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COVID-19 Serves as Catalyst for Telerehab Adoption

2 months ago

COVID-19 Serves as Catalyst for Telerehab Adoption

By Michelle Despres, PT, CEAS II, CETS, National Clinical Leader, One Call 

SITUATION PRIOR TO COVID-19 

Poor perception of telerehab services and technology barriers result in lack-of-use.

Prior to COVID-19, there was a perception within the industry that telerehab was inferior to traditional in-person physical therapy (PT). As a result, many injured workers relied heavily on brick-and-mortar facilities for treatment of common workplace injuries, such as those affecting the back, shoulders and knees.   

Although the technology has been available for nearly five years, telerehab was not widely offered by adjusters –representing less than one percent of total PT referrals.1 In conjunction, injured workers were hesitant to participate in telerehab due to a perceived notion that the technology would be difficult to use and the treatment would be less effective. 

NECESSITY IS THE MOTHER OF INVENTION 
COVID-19 pushes telerehab forward 

In February 2020, the Centers for Disease Control and Prevention (CDC) began issuing warnings to healthcare professionals about the impending threat of COVID-19. Non-emergency medical surgeries were cancelled, and in-person appointments were shifted to telehealth services to keep patients’ recovery moving forward. 

Although One Call’s telerehab program began in 2017, it had not achieved wide adoption. Everything changed with the onset of COVID-19. Since telerehab technology was available and accessible, One Call seamlessly converted thousands of traditional in-clinic physical therapy appointments to telerehab and increased its network of telerehab providers more than x10 to 7,500.2 As a result, One Call experienced a 650% increase in telerehab referrals, including an 8% increase in referrals from adjusters and nurse case managers specifically requesting physical therapy to be delivered virtually.3  

As a result of strategic communication and support from customers, One Call’s successful transition included: 

  • Reduced stress and anxiety levels for injured workers in need of treatment.
  • A better understanding from customers, providers and injured workers of the benefits of virtual engagement, including convenience, efficiency, injured workers participation in their own care, and cost savings, to name a few. 
  • Addition of a blended model, allowing injured workers that were actively being treated at a brick-and-mortar clinic to stay with their provider and transition to telerehab.
  • A newly developed SMS initiative to remind injured workers about upcoming appointments and allow for easy confirmation or rescheduling if necessary. 
    • Through this effort alone, One Call received a nearly 50 percent response rate and of those, confirmed more than 88 percent of appointments.4

REALITY REVEALED 
Perceptions changed

Five percent of the population used some form of telehealth during the COVID-19 pandemic. This translates to approximately 16.5 million new users and 88% said they would it use again.5 For injured workers, this pivot in treatment meant they had the opportunity to continue therapy virtually, resulting in increased range of motion, strength, function, symptom control and improved return-to-work outcomes.  

As perceptions change, injured workers are finally reaping the benefits of virtual physical therapy. The signature benefit is convenience. Injured workers can meet with their physical therapist anywhere – from the comfort of their home or during a break at work, if approved to return-to-work. With extended hours of operation, an injured worker can participate in therapy when convenient for them. For those living in remote or rural areas, telerehab is a wonderful alternative to reduce and/or eliminate travel time for treatment. 

The aging workforce, defined as those 55 and older, represented 35% of recent telerehab adopters.6 As we continue to learn the characteristics for ideal candidates of virtual care delivery, it is clear that this concept is both embraced by and delivers exceptional return-to-work outcomes for this workforce population. 

Another benefit is the opportunity for an injured worker to better understand their own muscle composition and strength. Therapists are working one-on-one with the injured worker, but because a therapist isn’t physically present to touch and move a patient, an injured worker stays more engaged during sessions and is empowered to take an active role in their recovery. 

To summarize, telerehab has become an accepted alternative to brick-and-mortar physical therapy, delivering high injured worker satisfaction and proven outcomes. Of note: 

  • Satisfaction: Patient satisfaction with telerehab averages five out of five stars. 
  • Compliance: Discharge due to patient noncompliance was 84% lower for telerehab versus traditional brick-and-mortar facilities.
  • Cost avoidance: On average, injured workers receiving telerehab attended 46% fewer visits than unmanaged cases, representing an average cost avoidance of $838 per referral. 7 

SUCCESSFUL OUTCOMES
Patient Experiences

Due to its many benefits, telerehab can help injured workers recover faster, thus saving customers money. Below are three success stories from injured workers following a telerehab referral, serviced by One Call’s exclusive partner Virtual Physical Therapists. 

