Episode 132: Physical Therapy Without the Commute: How Virtual PT Is Changing Recovery

In this episode, Sandy speaks with Ashok Gupta, physical therapist and founder of TheraNow, about how virtual physical therapy is making rehabilitation more accessible, convenient, and effective. 

Ashok explains how live, one-on-one care, personalized home exercise programs, and computer vision AI can help therapists measure movement, track progress, and guide patients from virtually anywhere.

They also discuss how virtual PT can benefit people recovering from surgery, living in rural communities, facing transportation challenges, or simply wanting more flexibility in their care. 

Listeners will learn how telehealth physical therapy works, how it may fit with insurance and hospital systems, and what patients should ask their healthcare providers when exploring virtual rehabilitation options.

Key Takeaways:

Virtual physical therapy can deliver strong results. With the right platform, trained clinicians, and structured care, virtual PT can be comparable to in-clinic treatment.

Convenience can improve access and consistency. Patients can receive care from home, avoiding transportation challenges, long travel distances, bad weather, and mobility concerns.

AI helps therapists measure progress remotely. Computer vision technology can track range of motion, movement quality, and improvement over time.

Virtual PT is more than a video call. Effective care combines live one-on-one sessions, personalized exercise plans, patient education, progress tracking, and ongoing support.

Patients should ask their providers about virtual options. Hospital systems and physical therapy clinics may offer fully virtual or hybrid programs that combine in-person and at-home care.

Resources:

TheraNow

Want to be a guest on Get Savvy...Demystifying Healthcare? Send Sandy Kibling a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/getsavvydemystifyinghealthcare

Transcript

SPEAKER_00 0:00

With two person assists, the wife and the daughter were in the room, but the therapist was so amazing that he was able to work with the patient during that period. Let me spoil the end of the story though. The patient never went back to the hospital. Today he walks a mile. That's an amazing testimony. Every single time I actually watched that video. After 72 days in ICU, he was actually like brought by 100% of virtual therapy to the person who's back to work, walks a mile, now you even run. So that is the level of impact a virtual therapy can make when done right.

SPEAKER_01 0:39

If healthcare has ever left you feeling frustrated, overwhelmed, or stuck, this show is for you. Welcome to GetStabby, the Mystify Healthcare weekly podcast, where we take complicated healthcare topics and make them simple. We bring you experts in real-world strategies from choosing health insurance to lowering prescription costs, to patient advocacy and the latest healthcare trends. So you give more options on your turn. Get Stabby with your host, Andy Kibling, changing how healthcare knowledge is shared.

SPEAKER_02 1:15

Hey everyone, before we get into the show, two quick things. Number one, if you are enjoying the show, I appreciate you listening. I've had the podcast for three and a half years now, and would be so grateful if you'd be so kind to leave a review. It certainly helps us to be found and help promote the show. Number two, I have a second podcast, Playbook AI Partners, where I bring on guests and talk about the latest trends in AI. Sometimes it's just me and the mic talking about an educational point or a skill that I hope is helpful to you. Because we know AI can be a little overwhelming. There's a lot going on. So I hope that's helpful. You'll also find out more on Playbook AI Partners website about the AI Solution Locker, how to learn a new skill in 20 minutes or less. Make sure you check it out because our goal with Playbook AI Partners is to help you get to where you want to be with AI on your terms and without the overwhelm. And now on with the show. Did you just have a knee surgery and are trying to get a ride to physical therapy? Or couple that with cold weather and icy conditions and you're trying to get to your appointment and avoid a fall. Can there be physical therapy with less of the hassle factor? To help us get into this topic, I have Ashok Gupta on the show. Ashok is the creator of There Now, a virtual PT platform that's helped 70,000 plus patients across the U.S. since 2021. Ashok didn't start as your usual tech guy. He began as a physical therapist treating veterans at BA hospitals and traveling through small town America, working everywhere from ICUs to home health. And everywhere he went, he saw the same issue. People either had to come to you or you had to go to them. And in rural areas, services were just too far away. Ashok and his wife, also a physical therapist, realized most of PT could be replicated virtually. Created, they're now a virtual option for physical therapy. Welcome to the show, Ashok.

SPEAKER_00 3:14

Thank you so much, Sandy. Thanks for having me over here.

SPEAKER_02 3:18

Oh, I'm so excited. I love that you're doing this. It's so awesome. So let's get right into it. Why don't you share with us more about your experience and how it led you on the current journey you're on today with virtual PT?

