On-Demand Outpatient Care

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

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.


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

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 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.


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.


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.


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.