting from running over time.
- Generate charges from the flowsheet or from SOAP notes with appropriate modifiers and codes.
- Apply telehealth billing settings for the appointment or date of service marked as telehealth.
- Then on, the process of sending claims and getting ERAs/EOBs back should be identical to in-person sessions.
- Set target KPIs and metrics to measure outcomes. Track if goals are being met with notifications for the therapist if targets are missed.
- Implement a dashboard with targets and achievements, analysis of progress, and therapy adherence.
The Next FrontierTechnology is moving to the next level with computer vision and AI (artificial intelligence) technologies entering the physical therapy realm.
- AI is being used to analyze movements and range of motion via video, generating near instantaneous and precise measurements.
- The idea is to learn from virtual interactions to reinforce approaches that are most effective for patient health.
- Our partner BlueJay is using algorithms to quantitatively assess videos in real time to measure range of motion and gather outcomes data.
- Analyzing outcome data and outcome scores can help modify exercise protocols and improve progress, establishing a virtuous cycle that can be immensely beneficial for patients and therapists alike.
- None other than Google has jumped into the fray with a solution for AI-driven image analysis and prescriptive care insights.