It got approved for reimbursement in 2021
It covers quite a range of services/products
It has many benefits for patients and providers
A definition was only proposed in 2020
Practitioners would like to use it more but need more formal training
Digital physical therapy is not a new phenomenon but it is one that is gaining popularity with patients and physical therapists alike.
Our Digital Diet
As a nation we spend an average of about 7 hours each day online, consuming digital content. We snap, we stream, we talk, we TikTok. Shopping, banking, even watching movies together but apart. Everything has gone digital.
The world was already heading towards increased digitalization, but the global pandemic really put the pedal to the metal and thrust us into a truly digital dimension.
Recent estimates report that US adults spent an average of 7 hours, 50 minutes (7:50) per day with digital content in the last year.
On top of all of that, the amount of time that we are spending with digital content is also increasing. 2024 Research has found that the '“typical” internet user spends almost 2½ hours each day using social media platforms, equating to more than one-third of our total online time. TikTok has the highest average time per user, but YouTube accounts for the greatest overall share of total social media time.' If companies like Google and Meta have their way we will soon be spending our entire day immersed in a virtual reality world like the Metaverse.
The Rise Of Telehealth
It should come as no surprise then that healthcare has followed suit. In October 2020 the CDC published a report on the trends of using telehealth during the Covid-19 pandemic.
The report compared trends in telehealth encounters during January–March 2020 (surveillance weeks 1–13) with encounters occurring during the same weeks in 2019. The results showed that during the first quarter of 2020, the number of telehealth visits increased by 50% compared with the same time period in 2019.
What's more, in week 13 they noted a 514% increase compared with that same period during 2019.
Across the board, everyone from large health systems to independent practitioners made the shift to telehealth in order to continue to provide essential healthcare services to patients during the pandemic, and physical therapy was no exception.
In 2022 around 38% of patients were receiving some form of virtual care and that number has continued to grow exponentially.
So What is Digital Physical Therapy And What Should We Know About It?
For some time now, the physical therapy industry has actually been carefully considering the digital technology available for their patients. On March 18, 2020, a white paper on Digital Physical Therapy was approved by the World Confederation For Physical Therapy.
The white paper was the result of thousands of interviews of physical therapists from around the world, and seeing what role technology played in the treatment of their patients.
The task force described the advantages and limitations, regulatory issues and recommendations for opportunities for using digital technology in physical therapy.
They also proposed a definition for digital physical therapy as there is currently no one agreed upon explanation for this term. The task force proposed a definition and purpose statement for digital PT.
Definition/ Purpose Of Digital Physical Therapy:
• Definition: Digital practice is a term used to describe health care services, support, and information provided remotely via digital communication and devices.
• Purpose: The purpose of digital physical therapy practice is to facilitate effective delivery of physical therapy services by improving access to care and information and managing health care resources.
Musculo-skeletal conditions are a big challenge for the US healthcare system and companies are jumping on board to offer up a variety of solutions to address this challenge.
So, what should we know about virtual physical therapy and how can it help those who suffer from conditions like low back pain?
5 Things To Know About Digital Physical Therapy
1. It got approved for reimbursement in 2021
The first thing to know, in our 5 things to know about digital physical therapy is that in the past, many providers kept telehealth options mostly for emergencies. It was challenging to bill for and equally difficult to get reimbursed for.
When the Covid-19 pandemic arrived, health insurance companies realized that telehealth services were the only way that many people would be able to continue to have access to care and so reimbursement for these services quickly became a priority.
While this shift was positively received by the healthcare community, many were left wondering if this benefit would disappear when the pandemic was over.
On April 30, 2020, the Centers for Medicare & Medicaid Services added physical therapy providers as eligible health care professionals who can furnish and bill for telehealth services in certain settings, retroactive to March 1, 2020, and through the duration of the COVID-19 emergency declaration.
Digital health definitely has its uses and benefits and many patients continue to need access to digital health services. Fortunately, reimbursement for these services also looks like it is here to stay.
2. It covers a range of services
So what exactly is involved with Digital Physical Therapy?
In the world of physical therapy, the digital part of the definition can actually be quite broad. Digital therapy can include things such as:
home exercise videos
online consultations
virtual reality sessions for balance exercises
heart rate monitors
text messaging
video assessments
What Digital PT Tools Are Patients Willing To Use?
