Telehealth for physiotherapists

Delia: I would like to introduce Marijn Kortekaas, the general manager for Physitrack. It’s a platform that promotes four key areas, which is fitness, exercises, fitness tracking, and tele-health. Is that correct?

The four components to physitrack

Marijn: Yeah, more or less. Those are the four key components to Physitrack, so it’s prescribing exercise programmes to patients, track their outcomes, educate the patients, and have telehealth video calls with patients as well.

Delia: Now, you’ve come to the health startup world via business management, is that correct?

Marijn Kortekaas

Marijn: Yes, so I was actually, prior to Physitrack, no professional experience when it comes to healthcare, but as a patient, I’ve seen many a physio and chiro. Yeah, business management, worked for Nike for about eight years, both in Europe and here in Australia.

And I worked for some marketing companies here in Australia and the US as well. So quite a diverse background, and then I actually know one of the co-founders of Physitrack very well.

We used to go to high school back in Amsterdam where we grew up. Yeah, he just asked me to have a look at their product three or four years ago. I’d liked what they were doing, and came on board full-time, just under three years ago now.

Delia: Can I ask, have you had any exposure to the health industry yourself? Have you been into hospital or seen a relative who’s been in there and had a chance to have a look at how things work?

Marijn: Probably not so much recently, I’d probably have to go back to my youth, I would say, but I guess in general, listening to how people see obstacles in healthcare systems, whether it’s in public hospitals, private clinics, I think there’s quite a bit of disjoint between what’s on offer, in terms of healthcare, and what patients expect, and consumers in general, how they live their lives.

And I guess that’s where Physitrack was born, where we found that opportunity to improve the patient experience on one end, but also provide practitioners with more insight in how the patients are tracking in terms of outcomes, which again all stems from that gap that’s in healthcare at the moment.

Delia: Many people who come into healthcare are surprised by how behind the modern world it is. Can you explain what problems you actually solve in Physitrack?

Inspired by a bad experience one of the founding members faced

“One of the co-founders family members who had an ACL procedure, he was given a piece of paper with some exercises… he didn’t feel very motivated by just staring at a couple of stick figures with some scribbles he didn’t understand.”

But also for the surgeon and the physiotherapist, once they let the patient go and basically see them again in a couple of weeks’ time, they lost track of how the patient was actually progressing, and that’s how Physitrack started. What we do change is actually give the practitioner- whether you’re a physiotherapist, a surgeon, exercise physiologist- basically real time insight into how your patients are tracking.

And what it does is a couple of things: patients know that you can see what they’re up to, so patients are more likely to adhere to their exercises, which obviously has a positive effect on their outcomes. But also, as a practitioner, being able to see how your patients are progressing allows you to be more proactive when it comes to reaching out, whether it comes to modifying their treatment plan.

So it’s in a way eliminating a lot of wastage in terms of a patient that might just get stuck for two weeks comes back, no progress, maybe even gone backwards, whereas now we actually get that insight to practitioners when it comes to patient outcomes. Yeah, allow them to be more on the boat with their patients.

Delia: So in the traditional way, and that refers to an anterior cruciate ligament, people just get drawings of exercises. There’s no chance to review how they’re actually doing them. There’s no proper follow up.

So how does Physitrack actually work when physios actually contact people through the platform? What is the process that they actually go through?

Helping physiotherapists to provide better content and stay more in touch with their customers

Marijn: It all starts on the practitioner’s side, so let’s use a physiotherapist as an example. So they use Physitrack to put an exercise programme together- and not just that, they can pick and choose from different exercise videos.

So, as a physiotherapist, you build a package of content inside Physitrack- so you put that package together, send it to the patient, the patient then downloads a free app from the app store, it’s called PhysiApp. And inside the app, once you log in, you have all your content there, so it’s all there for the patient, because they report back to their practitioners on how they track with their exercises in terms of set and reps that they complete, in terms of their pain scores, the practitioner has real time insight into what the patient is up to.

We really try to create that whole 360 degree feedback loop between the patient and the practitioners, so the practitioner knows what’s going on, the patient feels better supported, and in the end, we help people achieve better outcomes.

Delia: So, with telehealth are they able to text their physiotherapist? How are they able to get in touch?

Marijn: The telehealth basically consists of two components: the secure messaging, so as a patient you can message your practitioner with quick question, but the key component of telehealth is the video call. As a practitioner, instead of scheduling a face-to-face, in person consultation, you can use the video call feature, so it’s again, all built into the platform, not just for the practitioner, but also for the patient.

