It’s no surprise that the COVID-19 public health emergency (PHE) kicked innovation and out-of-the-box thinking into high gear. In particular, one area we’ve seen a lot of interest and efforts is the implementation and adoption of telerehabilitation (TR) care by therapists during every day clinical practice. Rehabilitation providers continue searching for ways to enhance better patient treatment outcomes while simultaneously meeting the unique demands brought on by the PHE.
And with all of the potential benefits that come with telerehabilitation solutions like convenience, cost-savings, and greater efficiencies, it’s no surprise TR makes the shortlist as a viable care model used in conjunction with or in replacement of the traditional in-person clinic visit.
But is TR really all it’s cracked up to be? Are there things we should be considering before investing in this new set of tools?
The answer is a resounding yes, there are always things we should consider before making any changes to how we meet the needs of patients. One of the chief concerns, and one of several aims examined in a recent data study, is how satisfied patients are with their treatment results when TR was used during their episode of care compared to in-person clinic visits alone.
Let’s take a look at the details of this study and what this could mean for PT providers.
The Details of the Study
Published in the July 2021 issue of the Physical Therapy Journal, researcher Mark W. Werneke, PT, MS, Dip.MDT and his team looked at the impact of telerehab in the outpatient rehabilitation setting during the Covid-19 PHE. The study, as described by Werneke in a recent APTA podcast was a retrospective look at over 220,000 episodes of care where TR was or was not used. Data was drawn from the FOTO Patient Outcomes (FOTO) database, the industry leader in outcomes management systems with a very large national sample including all 50 US states of nearly 10 million completed rehabilitation episodes of care.
While the study examined many aspects of TR, we want to look specifically at patient satisfaction. Patients were asked at the completion of the episode, “How satisfied were you with overall results of your treatment at this facility?”
Here are the findings:
There was a small but noticeable 3.4% difference in patients who were ‘Very Satisfied’ with the higher level of satisfaction going to those not receiving TR during their episode of care. However, while this finding is certainly something worth considering, it’s important not to over-interpret these results for a couple of important reasons.
- Satisfaction results between patients receiving and not receiving TR were not risk adjusted. Therefore, the satisfaction differences observed could be explained by many other confounding factors not related to the patient’s satisfaction with treatment but more to do with the patient’s restrictions due to the PHE.
- When you include the percentage of patients that were ‘Very Satisfied’ and ‘Somewhat Satisfied’, the difference between TR (86.2%) and No-TR (87.9%) is marginal and clinically unimportant.
- When you consider the percentage of patients that were Very Dissatisfied or “Somewhat dissatisfied” between TR (0.6%) and No-TR (0.4%), the difference is nearly identical. Low TR dissatisfaction rates provides promising evidence supporting TR use during routine clinical practice.
- Note that dissatisfaction rates are nearly identical. This could me more promising evidence for the efficacy of telehealth.
Considerations for PTs Thinking About Implementing Telerehab
For many providers, these encouraging satisfaction results imply that TR is a viable alternative care model compared to in-person care not only during the current PHE but also in the post-PHE era. If you’re considering utilizing TR in your practice, here are a few helpful hints to consider:
- Understand that TR may not be for every patient. It may be important to discern during the initial evaluation whether or not a patient is a potential candidate for treatment using TR. For instance, a patient’s lack of knowledge and comfortability with technology as well as limited broadband internet access may identify patients who may not benefit from TR treatments.
- During the initial evaluation, educate the patient on the effectiveness and benefits of TR technology by explaining how TR works and how TR can facilitate better outcomes for the patient. Using posters, video examples, or other educational materials to demonstrate the benefits of TR could be an ideal way to communicate with the patient.
- Understand and share some of the unique benefits of TR with the patient. For example, TR could help reduce travel time, resolve scheduling conflicts, overcome mobility concerns, and enhance convenience. In addition, TR offers unique treatment advantages which allows the therapist to see the patient exercising and performing their usual physical activities in their home instead of trying to replicate these activities during the office visit.
- Realize that telehealth doesn’t need to be an all-or-none endeavor. Data shows the benefits of TR are present at all levels of implementation and does not require that 100% of visits use TR to enhance outcomes.
Learn More Now
As you can see, FOTO, the data source and outcome management software behind the study, is an incredibly effective tool for managing patient expectations and outcomes, which can not only be effective for data researchers but for PT providers on the local level. The services FOTO brings to the table can help you finetune the entire patient process (by seeing what is and what isn’t working), drive higher patient buy-in (by using real data to set realistic expectations), and ultimately deliver a stronger bottom line and better patient outcomes.
If you’d like to learn more about what FOTO might be able to do for you, we’d encourage you to take a moment and learn more about the full list of capabilities today.
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