The results of each musculoskeletal-related workers’ comp case are affected by multiple biological, psychological, and social factors. Each person and case are different. As a result, the more personalized care is, the more effective it will be.
To gain the benefits of scalable, customized treatments for patients, therapy providers can use digital tools to gather, analyze, and act on relevant data to achieve better outcomes and shorter case durations.
Understanding the importance of arming providers and patients with digital tools to supplement in-person care, Bardavon has just released an all-new Digital Recovery App. The Recovery App engages patients in their care plan outside the clinic. The app also provides important data to therapy providers that inform treatment decisions in the clinic.
Hybrid care in physical rehabilitation is ideally suited for the workers’ compensation industry. Digital options meet workers at home and in the workplace, but in-clinic care is necessary to address the hands-on and highly variable nature of work tasks.
Hybrid care marries the two—informing in-clinic treatment decisions with digital data, which effectively demonstrate physical and non-physical factors contributing to case outcomes. And it offers patients a more comprehensive plan to manage their injury. Here’s how digital data can improve the outcomes of clinical musculoskeletal cases:
Identify Issues Using Patient-Reported Outcomes
Considering the patient’s perception of their care and functional ability alongside the in-clinic task assessments and physical testing, we can see an overall picture of the success of the care plan.
In the clinic, when assessing patient care success, there are three areas therapists often look to determine the overall quality of the outcome, including:
- Ability to complete activities of daily living
- Return-to-work success
- Returning to pre-injury functionality
Patient–reported outcome measures (PROs), captured along milestones in the path of care, can be quite telling. These factors can reveal the necessary psychosocial information needed to indicate a risk for a prolonged duration of care or poor outcomes.
Collecting PROs throughout a case can help identify issues that require immediate clinical attention and enable personalized care. These assessments examine various areas, including pain, fear avoidance, mental health, and function.
Of course, attentive care providers ask patients about their progress and how they feel—physically and mentally. But when PRO data is collected and assessed, it can be used in several ways:
- Clinicians have more data available to tailor care plans to individual needs.
- The care plan will be more adaptable to progress and emerging setbacks.
- Patients will be more engaged and feel they have a share in decision-making.
Historically, PROs were aggregated and used after the fact to serve the clinic’s needs regarding clinical intervention and outcomes. The efficient collection, cadence, and delivery of PRO information allow the patient to have a voice in their care and the information to be used by the clinician in real-time to deliver improved, personalized care. PROs can now serve the patient, clinician, and healthcare system.
Psychosocial Factors Can Affect Physical Recovery
Non-physical psychosocial factors can be a driving force in a case. Mental health, self-efficacy, trust, and other factors can decrease engagement, increase case duration, and lead to poorer treatment outcomes.
Patient perception of their injury, situation, and quality of care plays a major role in how non-physical factors can help or hinder their care plan.
Patient perception is the patient’s overall subjective experience with their injury, physical capability, social support system, financial strain, healthcare provider, and care plan.
We are becoming increasingly aware that a single avenue of intervention, including in-clinic PT alone, is not enough for the many patients that come into a musculoskeletal injury with non-physical factors. For most patients sent to rehab, what they can do physically gets most of the attention – measuring and treating functional impairments and pain. But what if how they perceive or feel about their function is equally important as how they perform in the clinic? Their perception about the following questions, may create physical dysfunction:
- What do they think they are capable of?
- What if they are consumed by thinking their exercises or work tasks will increase their pain?
- What if their family will be disappointed if they don’t fully recover?
- What if they perceive their financial risk as too high to survive without returning to full duty?
The patient’s perception of the severity of the injury, somatic symptoms, distress, depression, and social support creates true barriers to physical improvement that affect the outcomes of the case.
Ignoring the patient’s perception of the situation, function, and mental health needs lacks the holistic approach necessary to personalize care.
Conversely, utilizing the patient’s perception helps determine the barriers to improvement, write appropriate goals, and incorporate the right players in the care team, allowing therapy providers to address the patient’s coping skills.
Incorporating Biopsychosocial Factors Improves Hybrid Care
Layering the information from functional and psychosocial PROs with the rate of assessed functional improvement in physical therapy can help discern if non-physical factors may be impacting case visits, duration, and overall outcome.
As an example, imagine a warehouse worker who has a shoulder injury. He is invited to the Recovery app and completes multiple PROs prior to his PT evaluation. Going into the first appointment, the therapist knows the patient has recorded a “severe” score for anxiety & stress on the DASS-21, “severe” pain on the VAS, and a “moderate disability” on the QuickDASH. He also notes during his evaluation that he has financial distress due to his injury.
If his clinician learns this information at the start of care, how can she use it to tailor treatment?
- She can discuss the patient’s reported stress and anxiety during the initial appointment to acknowledge the patient’s distress and educate the patient on what to expect with therapy and workers’ compensation to decrease fear.
- She can work with a Nurse Case Manager to make sure the patient has the necessary care team and community resources to meet his needs.
- She can incorporate pain education and promote the app content for stress management and mindfulness to minimize impacts on these symptoms.
- She can create a physical therapy care plan with the patient focusing on work readiness, returning him to his pre-injury functional level to minimize his financial burden.
Four weeks later, if similar scores are presented and the in-clinic performance is improved, then the likelihood of a non-physical factor driving their self-reported symptoms and functional levels is high. This will allow the therapist to have necessary conversations with the patient and the rest of the care team to determine the next best steps for case management.
Digital tech can educate patients about their mental, emotional, social, and nutritional health needs and musculoskeletal recovery needs. Health education can contribute to a patient’s engagement with their care plan, which plays a role in positive outcomes. Digital health tools broaden the reach of the plan to include environments outside the clinic. Engaging a patient in multiple settings makes addressing biopsychosocial needs more viable.
More comprehensive treatment in a workers’ compensation setting means improved return-to-work outcomes. Taking PROs into account can also mean better patient satisfaction with their care experience. Listing to their voice through self-reported outcomes allows providers to develop a rapport with their patients, establishing trust that can contribute to positive treatment outcomes.
Finally, injured workers who have a positive experience through the treatment process are more likely to feel that their employer has taken care of them, giving them the confidence to return to work.
Ready to invest in biopsychosocial digital care? Go hybrid with Bardavon’s Recovery App. Connect with us directly by emailing [email protected].
