On-Demand Outpatient Care

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woman in wheelchair doing PT

Affordable home-based physical therapy for everyone

By Alyssa Brandt, MSc

My outpatient private practice company wanted to expand our availability to patients in a way that we had not done before.

In the face of the COVID-19 pandemic, there arose a need for patients to have access to high-quality outpatient physical therapy while also keeping convenience and safety paramount. To deliver this type of care, we partnered with a national company that was set up with the technology needed to provide outpatient physical therapy visits in a home or office setting to patients everywhere in Western Washington.

LAUNCHING ON-DEMAND SERVICES

We pioneered this program in our area because we pride ourselves on being innovative and forward-thinking, particularly when it comes to the convenient and effective delivery of health care to our patients. When we had the opportunity to develop “IRG On-Demand” services, we were confident that it would be well-received with our patients and local communities.

Home health is a well-known service, but on-demand outpatient physical therapy is vastly different from home health care. Home health is traditionally reserved for patients who are recovering from more acute illness or injury and are homebound, while outpatient physical therapy focuses on functional mobility in the community, addressing everything from post-operative care to back pain to fall prevention. On-demand therapy brings the outpatient experience into the home or work environment. By doing this, we offer patients a greater degree of flexibility as well as the security of staying in their homes. Since we began offering on-demand physical therapy in March 2020, our company has completed over 1,000 in-home visits and served nearly 100 individuals while also continuing our normal in-clinic appointments.

THE PERKS OF ON-DEMAND

The on-demand program’s coordinator (an on-demand therapist herself) says that her favorite part of caring for patients at home is the level of familiarity she is afforded. For a patient who has children at home, these sessions become exciting and adventurous. “When I arrive at someone’s home and realize they have three young kids running around, and need to be able to multitask, I prescribe exercises differently than I might do in a clinic without that full picture,” she said. “It gives me an immediate picture of what their life is like and what resources they have.”

Another provider, who sees on-demand patients full-time, describes the visits as “eye-opening” and says they allow him to see patients as a whole person more easily. “My favorite thing is actually getting to see what it’s like to adjust treatments to people’s homes … in my mind, [exercises] take up two feet of space, but after doing them in people’s houses, it’s more challenging! I’m glad I’m getting that perspective from patients.” The therapists are also able to evaluate fall risks and functional patterns that a patient does in their home, which allows them to better assess treatment options for them.

ON-DEMAND PROGRAM QUESTIONS

Where in the home do you treat the patient?

Before arriving at a patient’s home, we ask that they decide where in the home they would like to conduct the majority of the treatment session. Most choose a larger area, such as the living room.

What equipment do you bring?

The therapists carry a portable treatment table and an on-demand kit that includes several tools they might need. Since therapists do not have traditional gym equipment available, the physical therapist can create exercises using soup cans or other readily available home objects in unique ways.

Does insurance cover an in-home visit for outpatient therapy?

Typically, it does not cost more to see the patient in their home or office and insurances cover this service.

IS IT EXPENSIVE TO OFFER THIS PROGRAM?

On-demand overhead cost is low. There is no office space to rent and the equipment costs are minimal, so therapists can operate with higher profit margins. The costliest consideration is the mileage put on a vehicle while driving between patients. The corporation we partnered with handles the back-end billing and insurance considerations, which frees up the therapists to focus on treating patients. It also provides our brand a considerable amount of recognition within the community. In most instances, our therapists are seeing on-demand patients after hours so it also provides them with an additional stream of income.

THE LASTING IMPACT OF ON-DEMAND CARE

During the COVID-19 pandemic, on-demand physical therapy has been an invaluable service for patients who are high-risk, such as older adults or immunocompromised individuals. By having therapists go to patients’ homes, clad in masks and face shields and armored with good sanitization practices, the risk for COVID-19 infection drops. Beyond risk management, however, many patients who requested IRG On-Demand did so because it worked better with their schedules, or because they were recovering from a surgery and preferred having a physical therapist come to them, rather than deal with the hassle of transporting themselves to a clinic. As society slowly returns to normal, our team does not think IRG On-Demand will be phased out due to the many patients who have expressed great appreciation for the added convenience of being treated in their homes.

During this challenging era, we as a team have tried to think outside the box. We have worked hard to stay relevant and to provide our patients what they needed in the environment they were most comfortable in. 


Alyssa Brandt, MSc

Alyssa Brandt, MSc, is the project manager for IRG On-Demand and other specialty services at IRG Physical & Hand Therapy. She can be emailed regarding questions pertaining to the on-demand program at Alyssa.Brandt@irgpt.com.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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