by Susan Northover, Senior Vice President, Patient Care Services
You’re recovering from surgery in the comfort of your home. Your physical therapist makes house calls, but in between visits you undertake your prescribed exercises. Wait — am I doing this right? There’s pain after two rounds, but you’re supposed to do three. Should you stop?
Wouldn’t it be nice to have your questions answered in real time, your exercises monitored, and an expert overseeing your progress and offering motivation precisely when needed? Thanks to an innovative technology that puts a virtual therapist right in the home, on-demand coaching and health education are exactly what certain patients can expect when they rehabilitate in their homes.
The home represents the new frontline for many kinds of physical therapy today. In fact, the number of physical therapists needed in home care was estimated to grow by 47% during the last six years, making the home the fastest-growing setting for PT. There are several reasons for this. The population is aging and health care is moving from acute to more integrated care, with a focus on keeping people healthy. Value-based care means a shift whenever possible from the most expensive environment, the hospital, to more cost-effective and sustainable model, including out-patient facilities and ideally a patient’s own home.
In addition, as certain surgical procedures become more sophisticated and less invasive, people are able to resume activity — and head home — much sooner. Active people undergoing a total knee replacement can begin initial postoperative exercise as early as in the recovery room following surgery and, shortly afterwards, when they get home.
At the Visiting Nurse Service of New York, physical therapists work in close partnership with patients, to get them deeply and fully involved in their own care, and to empower them to understand, manage, and sustain their own health and wellness at home, on their own terms and with the help of family whenever possible. As such, we are always looking for new tools and techniques to help PTs empower their patients and keep them motivated throughout recovery.
This spring, VNSNY introduced an avatar-based technology to extend the reach and impact of our physical therapists by enabling patients to engage in virtual rehabilitation therapy sessions at home, between in-person therapy visits. Developed by digital health company Reflexion Health and approved by the FDA, the Virtual Exercise Rehabilitation Assistant, or VERA, uses a motion-sensor camera to display the patient’s own body movements on a computer or television screen alongside the figure of an animated “therapist” avatar.
The virtual therapist takes the patient through each prescribed exercise — making sure the patient is appropriately positioned and offering corrections when an exercise isn’t done properly — while the program counts and records every repetition, checking off each exercise as it is completed. We are initially working with patients recovering from total knee replacement procedures and anticipate expanding to a wider range of patients in the future.
“We are very interested in virtual rehabilitation’s potential to augment our rehabilitation therapy protocols,” says Joseph Gallagher, VNSNY’s Director of Clinical Operations Support. “This innovative and cost-effective tool is one more example of how VNSNY is pioneering the use of new technology to expand our clinical reach and transform the field of home-based care management.”
VERA also features an educational portal where patients can learn more about their recovery process and read health and safety tips related to their condition, as well as a feedback portal that helps clinicians measure their patients’ progress. A progress log is monitored by the patient’s real-life rehab therapist and other caregivers and can also be viewed by the patient, providing an additional avenue for positive reinforcement and motivation. Because VERA allows us to track progress and make adjustments as needed, we believe this cost-effective tool will improve patients’ success and guide them to better health.
While virtual rehabilitation can help reinforce the work of the in-home physical therapist, providing patients with 24/7 tools to help them achieve success, it is not meant to replace face-to-face visits or evaluations. There is still nothing like the power of the human touch — or the human smile — to motivate and support. Physical therapists have told me they often ask a patient to picture someone who really gets their blood boiling — a mother-in-law, that dreaded eight-grade math teacher, someone who cut them off in traffic. “Picture that person,” they tell the patient. “And now give a big kick.” That gets patients laughing, then it gets them moving. And when it comes to physical therapy, that’s what it’s all about.