Let’s say it’s 11:00, it’s time for my video call telehealth appointment. As a patient, I just open the app, and I just answer the call and start the video call component. It’s super seamless. The patient doesn’t have to leave their home, and the practitioner is charge.

Delia: What’s been the feedback of some of your customers, particularly people who’ve experienced traditional healthcare- which is, as you described before, paper scribbles for exercises, and “Make an appointment if you want to get back to us”?

“We have more than 4,000 videos on our platform. But… it’s not just about giving patients exercises, it’s also educating them on why it’s important to do exercise and how they can manage their condition.”

Feedback from physiotherapists is very positive

Marijn: Feedback from practitioners is fantastic. In the past, patients might not adhere to 20- 30% of their exercises, and the lack of adherence has a massive impact on how well they progress through their treatment.

But after using Physitrack with patients, now they achieve 80-90% adherence, which is fantastic, and patients’ feedback to the practitioners is a lot more positive as well, so I think that’s one of the key things that we do hear from reviews all the time.

It’s great for private clinic owners. If you talk about hospital systems, whether private or public, it’s identical. Again, patients love the service they receive, they feel it’s relevant to them, as to how they live their lives, which is very mobile and app-based normally nowadays.

For hospitals, they save a lot of time as well, when it comes to putting exercise programmes together, and being a lot more focused on where there are exceptions when it comes to the patient. So it’s not just about “How did you go with your exercise programme?”, but it’s about, “Okay, well I can see I had some real trouble with exercise A and B, so let’s focus on those specific exercises.”

It’s really about narrowing down the conversation to pain points of the patient, which again, makes the patient feel a lot better supported.

Delia: With the platform, a physiotherapist purchases it on a subscription basis, and then use for their patients or their customers, is that correct?

Marijn: Yeah, that’s right. So it’s a very straightforward system, so yeah, a physiotherapist subscribes on a monthly basis, so it’s around $13 per month per practitioner, and that gives them access to all areas, to set up as many patients- as many exercise programmes as they want.

It’s a very affordable platform and it hands- a lot of public hospitals in particular are very much drawn to Physitrack.

Delia: And I noticed that it’s HIPAA compliant, which is the American e-health security system, and fully encrypted, so there’s no concerns about broaches of privacy.

Marijn: That’s something that we started doing very early on when we launched Physitrack. In Australia, for example, all our data is stored on the local AWS server in Sydney, and we do it exactly the same in each market where we operate around the world. Backed up twice daily, encrypted, and we’re just finalising our GDPR certification with the new consumer privacy law coming into play in Europe.

The future - planning to be a publicly listed company

Delia: Where do you see Physitrack in five years from now?

Marijn: Probably the first next milestone for us is to go public. So we’re still a private company, we were founded back in 2014, and invested millions in a way, we were quite lucky that we had some family and friends investors coming on board very early from the start, which means we don’t report to any VCs.

We were very independent as a company to set our own trajectory, so I think going public later this year is the plan, and that’s really for us the springboard to moving to new markets. So that’s really the next big milestone for us in the next six to twelve months.

But from there, it’s really going to be doing more of what we’ve already done. In the last few years, it’s about opening new markets, putting new people on the ground. The other key thing is that we have been focusing on this integration with other platforms.

So one of the key things that we have done since we launched is to integrate with practise management systems, and that’s one of the key things, inter operability is becoming more and more an expectation.

Systems need to be able to talk to each other, exchange data, and see if sense can be made out of data. There’s a lot of data captured around the world, it’s just a matter of how do you actually connect those systems and combine data from different platforms to create a more efficient healthcare system, deliver better health outcomes.

Delia: That’s a big issue that people might not realise. In healthcare, we have something called information silos, which means that as people move from one area to another, there’s often a different computer system and they mostly don’t communicate with each other.

Marijn: It’s an issue that is slowly being addressed. In Australia there is some really good work happening with some of the healthcare systems, like in Queensland for example, where patient files are going digital, which is fantastic and obviously the next step would then be to look at which kind of systems do we use in our healthcare system.

How do they talk to each other, and how can we actually connect them better.

That’s one of the key focus areas for us.

Delia: Can you tell me a little bit about your team? Chief technical officer Nathan Skwortsow. Can you please give me a little bit of an overview of him?

Introducing the founding Physitrack Team

Marijn: Nathan and I used to go to high school together back in the days. So Nathan, after his high school period, he moved to the US and studied radio and TV for a while in California, and he studied multimedia technologies as well in the Netherlands after that.

