At the beginning of the COVID-19 pandemic, Upstream Rehabilitation implemented telehealth visits company-wide to ensure continuity of care for patients who were homebound.
Months later, we sat down with Krisi Probert, Executive Vice President and Jennifer Cazeaux, PT, DPT, OCS, Raintree and Clinical Education Specialist at Upstream Rehabilitation, for a look at how Upstream has leveraged digital care tools to maintain optimal patient care delivery throughout the pandemic, the results they’ve seen so far, and their plans to use virtual care to expand services moving forward.
Q: Prior to COVID, how had you been using telehealth and digital care tools at Upstream?
A: We had performed some early research but hadn’t yet implemented telehealth, although we had used MedBridge Patient Education and Home Exercise Program. Then COVID occurred and the next week we started Telehealth Virtual Visits. We’ve done 50,000 telehealth visits since March, so we’ve come a long way.
How has your team adopted telehealth over the past six months in terms of the clinical environment?
We really had two choices: Either to have dedicated telehealth specialists or to allow our clinicians to treat patients both virtually and in person. We decided to try both routes and that has worked really well in our model. We allow clinicians to let patients go back and forth, and we’ve also hired telehealth specialists.
As we move forward and hopefully out of COVID in the future, how do you anticipate that you’ll continue to use telehealth?
Jennifer: We’ve found great success with telehealth so far. Our patient satisfaction rates and outcomes data show that telehealth allows us to increase visit frequency just enough that our outcomes and satisfaction improve. So not only do we want and need to use telehealth now during the pandemic, but we’re trying to include it as part of our standard of care. We want it to be an option in all our clinics. If one of our providers isn’t comfortable providing telehealth as a service because it’s a bit of a culture shift, we can use one of our telehealth specialists to make sure patients are getting their prescribed frequency of care and getting those good outcomes that we know telehealth can provide by helping to fill in the gaps in our in-clinic services.
Krisi: Another great way that we’re using telehealth is to offer specialty services like pelvic health. Since we don’t offer specialty services at every clinic, telehealth has opened them up to the entire country, so that’s another great advantage.
Will you see that change if they roll back the telehealth reimbursement?
I think the ability to provide those different services adds to our offering. We’re actively in communication with our payers to help them understand that we still need to cover the basic cost of the telehealth service. It’s still the clinician’s time, it’s still one on one. There really is no need to devalue it. Some of our states, like Georgia, passed a parity law in January before the pandemic that required insurance companies to pay parity with clinic visits and telehealth visits. So we’re hoping that kind of legislation spreads to protect the service. We don’t want to discontinue it because reimbursement decreases so much that we can’t offer it to our patients.
Do you think that some of those demonstrated outcomes are due to the fact that the accessibility of telehealth allows people to stick with their plan of care in a more holistic way?
Jennifer: Absolutely. We’re finding that even if you take the pandemic out of it, we have patients who can’t come into the clinic on a given day. Maybe they have transportation issues, a sick child, or a work meeting. All those reasons were always there; the pandemic didn’t create those. So it’s nice that we have this platform to continue the frequency that’s prescribed in a plan of care and get these patients better. It eliminates transportation and geographic barriers and provides access to specialists across the nation.
Krisi: I think this shift is going to open up more and more opportunities for us, from being able to be in a patient’s home to being at a worksite to being able to educate large groups of employees. I think it’s also going to allow us to help sicker folks who might not have the opportunity to get to the clinic in person. The sky’s the limit in terms of where we can take telehealth now and what it opens up to us. We just need to get payers around to the idea that it’s an incredibly valuable service.
To find out more about Upstream’s plans for virtual care, as well as the specific metrics they are collecting to prove its value to payers, watch the full presentation here.
About Upstream Rehabilitation
Upstream is the third largest provider of outpatient physical therapy services in the United States. Upstream owns and operates over 760 clinics through a network of strong regional brands including the following: BenchMark Physical Therapy, Drayer Physical Therapy Institute, Peak Physical Therapy, SERC Physical Therapy, Integrity Rehab Group, and more. The company provides a comprehensive suite of outpatient and specialized physical therapy services and sees over four million patient visits annually. Upstream is headquartered in Birmingham, Alabama.