“Mike Wehrhahn and Justin Lee are graduate students in their last year of the DPT program at Ithaca College (NY) and were winners of this year’s PPS Student Business Concept Competition. Their company, revoPT, provides mobile and video-based exercise prescription solutions for physical therapists.  As winners of the competition, they were invited to attend the 2012 PPS Annual Conference in Las Vegas. We asked them to write about their experience:

Attending the PPS Conference was an amazing opportunity. We are extremely grateful to the APTA for putting on the Student Business Contest and giving us a once in a lifetime chance to learn and grow. We are both business-minded people and love that aspect of physical therapy, but there really isn’t much room in PT curriculums for business education. It was great to experience the power of continuing education first hand. In four days, we learned lessons that will benefit us our whole careers. The sessions we attended were all eye-opening and informative, and the breadth of topics offered allowed us to choose the ones most applicable to us as new professionals.
Our favorite session was Defining Value in Physical Therapy Care, presented by Jeff Hathaway and John Childs. One of the overwhelming vibes we felt at the conference was disconcert over decreasing reimbursement rates and looming healthcare changes. Jeff and John’s presentation laid a great foundation for how physical therapists should position themselves in the evolving healthcare system.

We met a lot of great people in Vegas. The conference was not only an opportunity to learn, but also a great opportunity for us to expand our network.  We talked to practice owners from all over the country! We are also very thankful to Laurie Kendall-Ellis and Marc Rubenstein for getting us involved at the conference and helping us make new connections.

We were asked to moderate sessions and introduce speakers for a number of presentations. It allowed us to talk one-on-one with some of the presenters and pick the brains of some of the most respected people in the profession.

We left the conference with mixed feelings about the state of the profession. An interesting dynamic between concern and optimism existed at the conference. It was hard at times not to feel like the profession is sitting on some sort of bubble. Patient visits and reimbursement rates are decreasing and eating into clinic profits. At the same time, clinicians feel deserving of higher pay and a cloud of uncertainty lingers over healthcare reform. Physical therapy as a profession appears to be on the brink of change—but after attending the conference, it is clear that the Private Practice Section and its members are at the forefront.

If our experience with founding and running a start-up has taught us one thing, it’s that business is all about creating value. The value proposition physical therapists have as providers who deliver efficient and cost-effective care is a powerful one in the new healthcare landscape. But if we fail to live up to it by remaining stuck in the fee-for-service mentality of quantity over quality, the services provided by physical therapists will only continue to become commoditized.

It is our belief that demonstrating and marketing the value we create in the healthcare system is the path to our profession’s brighter tomorrow. It’s obviously a tough shell to crack, but we feel that continuing to develop and support new care delivery and business models is imperative to the future success of the profession.

Mike and Justin’s company, revoPT, currently has a mobile application in beta testing and was one of 8 companies that participated in last summer’s prestigious StartFast Venture Accelerator Program in Syracuse, NY.  For more information, visit www.myrevopt.com or email team@myrevopt.com.”    

All private practice owners are concerned with improving their clinic’s brand image. But go to any clinic’s website, and you’ll inevitably see some rendering of the same dry, generic mission statement:

“At [INSERT ANY CLINIC’S NAME HERE] our focus is you.  Our staff is committed to providing personalized care that uses the newest techniques and state-of-the-art equipment. Understanding your needs and goals, we develop a plan of care to achieve your maximum recovery.  No clinic in the area has our level of professional knowledge and experience at rehabilitating musculoskeletal impairments” 

Blandly and non-specifically broadcasting what you do and expecting people to trust your brand is unreasonable—because brands are built through experiences.  Engaging patients and giving them an experience that makes them want to come back is the most powerful branding strategy private practice owners have.

Patients who are satisfied with their care are more likely to return in the future and be evangelists for your clinic.  Improving the care experience can go a long way towards maximizing the lifetime value of your patients (LVP) and, ultimately, the bottom line for your clinic.

Home exercise programs provide an underutilized medium for enhancing the care experience. But many PTs are missing the boat.  A majority of us still provide patients with generic picture handouts that look like we put no time or thought into making, and that are often extremely difficult for our patients to understand—then we get frustrated when they fail to comply.
Something is getting lost in translation.  As EMRs, iPads, and smartphones become more and more prevalent in PT clinics, it’s time to rethink how we prescribe exercises to our patients.  But as with sending out patient newsletters, the key is being able to find a tool that can help you automate and efficiently personalize as much of the experience as possible.

If you’re the type who wants full control over every aspect of your practice, then revoPT is the app for you.  It gives PTs the ability to seamlessly integrate instructional video into clinical practice.  The app allows you to record your own exercise videos and assign exercise programs on the spot using your smartphone or computer tablet.

Patients can access their programs anywhere.  All they need is internet access.  You can even set automated text messages to remind your patients to do their exercises.  RevoPT provides unparalleled versatility and unlimited potential for enhancing patient education and engagement.

If you are interested in using the app, sign up here.  They are only issuing a limited number of free accounts.