Digital PT Companies On The Rise
Within this arena, companies such as Kaia Health, Reflexion Health, and Hinge Health have developed programs to help patients with their rehabilitation after musculo-skeletal surgeries or injuries.
These businesses have had great success with their programs and have helped to reduce the costs typically incurred by health insurance companies with these types of rehabilitation programs.
If you are fortunate enough to have an employer who has partnered with these companies then you might have access to these programs through your employment.
As technology advances there are sure to be new devices and programs to assist with the rehabilitation of patients in both clinic and home settings. Hopefully some of these programs will be more widely available to the public and not restricted to people who only work for certain companies.
3. DPT Has Many Benefits For Patients And Providers
Thanks to the nature of the technology, virtual PT has benefits for both patients and providers with both parties finding the technology beneficial for treatment.
Key Advantages Of Digital Physical Therapy:
Expands the ability to connect with PTs, regardless of distance
Reduces barriers to care like parking, waiting rooms and travel time/costs
Promotes independence for patients in managing their own condition - increased buy in from patients
Improves flexibility of appointments for patients
Reduces cancellations and no-shows for physical therapists
Helps patients continue their treatment at home and between sessions for faster and more effective recovery results
Decreases costs associated with travel, childcare, lost work time, assistance with getting to appointments.
Interestingly, the most commonly reported benefits of telehealth services were related to the patient experience.
58% of people interviewed about the benefits said that decreased travel was a huge benefit to them and 38% of physical therapists reported improved convenience for patients.
With the rise of digital technology and healthcare wearables, Forbes magazine believes that “in 2021 we’ll see telehealth continue to play a huge role for patients” with issues like hypertension, diabetes and heart disease.
Being able to track healthcare outcomes via a wearable medical device and then being able to send that data to the patient’s healthcare provider to access virtual continuous care will become more and more effective.
5. Practitioners like it but need more training
When it comes to digital health, many healthcare professionals are in favor of the technology but many also lack the training to understand how it can fit into their practice.
There are already so many different types of services and devices on the market that it can be overwhelming for practitioners to know which device (or program) to use for which customer or condition.
Medical schools have recognized that digital health training needs to be part of the core competencies for many healthcare professionals.
Unfortunately there is a serious lack of national digital practice education standards in countries around the world which makes it hard for schools to know what needs to be covered.
According to a study published in JMIR, providers are generally positive about remote therapy and tele-rehabilitation, but they want more training and support to overcome obstacles like technology hurdles and practical concerns.
"Although practitioners have rapidly adopted remote ways of working and viewed tele-rehabilitation positively overall, there are technical, practical and organizational obstacles to overcome to maximize the success of this approach,” researchers wrote. “There is a clear need for improved guidance and training, particularly surrounding physical and movement-oriented assessments.”
The study also found that 84% of practitioner respondents had used video-based consultations in their practices before and that the number of those digital consultations had grown significantly since the beginning of the COVID-19 pandemic. In contrast, prior to March 2020, only 13% of that group had used video-based tele-rehab.
Obstacles to Digital PT
While there are many benefits of digital physical therapy, it is important to recognize that there can also be obstacles to implementing this technology. Some of these obstacles include:
Lack of internet connection/service
Lack of confidence in using the technology
Lack of patient access to the technology.
Lack of technical skills
Lack of integration of electronic medical records
As digital solutions continue to enter the market, it is important for companies to keep these challenges in mind and innovate ways of overcoming these obstacles.
How Can Healthcare Providers Get The Digital Training They Want And Need?
Only 19% of healthcare practitioners who were surveyed said they had received any formal training on how to do remote rehab or video consultations. “We are expected to provide tele-rehabilitation without guidance or training – we are feeling our way in the dark.”
While medical schools are trying to tackle this challenge, a prime opportunity exists for the biotech companies who make these devices to educate healthcare providers on the correct use.
And while we know that many healthcare providers like physical therapists are extremely busy, making time to learn about these new digital offerings is essential to moving forward into a digital future.
The benefits of digital physical therapy can actually help to reduce their workload and improve patient outcomes.
Conclusions
Digital physical therapy is a great way for patients to connect with their physical therapists. While virtual PT won't be able to address all of the challenges it can address a number of issues that prevent people from getting the care that they need for conditions like lower back pain.
As companies start to develop new digital tools and wearables patients and providers will be able to choose from a new range of solutions that hopefully put the patient's health first.
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