Bilateral Ankle Surgery

After twisting their ankle on the steps of their workplace, an injured worker underwent bilateral ankle surgery and was prescribed physical therapy. Due to COVID-19, telerehab was assigned instead of an outpatient clinic. The injured worker loved the one-on-one support received from their physical therapist and now prefers telerehab to a traditional brick-and-mortar experience. 

Clavicle Fracture and Bilingual Translation Services

An injured worker with a labor-intensive job as a construction worker, suffered a triple clavicle fracture. English was not their primary language,* so they were assigned a Spanish-speaking physical therapist to complete telerehab. Following treatment, the injured worker had full range of motion, even seeing significant improvement to two non-injury related ailments. The injured worker credits telerehab with helping them heal and igniting confidence to return-to-work. 

*Nearly sixty-seven million U.S. residents’ speak a language other than English at home.8 When viewed through the lens of healthcare, this can lead to a communication breakdown that causes inefficient or improper patient care. In the case of the workers’ compensation industry, it can lead to delays in recovery and return-to-work, resulting in higher claim costs.

Rotator Cuff Injury, Cancelled Surgery 

Rotator cuff surgery* was scheduled for an injured worker until COVID-19 forced it to be postponed. Worried that the injury could get worse, doctors prescribed telerehab to reduce inflammation and scar tissue growth until surgery could be rescheduled. The injured worker underwent seven telerehab appointments to reestablish full range of motion, strength and function conservatively. In the end, the injured worker was able to cancel their surgery, eliminating prolonged recovery time and thousands of dollars in medical expenses. As a bonus, the therapist was able to introduce simple neck exercises that helped relieve carpel tunnel symptoms. 

*Recovery from a rotator cuff surgery can range 4-6 months. For 70-80% of patients who experience a chronic shoulder tear, like a rotator cuff injury, physical therapy can completely restore range of motion without undergoing surgery. With One Call’s oversight and telerehab services, injured workers attended 65% fewer visits than the Official Disability Guidelines (ODG), representing an average cost avoidance of $1,154 in comparison to unmanaged cases.9 

THE FUTURE OF TELEREHAB 
A long-term solution 

Telerehab will not replace brick-and-mortar facilities for all physical therapy treatments. However, COVID-19 did serve as a catalyst to garner acceptance of telerehab from the workers’ compensation industry and injured workers alike, showcasing it as an equivalent treatment to consider based on injury type, return-to-work timeframes, and travel limitations for the injured worker. 

Capacity is also not an issue. Many providers easily transitioned to virtual care during COVID-19, and this capability will remain moving forward – even offering hybrid solutions to meet with patients inside or outside the office based on scheduling needs. For example, One Call’s fully virtual solution can treat 1,200 patients per day in addition to 26% of its brick-and-mortar network now offering telerehab services. 

Telerehab is just one solution offered by One Call to meet the needs of injured workers in a post-COVID environment. 

For more information, contact Michelle Despres, Vice President, Business Development, National Clinical Leader at michelle_despress@onecallcm.com 

 

Watch a demonstration of a telerehab appointment 

 

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Sources: 

  1. One Call national data based on prospective referrals received from adjusters and nurse case managers in 2020. 
  2. Wunker, S. (2020, June 16) How to Make the Coronavirus-Led Growth of Telehealth into an Investment Thesis. Forbes. https://www.forbes.com/sites/stephenwunker/2020/06/16/how-to-make-the-coronavirus-led-growth-of-telehealth-into-an-investment-thesis/#326322c74c8b 
  3. One Call national data based on prospective referrals received from adjusters and nurse case managers in 2020. 
  4. One Call national data based on response for transportation and language services in 2020
  5. PWC. The COVID-19 pandemic is influencing consumer health behavior. Are the changes here to stay? https://www.pwc.com/us/en/library/covid-19/covid-19-consumer-behavior.html#content-free-1-fe80 
  6. One Call national data based on prospective PT telerehab referrals successfully discharged from therapy in 2020. 
  7. One Call national data based on prospective PT telerehab referrals successfully discharged from therapy in 2020. 
  8. Camarota, S.A. & Zeigler, K. (2018, September 19). Almost Half speak a Foreign Language in America’s Largest Cities. Centers for Immigration Studies. https://cis.org/Report/Almost-Half-Speak-Foreign-Language-Americas-Largest-Cities 
  9. One Call national data based on prospective PT telerehab referrals with rotator cuff tear who were successfully discharged from therapy in 2020. 

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