MedCity Influencers, Patient Engagement

Unlocking digital MSK for providers

Recent advances in technology have created an opportunity for traditional providers to overcome these hurdles and deliver virtual PT in a way that is convenient for both patients and frontline clinicians and has a high degree of clinical integrity.

The adoption of digital health tools, including synchronous and asynchronous treatment options, has exploded during the Covid-19 pandemic, growing at a faster rate and reaching more patients than ever before. This shift is driven by a rise in current consumer demand for digital care during Covid—a trend expected to continue post-Covid. As lockdowns, social distancing, and other pandemic-related mandates limited in-person options, consumers looked for ways to engage their care team and track and maintain their health remotely.

Even as lockdowns have lifted and the world opens up again in this next phase of the pandemic, consumer demand for digital healthcare remains elevated, with a 38X increase in telehealth use since pre-Covid baseline, according to research from McKinsey & Co. Further, 76% of individuals surveyed during the pandemic indicate interest in using digital healthcare in the future. This demand is not exclusive to younger populations. Medicare members are also demanding home-based digital health solutions, with 52% of Medicare beneficiaries having received some sort of virtual care between March and December of 2020.

While this upward trend in digital health use has been growing for years, even before the pandemic, it was always somewhat constrained by the lack of adoption by traditional brick and mortar providers and health systems. However, that mindset has shifted over the course of the pandemic. Today, many providers view digital health as a core component of their long term strategy to deliver the best care for patients. Moving forward, those providers who can harness the power of digital health stand to move quickly ahead.

These broader trends are also playing out in musculoskeletal health and physical therapy. According to the American Physical Therapy Association, “Prior to the pandemic, telehealth was the exception to the rule in physical therapy. Once the pandemic began changing behaviors, the number of PTs providing video consults significantly increased, as did the volume of patients who received video consults.” Physical therapists saw a drastic increase: from 2% providing video consultations before the pandemic to 50% providing virtual consults during Covid-19. Of those PTs delivering care virtually, 51% saw between 1 and 5 patients per week, 17% saw 6 to 10 patients per week, and 17% saw more than 10 patients.

Challenges of musculoskeletal care

Despite this growing adoption of virtual PT during Covid, patient access to appropriate musculoskeletal (MSK) care when and where they want it is still a challenge. The cost of musculoskeletal disease in the U.S. continues to outpace all other conditions, representing $400-600B in annual spend (10-15% of total health expenditures). However, many patients still experience suboptimal care throughout their MSK journey, including unnecessary interventions (e.g., opioid prescription, injections, surgery) and poor outcomes (e.g., limited clinical improvement, surgical complications).

One of the driving forces behind the high cost and variable quality of MSK care today is limited access and poor adherence to physical therapy. Typically, only 20% of all people who need outpatient PT receive it, and only 30% of people who start PT finish treatment. Challenges contributing to this trend include geographic limitations (‘PT deserts’), limited PT clinic hours, high co-pays and poor at-home adherence to prescribed PT exercises.

Digital MSK can tackle access and adoption issues

Digital MSK solutions represent a significant opportunity to add value throughout the MSK care journey. In particular, increased adoption of virtual PT can offer an affordable, accessible treatment option across a range of clinical conditions and patient populations.

Yet some hurdles remain for traditional providers to effectively deliver virtual PT at scale:

  • Lack of technology solutions which are easy to use and integrated with providers’ clinical workflows – 21% of PTs cite this as the primary hurdle to offer virtual care
  • Limited ability of clinicians to monitor at-home adherence after in-person treatment
  • Affordability challenges of current solutions which make it difficult for providers to deploy at scale
  • Slow evolution of the industry beyond traditional fee-for-service payment models that historically incentivize in-person care

These challenges underscore why many virtual PT solutions today are not being delivered by a patient’s preferred provider, but rather by clinicians outside of their broader health care ecosystem. This is despite the fact that many patients would prefer receiving virtual PT care as part of their ongoing relationship with a broader MSK care team, so they can schedule in-person, virtual, or remote asynchronous visits at the time and place most convenient for them—without interrupting their existing provider relationships or overall MSK care journey. Importantly, recent advances in technology have created an opportunity for traditional providers to overcome these hurdles and deliver virtual PT in a way that is convenient for both patients and frontline clinicians and has a high degree of clinical integrity.

A new standard of care

For virtual PT solutions to reach their true potential, the next evolution must enable a hybrid, integrated care model powered by patients’ preferred providers that combines the best of in-person and virtual touchpoints.

Digital MSK companies must deliver on several critical elements to be a value-add partner in defining this new standard of care:

Access Personalization Accuracy Continuity
Care delivered anytime, anywhere so patients have ubiquitous access to their digital health solutions Platform that enables real-time clinical guidance from providers through personalized care plans Advanced technology which can objectively track and quantify movement for clinical use Connection of digital health tools with EMRs and other devices to deliver integrated, provider-led care


Health systems and providers can benefit from integrating digital solutions that enable MSK patients to experience seamless, uninterrupted care across their journey, driving stronger adherence and outcomes and fostering lifelong patient-provider relationships. Such solutions hold the transformative potential to remove barriers for patients and empower a lifetime of MSK health for all.


Ryan Eder is Founder and CEO of IncludeHealth. Ryan has a passion for fusing technology with design to lower barriers to care - he launched IncludeHealth to empower all people to achieve a lifetime of musculoskeletal health and wellness. Ryan is an innovator and designer by trade. Prior to founding IncludeHealth, Ryan spent 15 years designing products and experiences across the healthcare (e.g., Ethicon, Stryker) and sporting goods (e.g., Nike, TaylorMade) industries. Ryan has received over 40 national and international innovation and design awards, including winning Gold and Best in Show (twice) in IDSA's International Design Excellence Awards. Ryan lives in Columbus, Ohio with his wife Alexia and two children Camryn and Parker.

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