Last week, I described a new approach that could transform recovery in workers’ compensation as we know it: Early PT Intervention.

To recap, traditional processes can be slower than we may like. We are familiar with it: an injured worker gets evaluated by an adjuster or nurse, then referred to a physician who may order diagnostics, schedule follow-ups, and finally prescribe physical therapy, where treatment begins. The new focus involves getting an injured worker evaluated by a physical therapist within 14 days of an injury, as documented in a 2020 Workers Compensation Research Institute Study. Even sooner could be better. This acceleration in treatment by a physical therapist has multiple benefits, including less clinic visits, lower dependence on pharmacy, improved recovery times, and lower costs.

So we all know we want to get people to PT faster. But how can we actually do it?
There are two approaches. Depending on the context of the situation, one of both may be what it takes for each program to feel the impact.

Approach 1: Optimizing the Current Process by doing the same thing, faster
Implementing early PT intervention doesn’t necessarily require a complete overhaul of the existing system. Here’s how to expedite the current process and get workers into PT faster:

• Strengthen Relationships: Build stronger relationships between adjusters, case managers, healthcare providers, and physical therapists. This fosters better communication and collaboration, leading to faster referrals.
• Process Mapping: Analyze the current process to identify bottlenecks. Involve stakeholders in identifying delays and brainstorm solutions for streamlining referrals.
• Measure Performance: Track key metrics like time to PT referral and cost per claim. This data will be crucial for measuring the success of implemented changes.
• Continuous Improvement: After implementing changes, re-evaluate metrics to assess the impact on efficiency and cost reduction.

Approach 2: Direct PT Referral: Bypassing the Initial Physician Visit
When a professional athlete suffers a soft tissue injury, they go directly to the training room and start treatment immediately. So why treat employees’ injuries differently? Why not just get them straight to a physical therapist when they get injured?

For low severity, low complexity cases – such as acute low back pain, sprains, and muscle strains – early PT intervention could mean bypassing the initial physician visit. There are multiple ways to structure the program, but one way may look like this: A well-trained triage team assesses the severity of the injury. A patient requiring emergency care or complex medical interventions would still be directed to a physician or hospital first. While a patient with a less-severe injury as described above, would go to a physical therapist to begin treatment well ahead of the 14-day window we measure for success.

It’s important to note that right now this is only possible in states where self-directed referral is allowed. However, marked success in these states could drive legislative change in the remaining states.

The Role of the PT has Evolved to Match this Approach
This new way isn’t possible if you hold a limited, antiquated view of a PT’s capabilities. The scope of practice for physical therapists has expanded significantly. Today’s PTs are equipped to perform detailed evaluations, diagnose musculoskeletal conditions, and even triage patients for additional diagnostics or physician referrals when necessary. This expanded skillset ensures that early PT intervention doesn’t delay necessary medical attention in complex cases.

This Model is Successful Outside of Workers’ Compensation
Triaging patients directly to PT isn’t a new idea. Numerous group health insurance providers recognize its value and reimburse patients for early PT visits. The Department of Defense, for example, has implemented programs allowing patients to bypass initial physician visits and receive immediate PT after injury. In fact, research conducted by the American Physical Therapy Association (APTA), in collaboration with the Joint Base Lewis-McChord Physical Therapy service line showed that the use of early PT intervention saw a reduction of $3.6 million in healthcare costs.

A First Step to Future-Proofing Your PT Program
Partnering with a physical therapy network who understands and advocates for early intervention is a core strategic move that can future-proof your program. Their expertise can help navigate the complexities of implementing earlier PT, measuring success, and ultimately leading to a healthier workforce and reduced costs.

Regardless of which approach fits your organization and jurisdictions the best, embracing a collaborative approach that rethinks triage procedures, adapts claims processing, and prioritizes early PT intervention, offers substantial clinical benefits to patients and financial benefits to the payers. And with the general shift toward more conservative care, earlier PT can add another proactive layer toward success.

About Brian Peers
Brian Peers is a licensed physical therapist serving as MedRisk’s Vice President of Clinical Services and Provider Management. He is responsible for overseeing and ensuring the clinical quality of the MedRisk network.  He is board certified as an orthopedic clinical specialist and is recognized as an expert in rehabilitation of the injured worker. Prior to joining MedRisk, Dr. Peers was the owner and operator of an interdisciplinary rehab practice and has held faculty appointments at multiple physical therapy education programs. He has also served as an injury prevention consultant for multiple large corporations and the United States Department of Defense. He holds Bachelor of Science and Master of Physical Therapy degrees from St. Francis University in Loretto, Pennsylvania, an MBA from Louisiana State University in Baton Rouge, Louisiana and a Doctorate in Physical Therapy from the University of St. Augustine, in St. Augustine, Florida.

“Brian Peers: Revolutionizing Recovery: How to actually get injured workers into PT earlier.” WorkCompWire.com, https://www.workcompwire.com/2024/06/brian-peers-revolutionizing-recovery-how-to-actually-get-injured-workers-into-pt-earlier/