A Pilot Study of a Sensor Enhanced Activity Management System for Promoting Home Rehabilitation Exercise Performed during the COVID-19 Pandemic: Therapist Experience, Reimbursement, and Recommendations for Implementation

Veronica A. Swanson, Vicky Chan, Betsaida Cruz-Coble, Celeste M. Alcantara, Douglas Scott, Mike Jones, Daniel K. Zondervan, Naveen Khan, Jan Ichimura and David J. Reinkensmeyer
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Veronica A. Swanson: Department of Mechanical and Aerospace Engineering, Henry Samueli School of Engineering, University of California, Irvine, CA 92697, USA
Vicky Chan: Department of Outpatient Physical Therapy, University of California, Irvine, CA 92868, USA
Betsaida Cruz-Coble: Department of Outpatient Physical Therapy, University of California, Irvine, CA 92868, USA
Celeste M. Alcantara: Department of Outpatient Physical Therapy, University of California, Irvine, CA 92868, USA
Douglas Scott: Division of Rehabilitative Services, University of California, Irvine, CA 92868, USA
Mike Jones: Virginia C. Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA
Daniel K. Zondervan: Flint Rehabilitation Devices, LLC, Irvine, CA 92614, USA
Naveen Khan: Pt Pal, Cherry Hill, NJ 08003, USA
Jan Ichimura: Department of Physical Therapy, Acute Rehabilitation Unit, University of California, Irvine, CA 92868, USA
David J. Reinkensmeyer: Department of Mechanical and Aerospace Engineering, Henry Samueli School of Engineering, University of California, Irvine, CA 92697, USA

IJERPH, 2021, vol. 18, issue 19, 1-18

Abstract: Adherence to home exercise programs (HEPs) during physical rehabilitation is usually unmonitored and is thought to be low from self-reports. This article describes exploratory implementation of a Sensor Enhanced Activity Management (SEAM) system that combines HEP management software with a movement sensor for monitoring and motivating HEP adherence. The article also presents results from attempting to gain reimbursement for home use of the system with therapist oversight using Remote Physiologic Monitoring (RPM) codes. Four therapists used the system in their regular practice during the first six months of the COVID-19 pandemic. Therapists filled out surveys, kept notes, and participated in interviews. Billing and reimbursement data were obtained from the treatment facility. Exercise data from the SEAM system were used to understand HEP adherence. Patients were active for a mean of 40% (26% SD) of prescribed days and completed a mean of 25% (25% SD) of prescribed exercises. The therapists billed 23 RPM codes (USD 2353), and payers reimbursed eight of those instances (USD 649.21). The therapists reported that remote monitoring and the use of a physical movement sensor was motivating to their patients and increased adherence. Sustained technical support for therapists will likely improve implementation of new remote monitoring and treatment systems. RPM codes may enable reimbursement for review and program management activities, but, despite COVID-19 CMS waivers, organizations may have more success if these services are billed under supervision of a physician.

Keywords: physical rehabilitation; mRehab; telerehabilitation; implementation; COVID-19; mobile applications; remote physiologic monitoring; RPM; HEP; home exercise program (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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