Currently, 47 states have granted physical therapists direct access, which is a tremendous achievement for PT; but the changes in legislation have failed to translate into a significant shift in the profession.  In a study by McCallum and DiAngelis (2012), 1,795 PTs practicing in Ohio were surveyed about direct access in clinical practice.  Results revealed that direct access PT clinics treat only 1-10% of their overall patient caseloads by direct access.  It was also found that over 25% of direct access patients were past patients of those clinics, meaning they only knew about direct access because they were educated on it the first time they came to the clinic.

The problem with taking direct access from vision to reality is that PTs are not “being recognized by consumers as practitioners of choice”.

When you hurt your back or pull your hamstring, who is the first person you think to see?  Your doctor.  For the sake of PT, that has to change.

PTs are experts at diagnosing orthopedic injuries, reducing pain and restoring function, but their unique talents and skill sets have gone under–recognized, and, frankly, undermined in the eye of the public.  The reason is not lack of interest or lack of respect—just ask any patient of a good PT—the reason is visibility.

The average patient does not know they can see a PT without referral, and the average person feels safer going to their doctor because they are unaware of the capabilities of PTs.  The APTA is attempting to address this through its Move Forward marketing campaign, which is attempting to brand the profession through various channels, including an interactive website, educational videos, and TV commercials.

Move Forward is a huge step in the right direction, but the campaign will never take hold unless it gains support from the very people it is trying to promote.  For the population to buy into physical therapy, physical therapists have to buy into themselves.  Public awareness is essential to make the vision of direct access real.

Something is getting lost in translation.

We go through four years of undergrad, two or three years of grad school, get a doctorate degree, pass the licensing exam, and gain years of clinical experience only to limit our knowledge and creativity to generic exercise handouts?  I don’t teach my patients based on generic descriptions produced by a big company:  these handouts fail to provide a level of personalization that engages the patient and keeps them accountable.

Patients are not stick figures on a piece of paper.  They deserve something more…we deserve something more.

There are a number of published studies that have examined the benefits of instructional video over visual illustration in teaching patients exercise programs. In a randomized controlled trial by Reo and Mercer (2004), 40 subjects were instructed in a series of five shoulder exercises through either one-on-one instruction with a therapist, videotaped instruction, or picture handouts.  The testers evaluated the patients’ performances of each exercise 24 hours after instruction and documented all errors in form.

The study found that the total number of errors in the handout group was more than twice the average of the videotaped instruction groups.  In addition, exercise performance of the videotaped instruction group was found to be nearly identical to patients receiving one-on-one instruction.

While the American Physical Therapy Association (APTA) and other influential figures in PT are encouraging evidence based practice models, the ability to clinically implement the research on video instruction has eluded physical therapists.  No wonder why the APTA is pushing for care innovation through technology and encouraging entrepreneurship in the profession.

Lack of adherence to recommended care is associated with increased healthcare costs. Fritz et al. (2008) found that PT patients receiving care that adhered to practice guidelines required 1.3 fewer visits, $167 less in average charges, experienced 12.3% better improvement in pain, and 17.6% better improvement in disability compared to those who received non-adherent care.  In the year after discharge, those who received adherent care required significantly less prescription medications, MRIs, and epidural injections

With 30 million people going to PT every year, solving the problem of home program compliance offers a significant opportunity to improve care and decrease healthcare expenditures.  One area of promise lies in changing the traditional method of delivering home programs to patients.

There are a number of published studies that have examined the benefits of instructional video over visual illustration in teaching patients exercise programs. In a randomized controlled trial by Reo and Mercer (2004), 40 subjects were instructed in a series of five shoulder exercises through either one-on-one instruction with a therapist, videotaped instruction, or picture handouts.  The testers evaluated the patients’ performances of each exercise 24 hours after instruction and documented all errors in form.

The study found that the total number of errors in the handout group was more than twice the average of the videotaped instruction groups.  In addition, exercise performance of the videotaped instruction group was found to be nearly identical to patients receiving one-on-one instruction. Weeks et al. (2002) also found that subjects receiving videotaped instruction were more motivated to perform their exercises in a home environment, and were more confident about performing the exercises correctly, compared to subjects receiving picture diagrams.

Roddey et al (2002) followed 108 patients for one year status post rotator cuff repair surgery.  For the last six months of rehabilitation, subjects were randomized into two groups:  one was instructed on a therapeutic exercise program in-person; the other was taught through instructional video.  It was found that patients who utilized the videotape method had self-reported outcomes equal to patients instructed personally by a physical therapist.

While the American Physical Therapy Association (APTA) and other influential figures in PT are encouraging evidence based practice models, research on the benefits of video instruction has been difficult to implement–until now.  With revoPT, a new mobile application, PTs can seamlessly integrate video-based instruction into their clinical practice.  The application gives PTs the power to CREATE instructional videos, ASSIGN them to their patients, and TRACK adherence to home programs—all on their smartphone.

The company is based on the premise that if home exercise programs are performed correctly and consistently, patients will get better, faster.

RevoPT is one of eight companies participating in the StartFast Venture Accelerator Program this summer in Syracuse, NY and is currently in private Beta testing.  The company is answering the calls of the APTA for care innovation through technology and entrepreneurship in the physical therapy profession.