An AI-Enabled Approach to Improve Access to Physical Therapy

An AI-Enabled Approach to Improve Access to Physical Therapy for ... unknown

Quantum Health, a healthcare navigation platform aimed at self-insured employers, has expanded its existing MSK offering with their collaboration with Sword Health to become the first partner to make Sword’s exercise tracker platform Sword Move available to its members. Sword Move enlists personal trainers who work with members to deliver personalized exercise programs. In addition to Sword Move, Quantum Health will also offer Sword Predict and Bloom. Predict is an AI engine using predictive analytics to identify members at high risk of requiring surgery. Bloom is a clinical-grade digital solution to address women’s physical health issues.

Self-insured employers are looking for ways to balance the need to trim healthcare costs and improve productivity without jeopardizing the health of their workforce. Quantum Health’s Preferred Partner solutions provide access to proven strategies to its 500+ employer clients totaling almost 3 million active members to better control musculoskeletal (MSK)-related costs. Quantum Health also partners and integrates Hinge Health as part of its overall MSK offering, which is also part of its larger navigation platform and member experience.

MSK are the most common conditions outside of cancer —1 in 2 Americans suffer from an MSK-related condition. MSK challenges affect more than 50 million Americans and are the top drivers of disability claims, according to data from Quantum and Sword. MSK is the top healthcare cost driver for businesses, with one-sixth of employer-sponsored plan dollars attributed to MSK-related care, totaling a whopping $600 billion annually. MSK-related surgeries can also impact productivity, drive absenteeism and lead to a slew of healthcare issues such as opioid abuse and mental health challenges.

In response to emailed questions, Quantum Health Senior Vice President of Clinical Strategy Dr. Mike Sokol and Sword Health Chief Medical Officer Dr. Vijay Yanamadala discussed the expansion of their collaboration.

Yanamadala explained how Sword Predict works.

Proprietary technology uses medical claims data to identify at-risk patients who could benefit from digital care. A targeted activation process is embedded for rapid engagement with potential patients to explain the risks of unnecessary treatment and drive users toward digital care as an alternative. The high-risk patient program is geared to individuals. It provides 24/7, on-demand access to digital physical therapists and clinicians. Predict can identify patients who are up to 40x more likely to have surgery, more than eight months before a decision has been made to operate. It helps people avoid unnecessary and costly hip, knee, and back surgeries with an alternative, more effective program – all by leveraging machine learning, Yanamadala shared.

Dr. Vijay Yanamadala

“Sword is providing massive healthcare cost savings, delivering a 62% reduction in pain and a 60% reduction in surgery intent,” Yanamadala  said. “With Sword, members recover as well as with the highest-intensity traditional physical therapy, while doing it from the comfort of their own home and on their own time. A majority of members also saw a decrease in depression and anxiety. The hope is to increase utilization of Sword through Quantum’s platform.”

The new partnership comes at a time when MSK-related surgeries require a more comprehensive set of solutions to meet the growing demand within the workplace for new MSK treatment options.

So how will Quantum Health integrate Sword Health’s technology?

Quantum Health helps clients support their employers with a better healthcare experience. Its thousands of trained Healthcare Warriors guide members through their healthcare journey whether it is routine care or a complex health condition.

Dr. Mike Sokol

“Sword Health’s products will be integrated into Quantum Health’s platform and Quantum’s Healthcare Warriors will provide proactive education, utilization management and post-discharge outreach to ensure the best outcomes and prevent readmission or ER visits due to complications after knee, hip or spinal surgeries,” Sokol said.

Given the number of people affected by MSK issues, lots of digital health companies have pursued this market. HR benefit managers responsible for choosing these programs have their work cut out for them. A survey of large employers by Business Group on Health found that four out of five employers prefer solutions that have been proven effective in the market, with almost one-third selecting an integrated solution to drive engagement and utilization at scale.

Quantum Health carefully assesses would-be partners based on strict technological and outcomes metrics. As an example, Sokol noted that Quantum recently ended a partnership with a leading digital health point solution partner who was not meeting various integration and member experience milestones.

“As good as a point solution may be, like in the case of Sword Health, it is Quantum Health’s ability to achieve 84% household engagement and our use of our proprietary Real-Time Intercept and Healthcare Warriors to intercept members early in their healthcare journey that allows us to not only drive better engagement and utilization of solutions like Sword Health, but also gives us a unique vantage point of what digital health solutions work at scale, and which ones don’t,” Sokol observed.

“Partnering with Sword Health further supports Quantum’s overall value prop and market opportunity as our navigation platform not only drives industry leading, hard ROI but our preferred partner program has vetted key point solutions and fully integrated them, so we know which ones do or don’t drive hard ROI,” he added.

Women’s health is also an important area of interest for Sword, demonstrated by the company’s Bloom product designed to help women with MSK pelvic conditions, such as those experienced after a pregnancy. Pelvic floor health issues can affect sexuality, fertility and overall well-being and symptoms can include bladder leakage, bowel issues, pelvic organ prolapse, and chronic pelvic pain, Yanamadala noted.

“Bloom breaks the barriers of time and resources, and confronts inequalities when it comes to access to healthcare. We have been overwhelmed by the positive response from members,” Yanamadala said. “They have said the experience with Bloom has been ‘life changing’ and ‘amazing’, especially for busy moms and anyone else for whom it would be difficult to get to in-person appointments.”

Photo: Sword Health