If there’s anything the last few years have shown us, it’s that the adoption of digital tools will continue to accelerate – and the physical therapy profession is no exception. Healthcare and technology now go hand-in-hand and incorporating telehealth or remote monitoring tools as part of clinical practice is becoming increasingly common. As such, it’s important to gain an early understanding of the basics. Clinicians and their support staff should have insight into the definitions and common terms associated with digital health, especially as insurance companies begin to normalize digital health tools as part of their reimbursable clinical services.
Telehealth? Remote monitoring? Digital physical therapy? It can be tricky to understand precisely what each term refers to as they are sometimes used interchangeably and ambiguously. Below are some of the common terms you will encounter and a brief breakdown of each to help you better understand the versatility of digital health and its potential applications.
Digital health is quite simply a broad, umbrella term used to describe a range of technologies and applications in healthcare and wellness. Examples include telehealth and virtual care, health information technology (IT), electronic health records (EHR), mobile health (mHealth), sensors and wearables, and digital therapeutics.
Digital health technology
Within digital health, digital health technologies (sometimes referred to as digital health tools) are designed to improve the delivery of healthcare services. These tools may be used to improve patient communication, monitor patient status and response to intervention, store personal health information, and improve interdisciplinary collaboration. Providers also use digital health technologies to practice more efficiently and reduce duplicative tasks. Administrators also leverage digital health to perform operational tasks like scheduling. You may also see other versions of this term such as health technology and health tech.
This is a term you are probably most familiar with. It falls under the digital health category and describes the synchronous and asynchronous healthcare services provided virtually. There are typically four applications associated with telehealth:
This is perhaps the most common as it describes synchronous (real-time) communication done via video conferencing.
Store and forward
This refers to accessing stored data or transmitting digital images. This can also include sending pre-recorded videos to the patient or clinician, sending imaging data such as MRI images. Assessment data can be incorporated as well.
This involves collecting patient data such as vital signs, motion analysis, and adherence metrics. It enables the clinician to monitor the ongoing progress or status of the patient when they are not in the clinic. Specific to physical therapy, these technologies enable PTs and PTA’s to deploy remote monitoring services under Medicare’s new remote therapeutic monitoring (RTM) program, which is described in more detail below.
Quite simply, mobile health describes specific applications that patients or clinicians can use to access their healthcare via mobile devices such as tablets and phones.
According to the digital therapeutics alliance, digital therapeutics (DTx) refers to technologies that “deliver medical interventions directly to patients using evidence-based, clinically evaluated software to treat, manage, and prevent a broad spectrum of diseases and disorders.” It is important to recognize that this term does not only apply to physical therapy interventions. Rather, DTx can be used in conjunction with other medical interventions to treat various conditions including mental health, sleep disorders, chronic pain, and even cancer.
Digital physical therapy
Another term that is growing in popularity is digital physical therapy. This is a broader term that is often used to describe the delivery of physical therapy services using digital health technology. Digital physical therapy (abbreviated as digital PT) includes various platforms, mobile health apps, and tools that are designed to augment the physical therapist, enhance the delivery of personalized patient care, and enable convenient virtual treatment solutions. Another term that you may encounter is telerehabilitation, which is commonly used interchangeably with digital physical therapy.
Medicare and payer terminology
Remote therapeutic monitoring (RTM)
RTM describes the reimbursable services that clinicians can provide to patients (with both Medicare and commercial insurance plans) to specifically monitor non-physiological data of musculoskeletal and respiratory systems. RTM data can be objective and subjective, meaning that data can be collected, recorded, and transmitted digitally and the patient can self-report data to their providers. RTM requires a device that meets the definition of a medical device defined by the FDA. There are five unique RTM CPT codes that qualified healthcare providers, such as physical therapists, may submit for reimbursement. It is important to recognize that RTM refers specifically to the monitoring of patients via the transmission of data, and thus there is a difference between RTM and regular physical therapy visits; they are performed virtually and may be billed for using different telehealth CPT codes.
Remote physiologic monitoring (RPM)
Not to be confused with RTM, RPM refers to the use of technology to monitor physiological data, such as blood glucose levels, heart rate, blood pressure, heart rate variability, etc. RPM requires a device that meets the definition of a medical device defined by the FDA to bill the RPM CPT codes. While remote physiologic monitoring is the technical term used for reimbursement, you will also see it described as remote patient monitoring.
Synchronous refers to services or communication between a patient and a provider that is happening in real-time. Synchronous care typically occurs face-to-face and involves both parties being present at the same time. Examples are phone calls or video calls.
Asynchronous refers to the delivery of care or communication that does not happen at the same time. Examples of asynchronous care and communication include the use of video messaging, text messaging or chat features, and scenarios in which data is transmitted at one point in time and then viewed by the provider at a later point in time.
Digital PT solutions in practice
Fully virtual models
Since the pandemic, fully virtual models of care have become more common to provide easier access to care for some lower acuity patients. These services combine the delivery of both the synchronous and asynchronous components of telehealth.
The ability to provide care to a patient both in-person (traditional care) and virtually during the same episode is called a hybrid model of care. This enables the clinical team to support the patient in and out of the clinic using telehealth and remote therapeutic monitoring services. The virtual options are used as an adjunct to complement in-person care and offer patients greater convenience and flexibility.
Remote therapeutic monitoring (RTM)
RTM is a great option for patients who have graduated from their initial plan of care but would still benefit from continued touchpoints with their therapist via remote monitoring. RTM offers heightened insight into the patient’s functional mobility within their own environment and over a longer period of time for excellent longitudinal progress data. Now there is even technology that is able to use the data collected via remote monitoring and translate it into accurate fall risk assessments, expanding the use case scenarios for RTM technology.
Using digital PT tools
Digital PT tools serve many purposes across multiple settings and include:
- Electronic health records and patient management systems
- Tools that track time spent documenting and analyzing patient data
- Remote motion and gait analysis
- Remote functional mobility assessments
- Digital patient-reported outcome measures
- Mobile fall risk assessment
- Audio/visual calling platforms
- Video and text messaging channels
- Video-based home exercise program
- Patient adherence metrics
- PT outcome metrics
Tips to jumpstart your digital PT transition
Whether you’re a new grad or have been practicing for many years, diving into the digital realm can feel like a daunting task – but there are ways to make this journey less intimidating so you can embrace technology with excitement! Here are a few tips to get you started:
- Find a great mentor or colleagues you can discuss digital PT with and learn from
- Evaluate tools that are HIPAA compliant and sign BAA’s to protect patient data privacy
- Become knowledgeable or seek help in understanding the rules and regulations around delivering virtual care within your state of practice. E.g. consent forms
- Read reliable online sources to build your knowledge base
- Follow related accounts on social media and engage in conversations
- Stay current on digital health policy
- Keep an open mind and stay curious
At OneStep, we are dedicated to healthcare innovation and educating professionals for the future. We believe that leveraging technology offers significant opportunities to enhance the physical therapy ecosystem for both patients and clinicians – and advance the profession as a whole. Follow along with us on LinkedIn, Twitter, and our blog for the latest healthcare trends, exciting new studies, and great educational resources.
Interested in learning how our unique digital tools can help you elevate your practice? Schedule a demo today!
Report of the World Physiotherapy/INPTRA Digital Physical Therapy Task Force
APTA Frontiers in Rehabilitation, Science, and Technology (FIRST) Council
APTA Health Policy and Administration Section
American Telemedicine Association