How a Surgeon’s Research Turned into a Device That is Advancing the Way Physical Therapy is Practiced
Orthopedic Surgeon, Reuben Gobezie, MD, is passionate about monitoring his patients’ outcomes following surgery. While many patients may only see their surgeon for a quick visit after a procedure, Dr. Gobezie continues to follow up with patients for months and even years after a surgery to measure their progress and help them achieve the best outcomes.
A nationally recognized leader in orthopedic surgery, Dr. Gobezie has been a shoulder specialist since he graduated from the Harvard Medical School Shoulder Fellowship in 2006. Over the years, he has led dozens of shoulder research studies, invented shoulder implants, developed new surgical techniques, published in several medical journals and delivered presentations to fellow surgeons all over the world.
Yet, in his quest to perfect the outcomes of his patients’ success after a surgery, one thing stood in his way: physical therapy.
A missing link in outcomes measurement
Physical therapy is a critical aspect of recovery from surgery. Studies overwhelmingly show that patients recover faster and with less pain when PT protocols are followed. Unfortunately, only 35 percent of patients actually complete their recommended PT plan. The result is a delay in recovery, potential complications, and for some – more surgery. For an orthopedic surgeon, this is extremely frustrating. Even when all goes perfectly with a procedure, they cannot control whether the patient is following through with their physical therapy exercises.
Dr. Gobezie and his team worked with his patients both pre- and post-surgery to educate them on the exercises they will need to perform and even placed a series of videos on his website www.clevelandshoulder.com for them to review. But this wasn’t enough. Dr. Gobezie teamed up with fellow orthopedic surgeon Laurence Higgins, MD, to find a better way.
“One of our challenges was understanding how effective a procedure or intervention was if we couldn’t account for the quality of rehab between patient visits,” said Dr. Gobezie.
For years, the two researched ways that patient monitoring could extend to physical therapy to ensure the best possible patient outcomes after surgery. The goal was to develop a standardized physical therapy regimen that featured exercises developed by top sports and rehab professionals. The device would lead patients through best practice protocols and measure the range of motion, volume and intensity of exercises. This data would enable the surgeon and therapist to correct an issue before it becomes a major complication.
Staying connected to the patient at home
PT Genie was the result of this collaboration: a remote monitoring system consisting of wearable sensors and a tablet. The patient wears small sensors while they exercise that send data back to the therapist to measure exactly how they’re doing and if they need assistance. Through an interactive, virtual reality avatar on a tablet, patients are guided as to exactly how to do their exercises. It provides real-time feedback and an ongoing connection between patient and therapist to ensure the patient is recovering on track.
PT Genie acts as a virtual coach and results tracker. The therapist can customize the plan of care and view the patient’s progress in real time on the therapist dashboard. After the patient completes the plan, the system provides patient outcomes data to demonstrate the success of the program.
Getting patients to play the game
Patients interact with the device in a game-like fashion. Part trainer, part task-master, the device keeps patients motivated to achieve more each day and strive for success – to win the game. PT Genie keeps the patient compliant with the program and enables them to exercise when and where they choose to.
A study of 124 post-operative patients that used PT Genie showed that patient compliance increased from 34% to 78% while using the device. Patients also recovered 60% faster than with traditional physical therapy alone. The study also demonstrated a 50% drop in pain scores and a 70% increase in overall patient satisfaction.
Gathering data to improve outcomes
In a healthcare environment that is increasingly moving towards value-based care, both surgeons and physical therapists need to develop ways to demonstrate that they are using best practice protocols efficiently and for optimal results. Monitoring systems like PT Genie provide the data to show what parts of the program are delivering and enables providers to establish standardized ways to measure results.
“I’m one of the busiest shoulder replacement surgeons in the country, but if you asked me what the best rehab protocol is for shoulders I could only tell you what I think because there isn’t any data for me to compare my rehab protocol to the next doctor,” Dr. Gobezie said. “With PT Genie, we’ll begin to understand what exercises work best from patient to patient based on things like age and gender. This evolution of data will help inform physicians and patients about the best rehab protocol for their recovery and which providers offer the best outcomes by region or hospital.”
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