So he’s basically built his career on building websites and also apps to address certain problems.

In the Netherlands, for example, he built the first dating website, which is very common at the moment, but back in those days, in the early 2000s, he was still quite a novelty. He’s built real estate websites, and that’s basically his forte.

So he’s very much in the middle of all the latest tech developments. He’s been one of the key driving forces behind Physitrack, together with Henrik.

Henrik Molin is our CEO. He used to be in finance and had a lot of high positions there, so it’s actually quite interesting with Physitrack, where we’ve as a business combined a lot of know-how from outside healthcare, coming in from a fresh perspective.

But then obviously working with a lot of healthcare providers and experts in healthcare, and I think that’s been one of our key success parts of the business, where we work with a lot of people that are not necessarily coming out of healthcare.

Delia: That’s a very interesting point, because people that have been in healthcare for many years are used to such poor standards of technology, to be frank.

We can have difficult acclimatising, but people like you who come from the commercial world, you have standards that you expect and you carry them through into the health industry.

Marijn: Absolutely, and I totally agree and I think that if you look at all other industries, whether it’s retail or whether it’s travel, there’s a lot happening, especially on the consumer side, when it comes to innovation.

I mean, look at Amazon for example, or even at Apple. Some of the bigger companies traditionally are not coming from healthcare start moving into healthcare, and they bring a certain level of expertise and innovation that hasn’t been present in healthcare itself.

Helping physiotherapists reach their full potential

Delia: Also, allied health professionals have to earn their own way. They’re really small, self- employed businesses, so they need to be part of the modern world. Now I notice that allied health services tend to have a higher level of technology and modern customer service focus than traditional health services.

Marijn: Yeah, that’s right. It’s actually quite interesting. I think a lot of health professionals want to innovate. They talk to their patients every single day and, of course, they’re all consumers and they know what’s important for their patients. I suppose there’s no issue with allied health practitioners not wanting to innovate, because they do.

So where do you start? Which platform do you use? So we help practitioners with that when it comes to training, but also again there’s integration through the practise management system as a key driver there as well.

Delia: I notice you’ve got half a dozen that you’re integrating with, which is really important when people are running a practise. They have to manage their bills, their appointments, so it’s really, really helpful that you can integrate with those clinic systems.

Marijn: It’s interesting. One of the first few questions that we receive when we start talking to clinic owners is “Do you integrate with the PMS A or PMS B?”

In Australia, we integrate with all the key ones. It makes a life of difference, and it really lets practitioners open their patient directly from the PMS into Physitrack, so there’s no double handling of data. And the other we’ve started doing now, which people love most, is- say you assign an exercise programme to a patient, a copy of the programme in PDF form is uploaded back to the practise management system, so as a practitioner, you don’t have to have two different screens open all the time.

We really try to keep the PMS as a source of truth, so you can always look in there to know exactly what your patients are up to, what you prescribed.

It’s really about making the practitioner’s day as easy as possible.

Looking at moving into medical practices in the future

Delia: Have you thought about moving into mainstream medicine? This would be very useful for doctors.

Marijn: There are a number of GPs for example, and even some surgeons, that are using Physitrack, so I think the surgeon angle is interesting, i.e., where surgeons would like to give their patients some prehab exercises before a patient goes into a procedure, and then follow up with some exercises afterwards.

And again, that’s where we see some really nice workflows happening, where a patient moves from the operating theatre to the in-patient department, start their exercises in their hospital bed. So start a little earlier, which has a really big impact on outcomes, and then move the patient from inpatient to outpatient, which can all be managed within Physitrack.

So the whole patient journey is basically starting before the procedure, all the way past out-patient into rehab.

So it’s really exciting to see.

Delia: Does your platform, Physitrack, connect with smart devices?

Marijn: Currently, we don’t, but we have a partnership with Apple, so Physitrack is part of the Mobility Partner Programme. Apple helped us with designing our iOS apps that we have, which was fantastic for us, as a smaller company. Since then, we’ve worked closely with Apple on some tweaks and refinements, and one of the things that we are looking at, is to see how we can integrate with Apple Watch for example.

As a healthcare practitioner, you’ll not just track patients’ adherence to their exercises and their outcomes as your surveys, but also be able to see how the health stats were collected from an Apple Watch.

Delia: Thank you very much for coming on the Wikihospitals show, we appreciate having you here.

© Wikihospitals May 2018