Telerehabilitation Boosts Patient Satisfaction for Young Patients

Telerehabilitation use during COVID-19 was most popular among young, city-dwelling individuals, and yielded high patient satisfaction, according to a new Focus on Therapeutic Outcomes (FOTO) study published online.

The descriptive study, based on a national FOTO data set of 222,680 patient records, examined how telerehabilitation frequency and telecommunication modes impacted patient variables and outcomes such as physical function, number of visits, and patient satisfaction. The sample of patient records spanned the second and third quarters of 2020.

The results provide new information about how telerehabilitation (TR) is being used in outpatient rehabilitation practices throughout the country amidst the COVID-19 pandemic. 

Researchers found that 6 percent of care episodes in the sample (13,059 episodes of care) incorporated some degree of TR. Among those episodes that leveraged TR, 75 percent of cases used TR in addition to in-person office visits, while the remaining 25 percent of cases only used TR treatment.

“Telerehabilitation has rapidly emerged as an alternative care model to traditional in-person office visits over the past year as a result of COVID-19,” Mark W. Werneke, PT, MS, Dip. MDT, lead author of the study article and clinicial research scientist on the FOTO team said in a press release.

“In the current study, we aimed to establish descriptive results, using large sample sizes and rigorous analytic methods, to provide detailed and robust information on the ‘who’ and ‘how’ of telerehabilitation,” Werneke explained. “We examined and described patient types more likely to use telerehabilitation, the frequency of use, and the kinds of telecommunication technology employed.”

The researchers found that fewer than 2 in 5 (37 percent) of the 13,240 therapists included in the sample used TR.

The study also found that TR was two times more likely to be used during the second quarter of 2020 (10 percent) compared to the third quarter of 2020 (5 percent). The study authors speculated that this could be partially due to loosening of mandatory COVID-19 restrictions in the second half of 2020.

Patients who were treated using TR were more likely to be younger and live in large metropolitan areas when compared to those patients treated with in-person care. The researchers also found that patients who received virtual care for outpatient rehab exercised more and had fewer medical comorbidities than the group of patients that received in-person care.

Additionally, patients who received TR treatment were most likely to have just a few care virtual care encounters—55 percent, 20 percent, and 25 percent of TR patients had TR during few, most, or all visits, respectively.

The researchers found that TR care was administered equally across orthopedic body parts. However, they observed lower use for non-orthopedic conditions such as stroke, edema, and vestibular dysfunction.

The study also revealed that providers used synchronous modes (two-way, real-time communication) in 60 percent of episodes that used TR care. Just over 20 percent of TR care was administered asynchronously (one-way E-visit communication, not in real-time) and 19 percent of care episodes used both modes.

Patients were almost equally satisfied with their rehabilitation process whether it included TR or not, with the rate of patients that reported being very satisfied with their treatment results being just 3 percent higher for no TR care compared to TR.

“These were fascinating and important findings for our industry, especially rehabilitation providers and payers,” noted Werneke.  “The descriptive research findings support the appropriateness of the FOTO database to contribute future studies on associations between telerehabilitation care and patient outcomes.”

“The researchers’ finding of limited and decreasing use of telerehabilitation over the study period suggests additional studies are needed to better understand facilitators and inhibitors of telerehabilitation use by therapists during everyday practice to promote its use when clinically appropriate,” Wereneke continued.