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Fighting Tech Bias to Better Treat Patients

September 1, 2022 • Behavioral Health • Heidi Jannenga

We in the rehab therapy industry are all about knocking down barriers to try and bring PT, OT and SLP to the wider public—but we have to be careful we’re not setting up barriers of our own. Despite our best intentions, there may be small, unconscious behaviors we engage in that hamper our ability to more fully connect with our patients and to create the trust and understanding that is necessary for the patient-provider relationship.

Technology offers us the ability to better communicate and interact with patients outside of our clinic, but there remains some resistance and skepticism within our ranks to greater tech adoption. Yes, we might have gotten into our profession to provide hands-on care to patients, but the industry as a whole has to adapt to the times, and recognize that technology can help us in our mission to aid patients in their recovery. That means examining our ideas about technology and approaching these changes with a growth mindset, rather than skepticism—especially if we don’t want to fall behind the rest of the healthcare industry.

So how can late adopters be more incentivized to incorporate technology into their work? There were a few points that stood out from WebPT and Clinicient’s joint PT Patient Experience Report as key areas for improvement.

Older patients want tech solutions—but aren’t getting them.

We’re all likely guilty of occasionally making assumptions when it comes to older individuals and technology; namely, that otherwise intelligent people are incapable of understanding or adapting to the latest and greatest in tech just because of their age. But the number of tech-averse seniors continues to diminish as digital solutions become more ingrained in our everyday lives.

Recent polling from Pew Research found that tech adoption among older Americans has grown considerably over the past few years. Among those 65 and older, 75% are regular internet users, 61% own a smartphone, and 44% own a tablet computer. Those aren’t necessarily overwhelming numbers, especially compared to younger groups, but it’s certainly a bigger percentage than many might have assumed. And, it’s a considerable improvement from 2012, when only 13% of that same group owned a smartphone, and only 6% had a tablet computer.

The research offers strong evidence that our older patients may be open to using technology as part of their recovery. Yet, our report found that, time and again, older patients weren’t being given or even offered digital options—even though 50% of those 45 and older expressed their preference for it. Granted, there may be some in that age bracket who prefer more traditional options, but we should avoid those kinds of sweeping assumptions based on a patient’s age and make every effort to educate older patients on technology that can greatly help the efficacy of their treatment.

In the digital age, paper HEP is somehow still a thing.

One surprising finding in The PT Patient Experience Report is that most people, regardless of age,  would prefer getting digital HEP, and yet a majority of survey respondents were receiving a paper HEP instead.

Even older patients—those we’re likely to presume would overwhelmingly prefer paper when available—are more open to digital options when it comes to healthcare. The report found that 41% of patients 60 and older preferred a digital home exercise program (HEP), and yet 81% of that same age group reported receiving a paper HEP.

Set aside for a moment that paper HEPs are far more likely to be lost or destroyed than a digital version; what might an assumption like that say to patients? For a relationship between patient and therapist that’s built upon trust and rapport, it’s probably not a great start to jump to conclusions about an older patient’s tech literacy. It might seem like a minor thing, but it suggests some larger issues at play within rehab therapy.

Rehab therapists aren’t communicating enough with the patients who most need it.

Another eye-opening finding in our report was that older patients and those who aren’t as active receive fewer check-ins and less communication from providers than younger, more active patients do. In the 60 and older group, particularly, a staggering 73% reported rarely hearing from their PT, if at all. While it’s hard to parse exactly why that is without talking to those patients’ rehab therapists, it’s fair to wonder what part communication bias plays into that disparity.

Technology has made it easy to stay in touch with patients in between appointments, but if you’re not implementing it with all of your patients, regardless of their age, you’re not using it as effectively as you could. Our report found that patients of all ages preferred digital touchpoints with their providers, including digital appointment reminders with text being the most-preferred delivery method. Rehab therapists can leverage those same digital touchpoints to check in on patients to see how they’re progressing with their HEP or how they’re feeling about their treatment in general. Older patients are interested in that additional engagement, and has been shown to improve adherence and subsequently outcomes.

