The technological revolution that has been occurring throughout the last 20 years has radically improved the ease of accessing and sharing information. In the midst of this technological boon, the healthcare industry has begun to realize and utilize this new technology’s potential to improve efficiency, organization, and patient-provider relationships. While there is an increased use of technology in some areas, such as the utilization of electronic medical records, there are still many others that are using inefficient and relatively archaic methods. As an example within the realm of physical therapy, tools that are used most readily by PTs to prescribe a patient’s home exercise program (HEP) are comprised of a printout of drawings of exercises accompanied by a description of how the exercise should be performed. According to research, many patients find this system vague and difficult to understand, which could lead to improper technique and decreased compliance, satisfaction, and outcome.
Although advances in technology have drastically altered our everyday life, the physical therapy profession has been relatively slow in integrating advancements in technology into its daily operations- especially when compared with physicians. As an example, many physicians are implementing the use of patient portals, which are online applications that allow patients to interact and communicate securely with their healthcare providers. While patient portals seem palatable to the average health care provider, they would only be beneficial if the average patient was equally intrigued and eager to try them out. A recent study by the Agency for Healthcare Research and Quality (AHRQ) set out evaluate the level of interest chronically debilitated patients had in using an online patient portal in the course of their care, and the results were overwhelmingly positive. The online features that patients expressed high interest in included: reminders on when to conduct regular health care routines (84.8%), access to treatment plan (88.1%), personalized health education (71%), and online communication with healthcare providers (60%). What is most surprising is that the average age of respondents to the survey was 75.7 years old, showing that even those that are widely believed to lack the skill and desire to access online information are eager to do so if it means they will be able to take a more active role in their course of care.
The above study showed that the majority of patients have an interest in accessing their medical health records online. What it does not touch on is efficacy; it is equally important to examine whether patient portals can improve patient satisfaction, compliance, and outcomes. Obviously, a physician’s patient portal would have a different makeup than a physical therapist’s. TheraVid, which is designed for use by PTs, is centered around these three features:
- An exercise database consisting of HD videos accompanied by descriptions of the exercises, additional provider comments, and frequency information
- A secure messaging feature that allows the client to ask their provider a question, or let them know if an exercise is too easy or difficult.
- The ability for patients to become more active in their own course of care by logging workouts, tracking progress, requesting progressions in their routine, and setting workout reminders.
The question remains: would these features provide a tangible benefit for patients? As for the concept of utilizing videos in exercise instruction, research has shown that individuals that have printed handouts of their exercises perform their exercises with roughly double the amount of errors when compared with those that watch videos. Self-report measures given after instruction showed that patients that watched videos were more confident in their performance, had better short-term and long-term recall, were more motivated, and were more likely to be compliant with their HEP. Interestingly, researchers also found that patients who utilized video-based instruction at home combined with the ability to contact their provider with questions or concerns had the same outcomes as patients that performed their exercises with one-on-one instruction from a physical therapist. Patients only have a finite amount of time to be instructed directly by a professional, therefore ensuring that they are getting the most out of their home program will hasten recovery. Citations of all of the studies utilized above can be found at the bottom of this post.
The phrase “patient-centered care” has become somewhat of a catchphrase within the healthcare community. This idea hinges on the patient taking an active role in their course of care. In order for this to happen, we as clinicians need to provide our patients with the tools necessary for success. We at TheraVid believe in providing a service based firmly upon evidence-based techniques that have been shown to improve patient satisfaction, participation, and compliance. Our mindset is simple: empower the patient, get results.
TheraVid is, at its core, a web-based home exercise program. Our mission is to become leaders in leveraging the power of technology to optimize patient outcomes and expand the possibilities of how clinics foster stronger relationships with their patients. We are currently at the end stage of beta testing, and are set to enter the market in the coming months. Feel free to direct any questions to our Director of Sales and Marketing, Ryan Klepps, at ryan@theravid.com.
References
http://www.ahrq.gov/downloads/pub/advances2/vol4/Advances-Fricton_21.pdf
Reo JA, Mercer VS. Effects of live, videotaped, or written instruction on learning an upper-extremity exercise program. Phys Ther. 2009;84:622-633
Roddi TS, Olson SL, Gartsman GM, Hanten WP, Cook KF. A randomized controlled trial comparing two instructional approaches to home exercise instruction following arthroscopic full-thickness rotator cuff repair surgery. JOSPT. 2002;32:548-559
Lysack C, Dama M, Neufield S, Andreassi E. Compliance and satisfaction with home exercise: a comparison of computer-assisted video instruction and routine rehabilitative care. Allied Health. 2010; 34,2;76-82
Weeks DL, Brubaker J, Byrt J, Davis M, Hamann L, Reagan J. Videotape instruction versus illustrations for influencing quality of performance, motivation, and confidence to perform simple and complex exercises in healthy subjects. PhysTher Practice. 2002:18;65-73
