Whenever I write a post for the WebPT Blog, I always start with a rough draft—and believe me, they’re usually very rough. Then, once I’ve gotten all my ideas onto the page, I go back through with a proverbial fine-tooth comb to make sure my post doesn’t sound like the vague ramblings of a madwoman. In some ways, I think many physical therapists can relate to this process—especially after the last three months. In March, we found ourselves faced with a global pandemic, which left many practices scrambling to implement a remote service option (i.e., telehealth) as quickly as possible. Now that the dust has settled somewhat, physical therapists have the chance to go back and clean that “rough draft” up—and to make telehealth a viable treatment option for years to come.
How should practices use telehealth post-COVID?
In response to the COVID-19 pandemic, physical therapists have become enlightened to the value of remote telehealth services during a time when social distancing and infection control are of the utmost importance. But, why should PTs continue using this service once the threat of infection has subsided? As Meredith Castin, DPT, writes in this blog post for The Non-Clinical PT, “We live in an on-demand society. People want what they want, when they want it. Even before COVID-19 began dominating our daily lives, people were changing how they approached life. Patients are trending toward wanting immediate care, and they don’t want to wait weeks for an appointment, especially if they only need exercise prescription and general education/guidance.”
Make physical therapy accessible.
It’s true: even before we knew about the coronavirus, on-demand, at-home services dominated our daily lives. Why wait in line at the grocery store when you can use a service that will do your shopping for you and deliver everything you need directly to your doorstep a couple hours later? Why go to the bank to deposit a check when you can do so right from your mobile device.
In the healthcare realm, virtual PT is especially valuable for individuals with limited mobility—like, say, post-surgery patients or individuals with physical disabilities or degenerative illnesses. But even if a physical therapy patient doesn’t have limited mobility, life can easily get in the way of his or her ability to attend physical therapy appointments in person—whether that’s a car breaking down or inclement weather making travel unsafe—and having telehealth as an option empowers patients to adhere to their treatment plans regardless of those challenges.
Alternatively, practices can offer a hybrid model where patients come into the clinic for on-site evaluations or progress updates while doing the bulk of their treatment sessions via telehealth. This offers a happy medium for patients who don’t always require hands-on treatment.
Who should receive telehealth services?
According to the APTA, “People of all ages and who have a variety of symptoms and medical conditions may be candidates for telehealth.” Some examples include patients undergoing treatment for:
- balance and dizziness,
- postoperative care,
- chronic pain,
- pelvic health,
- orthopedic conditions, and
- cancer rehabilitation.
This APTA resource also provides a variety of examples of outpatient PT practices that use telehealth for more than just social distancing.
What should practices do to adapt their current model?
Now, let’s shift the lens to your clinic. If you want to make telehealth a permanent fixture in your organization, here are six things you should do right now:
1. Gather feedback.
First, start by collecting feedback from individuals who have first-hand experience with your telehealth practices. This will give you a baseline for where your telehealth game is currently—and help you determine where it needs to be in the future.
Talk to your patients.
Patient feedback is perhaps the most valuable resource you have at your disposal when it comes to ensuring you always deliver top-notch services. If you haven’t already, send a satisfaction survey to every telehealth patient. Ideally, you should do this immediately after the patient’s appointment so that his or her experience is top of mind, and he or she can give you clear, detailed feedback. Be sure to ask patients what they liked about their appointment as well as how you can improve. This will give you valuable insight into how you can adjust your process to deliver an amazing patient experience.
Talk to your team.
Your staff can offer a lot of insight into the actual execution of telehealth services, so open the floor to them next. Specifically, ask them things like:
- Does the hardware/software meet their needs as providers?
- Do they feel their remote treatment sessions have been successful?
- Could the digital intake process be improved?
Talk to your peers.
There’s a pretty good chance you know at least one other provider who has implemented telehealth services in response to the pandemic. So, tap those network connections and ask them about their own experiences. They may have already found solutions to the same challenges you’re facing.
Talk to your payers.
