Mobile Technology and Physical Therapy – Ne’er the Twain Shall Meet

Bronwyn,

I was just updating The PT Project’s Twitter account and came across this company who is trying to be somewhat mobile teachnology savy:

http://www.clinicallyrelevant.com/

Great article btw. Is there a certain direction we should be focusing on, or is it more of a broad aspect of transitioning to the mobile community?

Clinically relevant is a great company that provides savvy, research-based clinical information for the physical therapist, enabling them to have a mobile reference library. I think we should also be thinking about extending our relationship with our patients by leveraging mobile technologies that they can easily access from outside of the clinic. People are able to manage more and more aspects of their lives from their phones, why not get on the band wagon by giving them access to their exercise program, their scheduled appointments, their goals?

Bronwyn,
What is our liability protection in the utilization of something like this? If we used software like this to give patients a HEP, would they be limited to seeing only what we authorize them to see, or would they have access to each condition? I think its a good idea to ensure the patient performs and records what we prescribe for them, but I would not want them to self treat which could further induce injury. I was considering starting a vimeo channel which could be accessed via password for my patients but was talking to a local surgeon who advised me against doing this due to liability issues. Whats your thought or advice on this?

It would be great to get our hands into the quickly advancing mobile technology craze. The one thing that I am concerned with is taking each patient as an individual. How well could we do an assessment on someone via mobile phone. I am all for general guidelines and reminders but how is one to differentially diagnose, or get a good “feel” for what is going on. Sometimes it is hard to put into words our health problems, or what something feels like.

I think we would need to be protected more by government guidelines that allow us to give general info. Thoughts?

Hi Joseph,
You bring up a good point. We should always be cognizant of our responsibility as treating therapists to prescribe an individualized program specific to each patient’s needs. I am not suggesting we alter the way we practice or prescribe exercises, just change the vehicle of delivery. So instead of providing our patients with a sheet of paper outlining their home program, we could instead provide them with an electronic personalized, password protected environment in which to follow our prescriptions. As long as we follow privacy protection best-practice procedures (randomly assigned passwords, securely encrypted web-pages etc) our liability is no more than as if we were handing out a paper copy of our exercise prescription.

Hi Ryan,
I am not advocating that any form of technology can replicate an in-person physical examination or treatment. We can certainly enhance certain aspects of patient care though, by accessing recent advances in our patients’ mobile devices. We can improve confidential communication between patient and therapist (email is not a secure or a recommended form of communication by CMS), we can increase patient involvement and engagement in their rehab process and we can certainly improve the efficacy with with we document and administer home exercise programs.

I totally agree with that. I was just curious as to what avenues you were talking about exploring with the techonological advances

The world of physical therapy would undoubtedly benefit from embracing online technology to a greater extent. I think it particularly has its place when it comes to seeing real time demonstrations of exercises, which we prescribe to our patients as part of a home exercise program (HEP). Nearly every PT can attest to the fact that we often give patients an exercise to be completed as part of an HEP and they perform it with good form and technique in the clinic and upon returning for the next follow up session have managed to completely bastardize it. Such situations could be circumvented if the patient could pull up the exercise online and ensure that they are doing it properly. This brings up another critical issue, which is that a mobile program must provide the patient/viewer with a sound model of performance. Otherwise, garbage in = garbage out. I very much look forward to what technology has to offer in terms of improving patient care in our profession. I think it will be a particularly valuable tool especially for PTs and I will say that I have been utilizing it in my clinic with great success and positive patient feedback.

Hi, really interesting article. I agree that our profession is stuck in the dark ages especially with regards to delivering home exercises. Word on the street in the UK is that exerciseprescriber.com, the only site that delivers narrated, video clips is about to release a facility whereby this will be possible. Perhaps a follow up feature would be of interest.

Hi Gary,
Exerciseprescriber is a great product, although have not seen it’s mobile capabilities. FORCE Therapeutics is a US-based program that offers narrated video exercises accessible on the web as well as a number of mobile platforms (currently optimised for i-pad, i-phone and blackberry). You can check it out at http://www.forcetherapeutics.com

Here in Australia we have a very professional internet based (ie mobile) exercise delivery software program where physical therapy leaders in their fields have provided the exercise/taping/posture programs which are available for practitioners to download for prescription and patients can access from home or mobile computers to review and monitor their correct performance. Have a look at http://www.ephysio.com.au.

Thanks for the useful info Craig! How are things?

Hey Craig,
Thanks for this information, the site looks great and I am not surprised it is the Australian physios who are innovating – yet again! I couldn’t find the mobile piece of this program. Is it available as an i-phone or android app, or mainly web-based?
My best,
Bronwyn

Great site. A lot of useful information here. I’m sending it to some friends!

I think one of the best ways to utilize mobile technology is through appointment reminders. If your practice management software allows for you to send emails from the system, you can actually send emails to their cell phone number directly from your system. To learn more, you can read the ofllowing article explaining how to send emails directly to your patient’s cell phones.

http://sms411.net/how-to-send-email-to-a-phone/