How to Integrate Healthcare Software Within Your Clinical Pathways

Today, many clinicians are leveraging a new combination of online healthcare tools and in-person visits to improve access to care, efficiently diagnose conditions, monitor progress, and improve patient outcomes. From online home exercise programs (HEP) and patient education to learning management systems (LMS), mobile apps, and HIPAA-compliant telehealth platforms, there are many opportunities to blend virtual patient engagement tools within the care continuum for hospitals and private practices.

Here are a few use cases showcasing how to integrate healthcare technology into clinical pathways to produce innovative solutions for new patient acquisition, evaluations, and follow-up sessions.

New Patient Acquisition – Stroke

Stephen, a father of three boys, has suffered a stroke within the last year. He has been referred to an occupational therapist for rehab, but would have to find a sitter for his kids and feels uncomfortable with regular in-person visits due to the COVID-19 pandemic.

Improve Communication and Access to Care

  • Telehealth or telemedicine can be used as a method to acquire new patients such as Stephen. A virtual visit can be used to educate Stephen on the benefits of occupational therapy, determine the appropriate level of therapy, or allow him to schedule a follow-up evaluation in-person if deemed necessary. Telehealth can also help someone like Stephen attend his appointments while balancing his family life in a safe and convenient manner.

Enhance Patient Self-Efficacy

  • The occupational therapist can send Stephen a packaged education program to educate him on his diagnosis, as well as set him up with a personalized home exercise program tailored to his condition, which Stephen can access from his laptop or smartphone. The OT is then able to keep an open line of communication available for Stephen to report on any pain and difficulty directly from within the virtual care platform. 

Increase Patient Activation and Home Exercise Program Adherence

  • Utilizing patient adherence tracking in a learning management system, the data collected can be reviewed by the OT during in-person or follow-up remote sessions. Based on patient responses, the OT can indicate adjustments needed to therapy to optimize care quality. 

Track Your Clinical Outcomes

  • The OT can monitor Stephen’s progress through the learning management system utilizing data provided on pain and difficulty, adherence to the care plan, and engagement metrics. As long as the OT can keep Stephen’s adherence and engagement high, telehealth is an effective tool for rehab therapy. A 2019 randomized controlled trial compared six weeks of upper extremity rehabilitation in the telehealth versus clinic settings among 124 stroke patients 1. The results in each setting were comparable, indicating telehealth is an equally effective and safe setting for stroke rehabilitation.

Evaluation – Total Joint Replacement (TJR)

Edna is a 67-year-old woman who is receiving physical therapy following a recent total joint replacement procedure. She is not very experienced with healthcare technology, and it takes her a lot of energy to get out of the house. Edna lives alone and has to get dressed, get ready, and organize a ride on her own. Due to these compounding factors, she is at a heightened risk of a fall. Since it takes so much effort to attend appointments, she doesn’t want to see a physical therapist if she doesn’t have to, and is at risk for no-showing appointments.

Improve Communication and Access to Care

  • Telehealth can be used for an evaluation of a patient who would prefer to be seen remotely instead of in person, and for repeated check-ins where an in-person visit might be unnecessary or inconvenient. Whether the patient’s reason is accessibility, a time constraint, or a disability, some circumstances make in-person visits more challenging. Edna’s physical therapist can use telehealth for more regular touch points to check on her progress without asking Edna to come into the clinic, or continue follow-up sessions in person as needed. These virtual visits support patient safety, and a hybrid approach can ease her into virtual care as she adjusts to new technology.
  • The physical therapist can use a pre-built template in the electronic medical record for the evaluation process which can also be customized for follow-up visits in the in-person setting.

Enhance Patient Self-Efficacy

  • During future in-person sessions, the physical therapist can utilize virtual patient education resources and videos to educate Edna about her joint replacement rehabilitation program and provide in-session videos to educate her on posture and movement mechanics. 

Increase Patient Activation and Adherence

  • After Edna’s telehealth evaluation, she could be recommended to attend in-person sessions. During the in-person session, the PT can walk her through the virtual platform on her phone, or send her home with a tablet which includes a patient mobile app. This app can be updated with her customized home exercise program, which includes easy-to-find video examples of her home exercises and education about her condition. The PT can also print a copy of her home exercise program for Edna to tape onto her refrigerator at home to cover all of their bases. Once this has been established, the PT can follow up more frequently with Edna through a telehealth platform within the comfort and safety of her own home.

Track Your Results

  • Considering Edna’s initial apprehension with technology, you might be concerned that her virtual care program may affect her satisfaction with the visit. To address this, you could send feedback surveys after each telehealth session to track patient satisfaction compared to in-person sessions and run a cost-benefit analysis on the results to see how they compare to patient access numbers. Research has shown patients are highly satisfied with telehealth. In one study, one hundred patients completed a 21-question survey after a video‐based telehealth visit with a surgeon. The average score across all questions was 6.01 on a scale from 1 to 7, where 7 indicated the highest level of patient agreement. The highest scores were for questions related to patient satisfaction with telehealth (6.29) 2.

Follow-up Sessions – Low Back Pain

Katie was evaluated for low back pain. She has a busy schedule, doesn’t drive, and relies on public transportation to commute. She arrived 30 minutes late to her evaluation due to traffic and missed her first follow-up appointment because she missed the bus. Her low back pain is made worse by prolonged sitting and taking the bus to see a physical therapist makes her back hurt more. 

Improve Communication and Access to Care

  • Telehealth can be used in combination with in-person therapy during follow-up sessions to maximize session attendance and punctuality, advancing the patient’s progression. It can be used with patients who have busy schedules, increased travel time, or who just want to minimize social contact. Katie can use virtual visits to reduce her time spent commuting.

Enhance Patient Self-Efficacy

  • Katie can access her condition-specific home exercise program by using a mobile app for physical therapy on her smartphone to improve the convenience of care and to motivate her to continue her care program. 

Increase Patient Activation and Adherence

  • Katie’s private practice physical therapy team can monitor her home exercise program compliance and send updates through patient messaging to encourage Katie to complete her home program. During sessions, her clinician can use a telehealth solution that pairs with Katie’s home exercise program so that Katie can learn exercises and receive education in real time.

Track Your Results

  • One way to improve adherence is by using an integrated home exercise program that monitors program completion, patient feedback on pain, and exercise difficulty. The therapist can then review data with the patient during follow-up visits to improve their activation and engagement in their home exercise program. This data can then be correlated to financial metrics and patient outcome measures. Research has shown that patients with high activation scores can cost up to 21 percent less than patients with high activation levels 3.

 

  1. Cramer SC, Dodakian L, Le V, et al. Efficacy of Home-Based Telerehabilitation vs In-Clinic Therapy for Adults After Stroke: A Randomized Clinical Trial. JAMA Neurol. 2019;76(9):1079–1087. doi:10.1001/jamaneurol.2019.1604
  2. Layfield, E., Triantafillou, V., Prasad, A., Deng, J., Shanti, R., Newman, J. G., & Rajasekaran, K. (2020). Telemedicine for head and neck ambulatory visits during COVID-19: Evaluating usability and patient satisfaction. Head & Neck, 42(7), 1681–1689.
  3. Hibbard JH, Greene J, Overton V, Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores’. HealthAffairs. 2013;32(2):216-222