Rehab therapy needs to join the rest of health care in the tech revolution.

If nothing else, our industry needs to match the standard set within other healthcare disciplines when it comes to providing better care for patients through technology. Much of the existing technological development and advancement for seniors has been with an eye towards allowing providers to monitor their health while they’re at home. And it’s easy to understand why: a key determining factor in tech adoption among older patients is the capacity that technology provides for them to continue living independently in the way they wish.

Telehealth showed that tech adoption is easier than you think.

Where rehab therapy can make strides is in how we explain the value of this new technology to older patients. Take telehealth, a technology that saw its use soar among older patients due to the COVID-19 pandemic. While the circumstances of its adoption are unique, it’s a great example of a technology that had its value proposition made abundantly clear to patients: talk to your doctor from the comfort (and safety) of your home. It’s not enough to introduce tech to patients and simply say they need to use it; providing the “why” as well as how it benefits them is imperative for adoption.

Remote care is a big win for rehab therapy.

The push for value-based care in not only rehab therapy but all of healthcare has been accelerated by the growth of remote care and its related technologies like wearable tech. And remote patient monitoring (RPM) has been a huge step in that direction with regards to providing better care for seniors. RPM allows providers to monitor critical data like weight, blood pressure, blood glucose and more to keep a close watch on patients in real time. Pairing that with other tech, whether that be clinician-provided or commercial options like the Apple Watch, gives providers the information they need  for a patient’s care, as well as helpful reminders for patients, as anyone who has ever been reminded to stand or walk by a watch can attest.

Remote therapeutic monitoring (RTM) can hopefully provide that same impact for the rehab therapy community. While it’s not collecting the same data (RTM collects non-physiologic data as opposed to physiologic data with RPM), RTM is providing rehab therapists with far more and better information than they were getting previously, with the added benefit of helping to improve patient adherence and boosting your clinic’s revenue. Crucially, it’s helping to improve outcomes for patients, which can only serve to reinforce the value of technology in healthcare.

Fortunately, rehab therapists can overcome tech bias.

It’s easy to understand why so many in the rehab therapy community are a bit hesitant when it comes to adopting more technology into their practice. We didn’t go to school with the aim of spending most of our days at a screen, and any technology invites the fears of eventual replacement, or at least displacement.

But I would argue that’s the wrong way to look at it. Technology is supplementing what we do; the efficiency it provides gives us more time to spend with patients, and the information it collects allows us to better treat those in our care. Most importantly, it’s something that patients want and  are willing and able to utilize to enhance their plans of care and ultimately their positive outcomes.

If you’re trying to work past your assumptions about tech, here’s a couple of easy steps to take to ensure every patient is getting the right level of digital care for their taste:

  • Ask about patients’ preferences, regardless of age. Digital patient intake forms make it easy to include a field about preferred methods of communication and HEP delivery for patients of all ages.
  • Provide patient training on how to use tech—and how it helps their recovery. Teach patients about how the technology you are implementing into their treatment works and explain how it stands to improve their outcomes.

Remote therapeutic monitoring (RTM) is a great tool for remote care, and a great example for this point: by explaining to patients how monitoring their condition and exercises at home allows you to optimize their treatment, patients can feel that they’re actively participating in their recovery rather than dealing with a homework assignment.

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Adopting new tech or making better use of the tech you already have offers greater efficiency to give you more time with your patients and more opportunities to engage with patients between scheduled visits. But, maximizing those benefits requires us to step out of our comfort zone and that can start with examining our biases regarding the patients that come through our doors.

Heidi Jannenga

Heidi Jannenga, PT, DPT, ATC, is the co-founder and Chief Clinical Officer of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi advises on WebPT’s product vision, company culture, branding efforts and internal operations, while advocating for the rehab therapy profession on a national and international scale. She’s an APTA member,...

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