The digital health industry is expanding rapidly, particularly during the current coronavirus (COVID-19) pandemic. With the impacts of so many people working from home and in isolation, technologies such as telehealth are helping to provide better access to healthcare for everyone, as well as revolutionising the way we capture and use data to support clinicians being able to help their patients, and track their progress.
Physiotherapy is one area of health care that is now able to assist most people via Virtual Reality technology to get better, or to undertake a rehabilitation program, at home.
Thrive talked to XRHealth, a company that has recently made revolutionary breakthroughs that have made having to do physiotherapy as much fun as it can be, which in turn leads to faster results, because most of us are more likely to keep up our exercise schedule if we enjoy doing it.
XRHealth’s Director of Operations in Australia, Esme Naidoo, explains: “We are really excited to launch our first Australian clinic, which offers fun and engaging physiotherapy via telehealth and virtual reality (VR) technology. This is how the system works; after an online consultation, all patients receive a tailored treatment plan and access to their own healthcare portal which displays data to better inform them of their condition and symptoms. We combine the application of digital health with personal consultation to offer our XRHealth patients the best chance of recovery.”
Esme advised that using their TGA-registered medical device technology, they can treat a range of physical conditions including whiplash, shoulder, neck and spinal arthritis, bursitis, rotator cuff tendinopathy, frozen shoulder, hip and knee injuries, and postural problems. They can also offer treatment for a range of other conditions such as ADHD, Autism Spectrum Disorder, stroke rehabilitation, and Cerebral Palsy.
While the XRHealth launch in Australia is focused on Physiotherapy, the company is in the process of expanding their offering to include mental health, occupational therapy, cognitive therapy and more, care streams that are already in practice by their sister clinics in the USA.
most of us are more likely to keep up our exercise schedule if we enjoy doing it”
We asked Esme how one gets to use a physiotherapy headset at home, she explained: “The process to sign up with XRHealth as a patient is simple. Patients register online and have an initial consultation with their clinician of choice. Their clinician assesses their suitability to ensure they can safely use a VR headset, then the headset is shipped to the patient via courier to ensure prompt delivery.
“From there, the patient can see their clinician as often as required, with appointments available at a range of days and times.” She continues, “Telehealth offers more flexibility and convenience to fit around family, work and other commitments, meaning you can see your physiotherapist at 8:00pm at night if needed.
“During the clinician-led appointments, the patient uses the headset to complete tasks and exercises which are designed to give the clinician data to assess and monitor the patient’s progress.”
A great advantage of this system is that the data is available in the XRHealth Portal, which is accessible to both the patient and the clinician, so that both parties can track progress over time. The clinician can also see and remotely control what is on the patient’s headset during the session, which allows them to guide and instruct on correct usage and ensure that the movement is correct and appropriate for that patient’s condition.
In between appointments with their clinician, patients are given exercises to complete, both with and without the headset. Headset-related exercises might include a virtual boxing game, where the patient has to punch a colour as it appears on the screen, or a balloon-popping game where one has to swipe a sword to pop balloons in a row. Each exercise/game is designed to promote proper movement of a particular muscle or limb, and increase their range of movement, whilst simultaneously measuring and monitoring progress.
By turning these movements and exercises into a fun, interactive video game-like experience, XRHealth’s VR technology increases the likelihood that patients will complete their prescribed exercises correctly. It also captures detailed clinical data that their clinician can access to help manage the care plan and fine-tune it as required. This is something that has not previously been possible in a traditional face-to-face setting.
We asked Esme how people are responding to the VR headset model in Australia, she says that: “To date in Australia our patient engagement data shows that on average, people spend time in VR above and beyond their prescribed care plans, indicating they are having fun while getting better.
“We are conscious that many patients who see a physiotherapist in a traditional setting are not always very good at completing their at-home exercises, or may complete them incorrectly. The benefit of using the VR headset is that it encourages proper movement and motivates patients to complete their exercises as often as required, while also empowering our clinicians to monitor and influence their adherence to their exercise program.
“In a 40 patient Bupa trial we ran in May-July 2020, our patients reported high satisfaction scores, displayed engagement above and beyond prescribed care plans, and we were able to show a clinical improvement or resolution of the leading symptom.”
Esme explained to us that there is a mobile app that is used alongside the VR headsets which is also a valuable tool in a patient’s treatment journey. Patients use the app to review their data and progress, so they can see their results from when they started their treatment and then view their improvement over time quickly and conveniently. The app also sends regular notifications to the patient to remind them to complete their exercises, particularly if they have not logged in for a period of time, which can be helpful for those who may have lost motivation or need a reminder to complete their exercises. For those of us with a competitive streak, the app also provides statistics to the patient showing how they compare to other users on each app. This can offer an additional incentive to work hard and improve performance. We queried how we get the headsets and how they are handled with the COVID-19 cautions. Esme told us that XRHealth is responsible for the entire VR headset logistic cycle, including sending out headsets from their Melbourne fulfillment
centre directly to patients to be used during their care plans, which are then sent back once discharged. When they are received back at XRHealth the team enacts COVID-19 sterilisation protocols, software updates and repackaging to be ready to send to the next patient.
The good news is, XRHealth are happy to treat patients from all around Australia, regardless of location, provided that the patients have access to a stable internet connection. Esme says: “We are excited to be increasing accessibility to virtual reality physiotherapy, and happy to advise that our services can be claimed back from most private health insurers (depending on your level of cover) and we are proud to be a Member’s First Provider with Bupa. Patients can also be treated via all compensable agencies in Australia, private health insurers, DVA, Medicare chronic health
care plans, and privately.”