Research has shown that a substantial portion of patients who are prescribed physical therapy fail to complete their treatment plans. In fact, one study found that only 43% of patients adhered to their in-clinic physical therapy program as most patients fall out due to logistic and accessibility issues.
It's estimated that 126 million Americans experience a musculoskeletal condition, and these conditions account for a significant portion of U.S. healthcare spending. It's an area ripe for tech innovation to expand access to care.
Medbridge, a digital patient care and clinician education company, sees big opportunities in this space to support existing providers. The company works with hospitals, health systems, home health agencies and physical therapy practices to support hybrid care so clinicians can expand the work they do during in-person appointments to patients' living rooms.
Medbridge is a software company, not a tech-enabled services company, CEO Donovan Campbell points out, and it works with more than 3,500 healthcare organizations including Intermountain Health, Advent Health, Ivy Rehab Network and Enhabit Home Health & Hospice.
The company has been building out its capabilities to support digital MSK and movement-based medicine and recently expanded its artificial-intelligence-powered motion-capture technologies. Patients can use their mobile phones or a computer enabled with a camera feature to log into the company's MSK platform, called Pathways, to complete AI-monitored therapeutic exercises, get feedback and track their progress.
With just the device’s camera, Medbridge’s proprietary motion capture detects body parts, records the number of reps completed and identifies body positioning accurately to deliver feedback to both the clinician and the patient in real time, Campbell said. The motion capture tech can flag issues and correct positioning as needed.
The information is fed to a clinician dashboard to support providers in their analysis of patients’ functional movement and range of motion. Clinicians using Medbridge Pathways can easily and efficiently transition care from in-person appointments to at-home support. They are able to prescribe exercises, monitor patient activities and identify progress through the platform, according to Campbell.
The platform also delivers more accurate feedback to clinicians on how patients are completing their exercises and identifies potential challenges like fall risks while providing recommendations for future exercises and education, both on the platform and during in-person visits.
Medbridge's Pathways library now includes evidence-based, medical-board-reviewed clinical programs for MSK care and joint pain, fall prevention, pre- and postoperative care and pelvic health support. The company will also soon launch an injury prevention and chronic pain program.
The company says it now works with the largest private practices and health systems along with employer health providers and home health companies with 350,000 clinicians using the platform and 86 million care programs assigned to date.
The company addresses many of the shortfalls of the "digital health 1.0" models, asserted Campbell, who led virtual specialty care company 2nd.MD as chief operating officer for five years. He remained at the company after it was acquired by Accolade in 2021. Campbell started his career in the U.S. Marine Corps, serving for five years as a ground intelligence captain with three combat deployments.
Campbell describes the early wave of digital health companies as technology-enabled clinical services that don't easily integrate into the existing care ecosystem and often struggle to drive engagement with patients.
"One of the things that I saw many of these companies do was just fail to reach the population health targets that they promised. And, in many ways, we were not delivering the kind of cost of care reductions that we promised," he said.
"You end up creating a really fragmented patient experience because they're engaged with this technology-driven service over here, and how do you get this information that you gathered in your own platform to their local care team?" he said.
If the patient care experience is fragmented, the patient data also aren't integrated, so clinicians may miss critical flags and provide the wrong care, Campbell noted.
Research shows that providing patients access to conservative care like physical therapy and pain management can improve patient outcomes and drive down the cost of care. But making conservative care accessible and engaging is the key, he noted.
"How do you get more patients access to that? You have to enable the existing clinical landscape and enable the local in-place, existing brick-and-mortar providers with powerful tools that help them practice hybrid care. The care team that's monitoring what's happening when they're out of the office is the same one that's seeing what happens when you're in the office. And, it also helps solve the data problem, because the information in your platform also is in front of the patient's local care team," Campbell said.
Medbridge integrates with providers' electronic health record systems for seamless, integrated workflows, he said.
The use of artificial-intelligence-powered motion technology is a multiplier for effectiveness and outcomes and enables clinicians to treat more patients, Campbell said.
"We believe profoundly that if we don't start leveraging AI to do what AI can, and allowing humans to do what humans should do, then we are going to face increasing shortages of care. We have a profound care provider shortage right now," he said.
He added, "If we can augment brick-and-mortar capacity with much more easily accessible, conservative care programs that are software-driven, self-progressed that a clinician can oversee, monitor offline or in non-real-time when they have capacity, you can help patients get better and you can avoid care that is higher cost, unnecessary and wasteful."
Medbridge uses AI to create patient summaries that help clinicians monitor patient progress. The AI-generated summaries pull together information into a single, easy-to-digest paragraph for clinician review and verification, according to the company.
And the company developed a patient co-pilot AI chatbot that enables patients to ask and receive answers developed from a library of clinician-backed education and exercises.
The company is working on other AI-driven initiatives including an AI care coordinator assistant, he said.
According to recent Medbridge data, 70% of Pathways patients reduce pain with an average reduction of 40%, and 69% of patients increase function by an average of 56% using the program.
Medbridge doesn't compete with digital physical therapy companies like Hinge Health, which just went public, or Sword Health, Campbell said. But, he added, the company's technology enables health systems and physical therapy practices to compete with virtual-only providers.
The company's Pathways platform collects patient-reported outcomes to assess changes in pain and physical function.
The data that Medbridge collects give providers a "window to something that they don't have right now, which is when patients are not in their office," Campbell said. "Patient reported outcomes are built into every one of our programs, whether it's falls or whether it's musculoskeletal or whether it's pre- or post-surgical, we're collecting a whole host of data that has heretofore been uncollected."
Campbell believes the combination of providers' clinical data in EHRs and Medbridge's outcomes data opens up opportunities to develop tailored patient care at scale.
"Each specific patient could have an incredibly nuanced care program that is customized and based on what patients like them have done to experience the best clinical outcomes," he said.