SPEAKER_00 3:30

Definitely. So just going back like nine years ago, that's when the uh main foundation of Theranel was put in. It was well before your uh COVID and like in today's environment where AI or in telehealth is like kind of natural and normal. But back in 2017, when we started out, it was very difficult to convince people that it would work. Um and if you would ask me back then if I had to explain somebody how would it work how does it work or is it going to really work or not, I would always lead with is like, I have 20 years of experience. Trust me, it does. This is my domain. I'm a doctor of physical therapy myself and I know what I'm doing. But today I can say after thousands and thousands of patients and then actually uh objectively measured data against uh their outcomes and effectiveness, we are comparable to as if you go to the clinic or the clinic comes to your home, or you virtually meet one of my physical therapists or myself, uh, which we now have a big network of 350 physical therapists. We work with the large hospital systems across the United States, from you name it from Providence Health Systems to Ardent Healthcare or University of Texas. And then also, not only like a large hospital systems is what actually defines us, where we are able to provide care to millions and millions of patients. But at the same time, we are also available via the small systems in the middle of nowhere in Kansas or in small parts of Texas where you have very small critical care hospital backbone for the community for their access to the medical services. And then we are the ones actually supporting them virtually to be able to offer the services. So um yeah, that's that's that's the uh way I would say um how virtual therapy works. And I'm looking forward to telling you a lot more about it in today's discussion.

SPEAKER_02 5:25

I think that's absolutely fabulous. And you know, it's not just rural areas, but I I mentioned to you before the show, I had uh knee surgeries, two of them. Um, and you know, I live in Colorado, so and I had them at the end of the year because I met my maximum out of pocket. So so most of it was covered, of course. But I, you know, you're trying, I'm I'm sitting there trying to navigate a walker or a cane to get to physical therapy and it's snowing and icy. And I just was thinking, I mean, it was so incredibly stressful for me. So it's it's rural conditions and all the above. So it's really nice to be able to have that option. And I would think that people like being able to do uh physical therapy in their in their home as well. So that I mean, with that said, you know, what are consumers that you're treating today, you know, saying about this service and the ability uh to have it in their home and convenience and all the above. What are you hearing?

SPEAKER_00 6:19

Right. I can speak data all day long. Means like our patients talk about a net promoter score of 93 on a scale of 100, which is like out of the box. Um our minimum clinical in identifiable difference, and we call it MCID, which is how you compare how effective any treatment or uh uh intervention is, it is actually as comparable to the clinics. But in real world, I'll tell you with this story. We have patients that actually like aged anywhere between 30 to uh 67 is our average, and all the way up to 93-year-old. Um, so we had a patient that actually went into this um uh had an MBA motor vehicle accident and then had a severed cervical at the C7, C6 or C7 level, 72 days in ICU, and then actually, like with two-person assist, goes home, and then he is friend of a friend, so comes to as a personal referral over to us and saying, Can you please help him? His insurance would not cover home health, and outpatient is backed for three weeks. Every single day he was making a little bit of a progress and not having therapy for three weeks. That was the only motivation. Otherwise, every ounce of myself was like, no, that's not a patient that's for good for virtual therapy. And then because we were like, okay, let's just see what we can help you with. We started out with that attitude. And our therapist sitting in Denver, Colorado, licensed in the state of Texas, treating a patient here in a small town of Henderson, Texas, uh, with two-person assists, so wife and the daughter were in the room. But the therapists were so amazing that it was able to work with the patient during that period. Let me spoil the end of the story, though. The patient never went back to the hospital. Today he walks a mile. That's an amazing testimony. Every single time I actually watched that video, after 72 days in ICU, he was actually like brought via 100% of virtual therapy to the person who's back to work, walks a mile. Now he even runs. Um so that is the level of impact a virtual therapy can make when done right. But that doesn't mean that you can give me a Zoom account and then actually offer and then say, go ahead and do physical therapy. And it will be as effective as like you go to the clinic or someone comes to your home. Um, it needs to be done via a specialized tool. It needs to be done via a specialized training and then uh SOPs that are really clinically effective and evidence-bound.

SPEAKER_02 8:50

Yeah. So speaking of that, take me through it. I I l one of my uh promises to my listeners is let's make it simple. Uh, because that that's a whole, that's a big task in healthcare, as we know. But take take me through that. Because when I think virtual, I mean I think, oh, okay, is it an app on my phone or am I on like a Zoom environment and I've got a ver a physical therapist across from me? What is it like for the consumer who's getting treatment?

