MedCity Influencers, Health Tech

Future-proof the health of rehab therapy with hybrid care

Technology exists today that enables patients to simply use a smartphone to do their physical therapy exercises and get recommendations from their provider based on objective and subjective data.

The pandemic has ushered in the dawn of the hyper-connected consumer in nearly every industry, including healthcare.

Pre-pandemic data shows that most patient care was being delivered in-person, with telehealth making up less than 10% of all visits. This was largely for three reasons: 1) payment systems and processes didn’t support virtual care; 2) both patients and providers didn’t feel the need to change; and 3) there was a misguided perception that virtual care is subpar to in-person care.

The pandemic clearly swung the pendulum the other way. Post-spring 2020, about 90% of patient care was conducted virtually out of necessity. Stalled digital transformation initiatives suddenly sprinted to the finish as providers were forced to create virtual platforms in a matter of months, not years. Insurance regulations loosened, facilitating reimbursement equal to in-person visits. Relaxed security requirements also enabled providers to move more quickly.

And then came a surprise. While many slogged through remote school and work hoping for a near-term end in sight, it turned out that the majority of patients actually enjoyed virtual care due to its accessibility and convenience. For many providers, it was still challenging to shift practice models and figure out how to do things virtually.

And then, as the pandemic became something to live with, patient sentiment changed again. Patients began balking at paying the same costs for a virtual exam as an in-person one. There was also concern about things being missed or overlooked virtually when they would have been noticed with an in-person visit.

The highs of hybrid care at a low time

Similar to the working world, the end result was that more patients began clamoring for hybrid options. It’s easy to see why. A virtual visit decreases the stresses of having to take off work or arrange for child care. Perhaps surprisingly, telehealth often allows doctors to better connect with their patients than in-person due to the sustained eye contact that can be maintained on-screen. It’s also more private. It, quite literally, allows healthcare professionals to meet their patients where they are.

There’s even proof that incorporating telemedicine can produce outcomes equal to in-person care. One study comparing telemedicine and in-person clinics found comparable outcomes for diabetes, hypertension and kidney disease. Telemedicine patients also reported being very satisfied with their care. A study from Cigna’s telehealth arm MDLive also found that patients who engaged in telehealth saw 19% fewer visits to the ER or urgent care.

And yet, only 47% of physical therapy clinics offer telehealth services based on recent survey results from WebPT. Clinics that have yet to begin offering hybrid options face not only patient satisfaction but also negative consequences among their therapist base due to a convergence of macro forces, such as a tight labor market, tremendous burnout among physical therapists, and the worst inflation in 40 years.

It’s expected that the industry will need over 15,000 new physical therapists each year, and in spite of thousands joining the field the industry still can’t meet demand. Many of the newer grads—the same Gen Z and millennial consumers driving the rapid acceleration to digital in all aspects of life and work—are hungry for a virtual care practice environment because of the improved access to care, the convenience of a remote work model and the clinical evidence supporting the effectiveness of virtual physical therapy. One therapist can see more patients virtually than they can in-person, achieving a one-to-many model. Virtual also lets you increase access to care; consider the patient who might struggle to afford bus fare or face long travel times to get to a clinic in-person.

Then, there’s the revenue-generation factor. In January, the Centers for Medicare & Medicaid Services released a group of new reimbursement codes that allow providers to bill payers using Remote Therapeutic Monitoring codes, or RTM, for digital musculoskeletal services related to technology that measures patient adherence to therapy and therapy response. Since more digital services are reimbursable, RTM codes provide incentives for therapists to give care at home, opening up new revenue streams.

Putting it all into practice

There is no rewinding the clock. Even if spawned by crisis, telehealth is now critical to the survival of the physical therapy industry. Because patients, like consumers, simply want more choice. They may go to a clinic in-person one month, and want virtual care the next. It’s up to physical therapists to give their patients this flexibility. If you try to revert back to the old models, you will fail. Instead, you have to find a robust partner that can help you build a new, future-proof model.

Technology exists today that enables patients to simply use a smartphone to do their physical therapy exercises and get recommendations from their provider based on objective and subjective data. Smartphone sensor technology helps therapists monitor how patients are doing with real-world exercises and share meaningful information that helps them stick to their treatment plan. Intuitive platforms let providers easily generate progress reports about any patient.

So much of our healthcare market is reactive, but with the right technology and partnerships, we can drive the entire clinical model upstream so that we move into prevention, not crisis, mode.

Photo: Liubomyr Vorona, Getty Images


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Patrick Tarnowski

As OneStep’s Chief Commercial Officer, Pat is accountable for the company’s US market entry through strategic provider partnerships. His deep healthcare experience as a leader in health plans, health systems, medical devices, startups and digital care delivery support and enable OneStep’s growth and scale. As an entrepreneur, Pat has successfully launched and scaled care delivery companies, digital solutions that focused on health and wellbeing, disease management and virtual care and worked with providers to achieve success in value-based payment models. He received his degree in physical therapy from Boston University and his master’s in business administration from the University of St. Thomas. He has been the principal investigator in numerous clinical studies and is the Vice President of Professional Practice of the Minnesota Chapter of the American Physical Therapy Association’s and the Minnesota Cancer Alliance Steering Committee.

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