CSP members share their advice and experience of using digital tools to provide physiotherapy services remotely during the pandemic
Phio:app for digital triage and self-management support in MSK physiotherapy settings: Peter Grinbergs, physiotherapist and serial healthcare entrepreneur discusses the Phio app for digital triage and self-management support in MSK physiotherapy settings
What physio services do you provide?
Phio is a chatbot and patient-facing app. Our digital triage tool allows patients to access the most appropriate care pathway without the need to see or speak directly to a physio. Those appropriate for exercise-based self-management can receive tailored rehab and guided support through the app. The app is continuously supported, clinically validated and evaluated on a regular basis.
What tools are you using to deliver your physio services digitally?
Our triage tool is a web-based solution that can be used on any smart device. Our Digital Injury management solutions is an app compatible with Apple and Android.
How have these services replaced face to face contact?
Phio triage helps to stratify MSK patients. It can be accessed at any time and on any device meaning patients do not need to book an appointment or speak to someone over the phone. The back end decision tree can be mapped to any MSK pathway meaning rapid access, fewer GP appointments and more appropriate onward referrals. The patient-facing app gives those who are appropriate for exercise-based self-management the support they need.
How has it been?
Instant stratification against any framework means clinicians are able to better prioritise referrals and patient needs. Clinicians going on to conduct assessments do so with a greater degree of knowledge due to the large amount of clinical data captured by Phio at the front end. This means less repetition for the patients and a more streamlined assessment. Capacity in the system is freed up for those with more serious injuries.
Any top tips?
Technology does not need to be scary so be sure to pick a partner who is motivated to provide user friendly and patient focused solutions.
Babylon:app for digital MSK consultations in first contact physiotherapy settings: Patrick Roberts, first contact digital physiotherapist, discusses the Babylon for digital MSK consultations in first contact physiotherapy settings
What physio services do you provide?
I provide digital physiotherapy services acting as a musculoskeletal first contact practitioner, including digital and face-to-face MSK physio assessment, diagnosis and treatment. The service is available to NHS patient groups across London and Birmingham, in addition to private patient groups.
What tools are you using to deliver your physio services digitally?
The Babylon GP at hand app is used for video and audio consultations. Patients select the symptoms they are experiencing, and are directed to the most appropriate clinician accordingly (for example dermatology is directed to GP, back pain is directed to physio). The digital clinical portal information for patients includes advice, education, videos and exercises, and can be accessed on the Babylon app.
How have these services replaced face-to-face contact?
Video consultations are used for subjective and objective assessments, and for providing subsequent advice and education. Exercise rehabilitation is discussed and demonstrated within the video consultation. This is then documented in the patient’s Babylon app and exercise videos are provided. Patients are only booked in for face-to-face appointments if there is a suspicion of something serious that requires a physical examination to confirm or eliminate.
How has it been?
There are obvious limitations on performing an objective digital consultation, most obvious being that you cannot physically palpate and assess. However, the assessment does become more interactive and functional, enabling the patient to become immediately proactive in functional movements and exercise. Providing you obtain a thorough subjective assessment, you can effectively assess, diagnose and treat musculoskeletal conditions.
Babylon Health uses a five-star patient rating system (5 being best, 1 being worst). The physiotherapy service has maintained a 4.89 rating, the highest average score across all clinician groups at Babylon Health.
Any top tips?
Good internet connectivity on both ends is crucial for video consultations. Very clear, succinct instruction is required when asking patients to perform an objective assessment without video connectivity. Practitioners demonstrating movements, special tests and exercises makes a huge difference in the assessment.
iPrescribe Exercise: app for monitoring physical activity programmes for people with long-term conditions remotely: Carron Manning, physiotherapist and co-founder of iPrescribe Exercise, explains how the app can be used for monitoring physical activity programmes for people with long-term conditions
What physio services do you provide?
iPrescribe Exercise is an evidence-based programme which uses an automated algorithm to analyse user health, resting heart rate and current fitness level, and it prescribes graduated and personalised physical activity programmes which are appropriate for 20 long term medical conditions (including diabetes, heart disease, cancer, hypertension, Parkinson’s, MS, osteoarthritis, and chronic pain).
What tools are you using to deliver your physio services digitally?
iPrescribe Exercise can be used to monitor patients remotely. The app is available for anyone to download from the App Store for iPhone or Google Play for Android. We are providing our platform for free to any clinician and rehab programmes such as cardiac rehab, diabetes management and cancer rehab during the Covid-19 pandemic. It is also published on the NHS Apps library.
The app was rebuilt in March with a number of new features based on feedback from clinicians and patients.
How has it been?
People generally find the programme achievable, they like that it is personalised to them, and there have been many comments about being able to select multiple chronic diseases. Patients also like that they can send a progress report at any time, directly from the app, to their health professional.
- For further information and guidance, as well as more member case studies, visit the CSP website.
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