Then, reach out to any insurance payers you’ve billed for telehealth in the past few months. Ask them to conduct a review of your claims and provide feedback on what you did right and where you could improve moving forward. Inquire as to whether their telehealth policies have changed—or may change in the future. This is a great way to refine your process while developing your relationships with your biggest carriers—and that will pay off big time later on down the road.
2. Collect outcomes.
I’m sure this goes without saying, but tracking outcomes data is important—like, really important. Not only does it help you assess the effectiveness of your treatments, but it also influences payment. (For example, check out this study Boston University conducted in conjunction with the APTA and OptumHealth.) This is a really big deal for newer treatment modalities (e.g., telehealth) in particular. One of the barriers that has prevented some payers—and lawmakers—from allowing PTs to provide virtual services is the apparent lack of data supporting the effectiveness of telerehab. And considering the fact that some payers (e.g., Medicare) have only lifted restrictions temporarily, it’s crucial for PTs to collect outcomes data proving that it’s the right choice for payers to make telehealth a permanent option for their beneficiaries. Plus, having that hard data will come in handy when touting the effectiveness of telehealth to future patients.
3. Close compliance gaps.
When the state of emergency went into effect, payers began opening up all sorts of virtual pathways between patients and PTs. With so much changing all at once, the federal government provided a little wiggle room to therapists when it came to the HIPAA requirements around telehealth. However, as we settle into our new normal, physical therapists should anticipate rollbacks on those HIPAA relaxations. So, as the APTA advises in this blog post, “Perform a gap analysis and ensure that you defensively document any compliance deviations.”
4. Evaluate your telehealth platform.
Speaking of HIPAA, you should also assess your current telehealth platform and make sure it’s equipped to meet all federal privacy standards. If it isn’t, start investigating your options sooner rather than later. While you’re at it, refer back to your team’s feedback. If they’re struggling with the limited capabilities of your current telehealth platform, figure out which platforms solve for those problems. Specifically, a telehealth program that’s intentionally designed to work with your EMR (like WebPT’s Virtual Visits tool) can help you streamline your treatment process—and even save you some money.
5. Adjust your marketing strategy.
Once you have your processes nailed down, shift your attention to your marketing strategy. After all, if you implemented telehealth in the middle of the pandemic, I’m guessing your main strategy out of the gate was to get the word out to as many patients as possible—and as quickly as possible. But now it’s time to think long term. Using the data you (hopefully) collected, you can speak to the effectiveness of your services—and maybe even garner a few online reviews and testimonials. Highlighting these real-life examples of telehealth success is a super effective strategy for reeling in the skeptics. You can even solicit reviews from patients who have used your telehealth services by tapping into your patient satisfaction data and reaching out to the patients who were pleased with their experience.
Reach out to referral sources.
Don’t forget about physician marketing! Using your outcomes data—as well as testimonials and patient satisfaction scores—get in touch with your referral network and let them know what people think of your telehealth services. After all, more and more patients will start going in for elective surgeries, so physicians should know that you can offer their patients effective rehabilitative services remotely.
6. Establish a disaster recovery plan.
If there’s anything we’ve learned over the past few months, it’s that public emergencies can—and do—happen. And whether that emergency is a natural disaster or a pandemic, telehealth services will be a big part of your recovery plan in the future. So, take this time to think about:
- the biggest challenges you encountered while switching to a remote practice model, and
- how you can make that transition smoother in the event of another major crisis.
For example, if you lack the equipment necessary for all of your therapists to provide remote services, you may want to establish rules around using personal devices to conduct telehealth visits in order to ensure their HIPAA compliance. Or, if your billing software was not equipped to bill for telehealth, make sure it will be in the future—or switch to one that is equipped. Once you have a solid disaster recovery plan, write it out and make sure key individuals (e.g., office manager, HR personnel, clinical director, etc.) in your practice are familiar with it.
If you found yourself scrambling to get your practice ready for telehealth, you’re not alone. But once you have it, the hardest part is out of the way. Now, it’s just a matter of perfecting your process so you can provide the best patient care possible—now and in the future.