SPEAKER_00 9:16

Absolutely. I love this question actually. So let me walk you through. So if you would be in a conventional setting, either somebody will knock on your door and walk in, and then they'll have like a couple of therabands or like a couple of dumbles, or generally we try to use the environment around you, like a chair, bed, and then actually use your body weight to exercise. Or if you would go to the clinic, you would have a little bit too much, uh too many extra things like a formal dumbbrack or treadmill and things like that. But between all of this, you would uh realize like only 20% of the time, either the therapist lays a hand on you to manually do something, or you use one of those machines in the environment. Majority of the time, it's your body weight and a technique of an exercise that is actually the intervention. So with the one-on-one live supervision uh of a physical therapist, um, sitting thousand miles probably away from you, but be able to be in a same room providing you direct instructions on what to do and then actually guiding you through the exercise with your body weights or items from your environment is very, very effective. So the way we had to elevate that, so uh just a zoom would be just an audio and visual. We had to add a lot more effectiveness tools. Like, for example, computer vision AI. So we introduced the computer vision AI to be able to quantify how much are you moving or how well are you moving. So when you join on a session right like right now, you can show me how much your shoulder is moving, but I have to eyeball it. I don't really have any documentation around it. I don't really know how much was it yesterday, and then how what's the quality of movement? Everything has to be eyeballed. Versus when you are joining via the Theranao app, or because uh Theranao directly works with the hospital partners. So one of our hospitals virtual therapy app, uh, which is ultimately a Theranao white label service. So you would log in, you will hit this big blue start button, and then you will just follow the instructions that the therapist is offering. And then the AI and a burden of technology is not on you as a patient, it's on the clinician side. All the intelligence and all the AI that is actually helping me provide a virtual care to you is on my end, on my computer. I'm able to in real time see how much to the point degree, um, see how much are you moving, document it, record it, and then the next time we perform that movement again and see the impact of my care directly on you. Not only that, in the real-time one-on-one session, the difference between conventional care and the care done virtually is you, the consumer, is more engaged with the technology and the program itself. So that means it's not twice a week you're gonna do a session. It's not like a massage therapy session where you just go to a session and you consume the services where you just sit down and somebody does things for you. Physical therapies tend to be an active process of rehabilitation. Even in the clinic, you are the one supposed to be activating your muscles and performing exercises. So now what happens is beyond the 60-minute session, because we are enabling you with the knowledge and the right tools, so as soon as the program is generally over, we educate and we actually assign you a care program that you can perform on the app on your own free time. So now you are able to perform the care every single day, document it in the app, and then I, as a as a your physical therapist, can asynchronously also work with you. That means I don't have to have you in the same room when I'm with you and be able to still work with you. That takes the patient's compliance to the next level. And that brings in any deficiencies I may have that I can't touch you. It just eliminates that difference and then adds more value that we are equally or sometimes even better than the conventional care.

SPEAKER_02 13:10

Wow, that is amazing. I appreciate it. So it sounds like it's a combination of that virtual meetup. So, because I explained to you in the very beginning when I had my knee surgery, I was a little naughty. So just using an app was not, I was not, I was not doing as well as I should. Because you well know as a physical therapist, you can provide that guidance, but we have to have that discipline. And sometimes that's hard when you're in pain. So, you know, to kind of push yourself that extra mile. So I appreciate what you said about having that that session, but also having that app. But I'm a little lost, and maybe you can help me a little bit. You talked about degree, and I again I go to my head because I had knee surgery, and and but whether it's shoulder, I think you were talking about as well. You know, the movement and the degree of movement and the bend in the knee is so essential to progress. I'm I'm I'm kind of missed how are you really being able virtually to really see the success of that degree of bending a knee as one example.

SPEAKER_00 14:05

Oh, amazing. Um, that's where the technology comes into play, right? So um uh the computer vision AI, when I say this is like a little bit hefty of a word, but simply what it does is like how I see somebody's human body and recognize this is a hip and then uh this this is a shoulder and this is an elbow and this is a wrist, and how much of a movement is happening. I can put an instrument here and measure it. Instead of that, AI is so smart today that it can recognize this is a shoulder, this is the elbow, and this is a wrist, and how much of that movement is actually happening. And then in real time, it is on the screen as you're moving. I can see that many range of motion degrees actually happening, be able to document in my note and also utilize for my rehabilitation. So that's the computer vision uh specifically I'm talking about.

SPEAKER_02 14:52

Okay, I get it. Oh my God, that is like blows me away. That's so awesome. So, so tell me how this, so now that we're all on the path of amazing and convenience and getting good results, where are we at with um embracing, you mentioned working with hospital systems. Where are we at with uh providers or you know, consumers embracing this, saying, Yeah, I don't know, I'm still a little skeptical about this? Or do you find that that that both providers and consumers are like, yeah, I'm on board, this is great, I'm ready to go. Where where do people, where do you stand with that?

