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Report: Virtual MSK Solutions Meaningfully Improve Outcomes

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Virtual musculoskeletal (MSK) solutions can meaningfully improve patient outcomes, a Wednesday evaluation from the Peterson Health Technology Institute (PHTI) showed.

PHTI is an independent evaluator of digital health solutions. It examined both the clinical effectiveness and economic impact of eight MSK solutions: DarioHealth, Hinge Health, Kaia Health, Limber Health, Omada Health, RecoveryOne, Sword Health and Vori Health. These solutions fall under three categories:

  • App-based exercise therapy with little physical therapist intervention (Dario, Kaia)
  • Physical therapist-guided solutions (Hinge, Omada, RecoveryOne, Sword, Vori)
  • Remote therapeutic monitoring-augmented physical therapy solutions, which supplement in-person physical therapy (Limber)

The analysis reviewed more than 2,000 articles (53 of which were from the evaluated companies). PHTI also received input from physical therapists, clinical advisors, MSK patients and others.

It found that the physical therapist-guided solutions had the best results: they improved pain and function comparable to in-person care and decreased net spending. The analysis states that these solutions can be used as a substitute for in-person physical therapy for many conditions.

The researchers also discovered that app-based exercise therapies can improve pain and function compared to no physical therapy. However, the researchers did not find evidence that they can improve function comparable to in-person physical therapy. Therefore, they likely can’t be used as a substitute.

“At an affordable price, these may be valuable solutions to provide broad-based virtual care for patients with lower acuity who may experience clinical benefits,” the report stated.

RTM-augmented physical therapy solutions were found to provide better clinical results than in-person physical therapy alone but increase net spending.

“Even after accounting for the health benefits of improved adherence and earlier initiation of PT, these solutions increase annual healthcare spending because they augment in-person care and the estimated savings from lower utilization do not offset the increased costs of RTM billed on top of existing treatment,” according to the report.

While the MSK solutions were found to be clinically effective, many patients and providers don’t know about these solutions, according to Caroline Pearson, executive director of the Peterson Center on Healthcare.

“This is in part because many solutions are offered as employee wellness benefits that are disconnected from medical benefits and spending,” Pearson said in an email. “This makes it more difficult for companies to quickly identify the patients who would benefit the most from care and approach them with their solution early in the treatment process. Therefore, we think virtual MSK solutions could deliver even better value by integrating into medical benefits, encouraging earlier referrals to PT, and actively managing other avoidable healthcare utilization.”

PHTI chose to examine these solutions because MSK disorders “have a significant disease burden,” Pearson said. The report states that about one in three people in the U.S. have an MSK disorder. Nearly 10% of medical spending in the U.S. can be attributed to MSK conditions.

There has also been “great technological innovation” in the MSK space, with numerous solutions emerging, she added.

“After a decade in the market for some solutions, it is important for employers and payers to know if they work and if they deliver the benefits they claim,” Pearson said.

This is the second report done by PHTI. The organization first evaluated digital diabetes management tools and found that they don’t provide meaningful clinical benefits and increase health spending. Looking ahead, the organization will assess virtual hypertension and mental health tools, Pearson said.

Credit: Christine Lui Chen, Hinge Health

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