A couple of years ago, I had a patient who reduced his cost for health insurance by participating in a program offered by his employer. The patient reduced his costs by always having an annual physical and staying at a particular activity level. The smart watch was responsible for tracking his amount of activity.

Fitbit Care sounds interesting. Technology has really changed to not only allow activity tracking and social competitions, but to also have coaching built into the app. For the large employers, I can visualize a dashboard of sorts in which every employee has an account within the platform. If the technology is smart enough, the platform can provide alerts as to when an individual’s behavior is changing outside of desired parameters.

What I am curious about are the coaches. As we begin to see more and more telehealth options on the market, it seems that we now need to wonder about the coaches. What credentials are required for health coaches? Do the coaches just follow scripts and find scripts to match the situation reflected in the data? Will coaches have a medical background to be able to provide excellent coaching advice?

As I sit here writing this, my mind wanders to some of my patients. All I can say is that life happens. When life happens and a loved one is hospitalized or the employee is ill or the employee is going through a divorce or the employee is a caregiver? As their physical activity is being tracked and monitored, what is in place to take into account life circumstances? There are times in our lives when all we can do is get up in the morning and focus on getting through our day – and truly not have time for ourselves. How accommodating will an employer be to provide assistance for these individuals? I’m thinking like continuing to pay wages, but allow the person to leave and go to the gym or leave and go home an hour earlier to be able to truly eat a healthy meal. For an employer to really be able to help and provide not only coaching, but the support for healthy behaviors may actually mean providing non-traditional support to give time for healthy habits to be maintained when life happens.

The next thing I wonder about: do physical therapists have a role in this coaching care? I mean, so many people are told: exercise. Exercise is just a single word. Exercise prescription is what is needed. Another component involves progression of exercise activities. Quite a few of my patients are a bit fearful when it comes to exercise. We really do have the knowledge and skill to prescribe exercises for sedentary individuals and help progress them to active individuals without incurring injuries.

Until next time,

~Selena

The post Wearable Technology Harnessed to Improve Health appeared first on FOTO Patient Outcomes.

It seems we are all scrambling to meet the various needs of those we interact. Our first responsibility is to the patient. Each patient is a bit different and has slightly different needs. I believe we always need to determine the best way we can fulfill the patient’s needs.

For example, with the pressure to provide value and cheaper care, we need to stay aware of new options as they become available to us. As new options become available to us, we aren’t going to have evidence be a guide for our care delivery – we will need to design our own screening processes to determine which patients a new option is appropriate. We will also have to have strategies in place to evaluate whether implementing a new option in care delivery is not only feasible but also whether it really changes anything. The biggest factor, if you place the patient in the center and forefront of care, is whether the new option was truly beneficial for the patient.

I recently came upon a company called Claris Reflex.  My attention was perked. Right now I have a “smart” treadmill that interfaces with a tablet. I am able to have all sorts of data at my fingertips about how my patient performed during the session. The patient is able to have immediate feedback on performance. I am able to provide functional goals and the patient is far more easily able to learn the movement pattern working with the devices than I have ever been able to do with verbal feedback or manual cues. There is also an opportunity to save a session and print it or add it to the patient’s medical record.

The focus of Claris Reflex is knee joint replacement care. There are already some bundled care initiatives and if joint replacement care becomes bundled across the board, everyone caring for these individuals may be looking at ways to improve outcomes. If most physical therapists are like me, then you all worry about the progression of gaining motion after the replacement. Patients are definitely able to do their home exercise program to increase their motion. The biggest problem is that some patients are a bit fearful and really aren’t willing to move their knee into a bit of discomfort for fear of damaging the knee. Another problem is that for some patients as they gain more and more motion, yet are not quite at the 120 degrees of flexion, they don’t have an accurate way to know they still have more motion that needs to be acquired. The same thing happens for some patients who have not felt their knee go straight in forever and their ability to determine their knee is straight is not accurate. I liked what Claris Reflex had to offer for those patients. 

So the question then becomes, how do we adapt our care to the opportunities that technology allows us to take? I mean, I know that every patient I treat does not need remote monitoring. How much time is acceptable to allow a patient to independently manage their care? When is the best time to introduce patient remote monitoring? What does it do to patients mentally and their pride of achieving if remote monitoring becomes a standard of care? I guess what I mean by this is that there are a lot of patients who do take pride in independently doing the work to achieve. I wonder if introducing technology for everyone without considering the individual will have negative ramifications. 

I definitely appreciate technology. It seems we will need to take some time to do some thinking before automatically bringing technology into the care.

• Which patients are the ones that need remote monitoring – which patients are at risk of failing to achieve results?
• Does the benefit outweigh the cost of the technology?
• Could there be detrimental effects using the new technology?
• How does the clinician’s role change?
• Are processes in place to help the clinician succeed as the new technology is implemented into practice?

We are going to see more and more options for remote monitoring. I think we need to have conversations in our heads and also within our organizations to help determine the best patients to incorporate this kind of intervention.

Until next time,

~Selena

The post Are You Contemplating Remote Monitoring? appeared first on FOTO Patient Outcomes.