JULY - 20199integrated automation model including the four technologies as one solution, has not yet been launched.What are the obstacles against large-scale adoption?There are safety concerns regarding technologies,for instance for motion capture systems that have wires likely to cause falls and subsequent injuries among elderly and cognitively impaired patients. There is also the concern within professional communities that embracing technologies and,consequently, automation, may result in cutting back on services and reducing the "personal touch,"thus compromising patient care. Major payers including Medicare, Medicaid, and private insurance do not provide a comprehensive payment model to reimburse care provided through these technological means.How could partial automation create value?According to the American Physical Therapy Association, an attrition rate of 3.5% projects a shortage of 26,560 physical therapists by 2025. The automation plan would bridge this gap and compensate for the shortage of physical therapists. Partial automation would improve accessibility to high-quality services and highly trained physical therapists, especially for health systems that face difficulty operating larger numbers of centers or hiring qualified therapists.An Integrated Partial Automation Model (IPAM) for rehabilitationWe can imagine a health system with two or three main campuses and some satellite locations serving a large geographical footprint. About 50% of the population served would be in rural areas and remote communities. These patients would have difficulty accessing rehabilitation services, especially highly specialized ones. Due to scarce human and financial resources, this health system would be challenged in deploying more satellite locations for rehabilitation services to cover the whole region. This is where the proposed Integrated Partial Automation Model (IPAM) for rehabilitation comes into play. This model's structure would include a main central rehabilitation office that employs highly trained and specialized Therapists. The Therapists would see patients face-to-face on intake to conduct a comprehensive evaluation and set up a plan of care. After the initial visit, the Physical Therapist would follow up with the patients remotely using motion capture and tracking technology on movement patterns. Subsequently, the Therapist could create a customized virtual treatment environment and deliver feedback and instructions through Tele-health. The patient would receive the follow-up treatments and reassessments at home or in some cases at small offices within his or her proximity. These small follow-up offices would be low-cost operations deployed throughout communities that employ only one Physical Therapist Assistant (PTA) responsible for monitoring the system and following up on the instructions of the central office's Physical Therapist. After widespread adoption of this system, AI technology would be integrated to analyze the data and provide the therapist with precise and cost-effective recommendations for intervention.Of course, a pilot program is needed to examine this model for better understanding and any needed enhancements. In preparing the field for innovation in the rehabilitation industry, messages are intended for different stakeholders. For the American Physical Therapy Association (APTA),establishing a separate section for Clinical Innovation would allow for a more proactive role in the innovation of the Physical Therapy profession. For physical therapy education Leaders, dual degrees combining DPT/MS in Information Technology and other computer sciences, would supply the job market with a generation of PT professionals equipped to lead the innovation revolution. For Health System leaders, large-scale investment in Physical Therapy Innovation would be beneficial. Collaboration with, and investment in,start-ups with new ideas is instrumental to reaping the benefits of the technology for more effective care delivery. Lastly, for CMS and health insurance leaders, there is an opportunity to work with professional associations and health systems to pilot reimbursement models designed for embracing technologies to save costs and improve quality. The assessment and treatment processes can partially be automated to improve patients' engagement and care accessibility, and to improve quality of careMohamed Abdelrahman
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