SPEAKER_00 15:29

We're in a very exciting time. Uh I'll tell you a few years ago, uh, it was very different. We had to convince people that, like, okay, telehealth is a thing and it'll work and it's effective. But uh today, because of the data and the results that we have shown, um, it has become a lot easier to tell about like what we do and how effective it is. But I would give a credit to our team also on how well we have implemented uh the program. So we we had our fair share of we're a tech startup. We also had our fair share of pivots. We thought like patients, we will release it and then patients will use us like an Uber. We'll connect the therapist and patients, patients will run into and they will love it, they will like it. We forgot the patient needs education. They need to be informed how uh one way of using a service is important versus when you really need the other way. And uh we miserably failed when we tried to convince patients like you need it, and then you need to buy direct services, especially when the payer uh is also paying, but if only if like certain different ways. But then COVID came. So the pay uh the payers got on board and then they were forced to embrace telehealth, and then they saw amazing results. That today it is a permanent level of care, as good as from the payer perspective. If you're an insurance company, uh from their perspective, it is as equal as if you go to the clinic or you do virtual therapy, is exactly the same, same service uh from their perspective. Now, what we did is like we took one step forward in the tech part. We wanted you to actually use more savvy technology, but we also took a one step backwards and we integrated every part of our workflow into a conventional workflow. So instead of offering telehealth on its own, come to Theranao.com and then consume the services. What we did was like we enabled existing outpatient clinics operated by hospitals and large systems, and then said, why don't we offer this together? Let's make an omnichannel experience. So if patient can 100% be seen virtually, we offer patients virtual and clinics. Um, so patient can come to the clinic and then 100% receive that care. Patient can 100% start out on virtual and finish on virtual, or patient can do one visit in the clinic, the next visit he doesn't need to go to the clinic and then do 100% virtual after that. So that's called as omnichannel experience. And that is what we are able to offer via existing resources off the hospital systems and then the newly built virtual care resources that we have here today.

SPEAKER_02 18:08

Oh, that's awesome. Well, and and just for my listeners, and I do this all the time because I used to do provider contracting payers, and our lingo means carriers or health insurance carriers. So for for listeners too. So speaking of that, I can I always say this on my podcast because I can hear listeners asking this question. That sounds great, but how do I use this with my insurance? I do I uh does my insurance take this? Is it going to be a prior auth nightmare? Or um what how do how does that work?

SPEAKER_00 18:38

Right. To offer virtual therapy or telehealth therapy at uh large scale, we had to take this partnership approach with the large hospital systems. For your listeners and consumers, um, if one the hospital system that you work with, if we are partnered with them, definitely if you're consuming virtual therapy, we are the one actually offering you. We have 400 uh physical therapists across this nation and we work with a many, many hospital systems. But if you uh um and the way, but if you want to engage with the virtual therapy and then try and taste it, the easiest way would be is like go to your hospital system, go to your provider, and then say is like, can we not do this virtually? And then if we can, then tell me, do you offer this service or not? That would be the best and easiest way to engage in the this movement of taking technology and embracing into healthcare, being a part of telehealth, being a part of service where you don't have to travel 30 minutes to the clinic, consume service, and then come back. You can get the same service and outcomes from the couch in your living room.

SPEAKER_02 19:45

Yeah. Oh, I like that. That's great. That is that's so awesome. And the convenience of it is is is just so so awesome. So you've already shared this story about the patient and and all the great things that you're doing. And just what's kind of next on the horizon with there now? Are you having more partnerships or what do you see coming next?

SPEAKER_00 20:06

Oh, that's a very loaded question.

SPEAKER_02 20:09

Whatever you feel comfortable sharing, of course.

SPEAKER_00 20:12

No, I love it. Um so we are at the forefront of tech innovation. So everything we do, we believe in how can we do the same thing more efficiently? How can we make uh care more effective? So a few weeks ago, we released uh a new feature because we were having, we saw 14 average days to bring in a clinician onboarded and hired and trained to get started and delivered care. That was a lot in our uh terms. For healthcare is normal. Uh so we we delivered a new tool uh that actually was able to reduce the onboarding and hiring time to 12 and a half hours, literally one business day. Uh starting uh from application all the way to the training and onboarding, be able to actually ready and start treating patients. That is what we delivered last few weeks ago. This specific week, we just got an invite from CMS uh for a CMS Align Network MVP. And uh to just give you a little bit of back in background of what that is, uh, CMS is very involved in digital and tech innovation. And then they're working with a lot of partners like health systems and payers and startups like ours and technology partners. And then uh so they're doing a first ever demo day on April 9th, and they wanted like any companies that are actually like uh developing something really incredible that will help the entire network. So we built a very important feature called as Clinician Coach. And uh it was built out of necessity. What happened was like we all went to school and and we were taught bedside manners. But when we went to virtual, nobody taught us website manners. So not everybody knows how to show up on a camera, not everybody knows how to actually like engage someone remotely. So We all developed our own way of practicing in style. Uh, not some amazing and some not too great. Uh so we had to build this clinician coach that is able to actually like see how well I'm performing in my sessions. If I introduce myself very well, did I explain my care? Did I actually give rationale about my plan of care? Did I actually explain the effectiveness of the exercises that I want you to do? And then rates me towards the end and then gives me a feedback on these are the areas I could have done better. And then to make it fun, we added a leaderboard. So outside inside all our clinicians can actually see who's doing the best in terms of website manners and who's on the top of the leaderboard. And we saw like amazing competition coming out. So we took that feature, applied to CMS, got chart listed, and today is the like last day. So we were just earlier this morning submitting it. And then if they're gonna actually like uh invite us, we will be at the stage on demo day for CMS.

SPEAKER_02 22:59

Well, and that is so exciting because so CMS centers of Medicare and Medicaid, right? That's when you talk about just Medicare. Right. And so um, and to my listeners, what's so awesome about this is is all insurances, whether Medicare or commercial, really do follow the guidelines of CMS. So if they're embracing what you're doing, and they then that is just better approval and better acceptance from the care all carriers. So that is such it's it's just so amazing to do that. It sounds like fun on the clinician view because you bring up such a point. You know, we all had to learn how to be better on camera. You know, we laugh about it during Zoom, and I still remember I saw this great meeting where everybody was dressed up from the the head to the top. They had their jacket and their tie and they had their you know pajama bottoms on, you know, because they were sitting down. But we all had to learn etiquette and stuff, but that's so incredibly important in what you do in terms of reaching out and meeting the consumer patient and and really meeting them where they're at. So I just love, love, love what you're doing. As we draw to a close, uh, tell us more about where folks can find Theranow and any final thoughts that you would like to leave consumers with.

SPEAKER_00 24:10

Okay, no, absolutely. So um I'm myself very active. I'm a CEO of Theranao, and um, so I'm very, very active on LinkedIn and uh trying to connect with our end users, which is the patients. We listen to them very, very closely and build the product and feature around the workflow that actually helps them. So LinkedIn is the best way. If you're not on LinkedIn, then Theranao.com, T-H-E-R-A-N-O-W, like right now, and uh.com, that is our website. That's the easiest way to communicate with us. But the best way you can help us in any way or form is go and talk to your clinical provider, your hospital system, and ask them, do you offer virtual therapy? And if not, tell them about us.

SPEAKER_02 24:55

Yes, no, absolutely. And that's the way to go. And I always say in healthcare, it it takes a village. And so we have to be proactive. Uh, my listeners hear me say this all the time. I think our traditional healthcare system, not to get preachy, but is so cumbersome that it's just, you know, we can barely get through a traditional day. And you've certainly been in it yourself. But if we can help others and just spread the word, then um we all benefit. So um, so this is just awesome. This has just been an enlightening conversation, but I want to say thank you to you and your wife for just getting out there and saying, I'm gonna offer something different because people need it. And uh, sounds like on your you're on is such a great path for great improvement. So I am so grateful for your time today and thank you for all that you're doing.

SPEAKER_00 25:40

Yeah, thank you so much, Sandy. Thanks for having me on this platform. This is amazing, and uh, I congratulate you on having such a successful platform.

SPEAKER_02 25:48

Yes. Thank you. It's been a lot of hard work, but thank you. I enjoyed having a shoke on the show. Such progress in the world of physical therapy, giving you options on your terms. To learn more about There Now and sharing with your providers and our hospital systems if they are interested in offering virtual PT. Make sure you check out the link to the website in the show notes. In our next episode, I have Adam Cunningham on the show. He is the founder of Silk Health, the first platform that lets you see what surgery actually cost at accredited hospitals in China, side by side with U.S. prices, no forms, no phone calls, just the real numbers. Adam studied medicine, but also ended up on the patient side of the system, which encouraged him to build Silk Health, especially after watching a friend get abused by the American insurance and healthcare system. I always like to present all sides of the healthcare so that you can be informed and make the decision that's best for you. This indeed is an interesting episode. Make sure and join us. Until next time, get savvy.