Potential Pitfalls and Possibilities: AI and Physical Therapy

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I know, I know, AI, could I have chosen more of a buzzword? However, there’s a lot of buzz for a reason. AI is here to stay whether we like it or not. So we might as well know what’s out there, the potential pitfalls, and possible benefits of AI. 

“They’re trying to replace everyone with robots! And AI is coming for our jobs!” are common sentiments surrounding AI in general. The idea that AI developers are trying to supplement physicians, including PTs, with AI bots isn’t entirely untrue. However, in my opinion I don’t think this is a legitimate concern for us. 

The apps available today that claim to use solely AI PT and don’t require extra equipment or cost aren’t going to be worthy competitors. How do I know this? Because I tried them. They’ll remain unnamed (not trying to get sued here), but I will tell you about my experience. 

I tried 3-4 of them. They each asked some basic questions prior to giving me my “personalized” plan. I chose common areas of pain like the low back and knee. On some of the apps I answered like my most low-level patients – high pain, high irritability, low tolerance. Want to guess the first exercises recommended to me? . . . All fours cat-cow, back foam rolling, and deadbugs. Not inherently bad exercises . . . except my most irritable patients usually can’t tolerate being on all fours, would sooner go get another injection than lay on their back on a foam roller, and they definitely can’t do a dead bug correctly. . .

I also tried answering like my high-level patients. Again, the exercises given weren’t necessarily bad. They suggested weighted squat variations, dynamic lunging, deadlift variations, single leg work. However, a lot of my high level patients are already doing these things. They just can’t do them without pain. I find for most of my high level patients things are more nuanced than just “do this exercise”. It’s muscle activation, movement patterns, joint mobility restrictions, soft tissue dysfunction, not just weakness. AI PT isn’t going to be able to pick up on that and get patients the results they’re looking for. 

Some apps have the option to connect to a real PT if the AI-generated plans don’t work. This is usually at extra cost. At that point I’d say most patients would rather just go see a PT in person. Basically, AI has a long way to go before it’s running us out of the job. Honestly, the personal and hands-on experience PTs bring to patients is something many other healthcare professionals don’t even replicate. So if bots taking over our jobs isn’t a major concern when it comes to using AI then what is? 

Decreased Critical thinking

There is talk of AI programs generating exercises or treatments based on a patient’s diagnoses (i.e. frozen shoulder, quad tendon tear, stenosis). In my research, I didn’t see a specific program that was doing this yet. I’m sure it will be out there eventually though. 

If we start relying on programs such as these, we’d be no better than the apps I mentioned earlier. Except we still do the hard part of carrying out the plan! If we’re just listening to whatever the computer tells us to do, there’s not much critical thinking involved. Critical thinking is what creates a personalized rehab plan that gets results! Sure, a tool like this could be helpful. It could be great if we get stuck or need a new idea for a patient, but then we walk a fine line of being resourceful…or dependent. 

Over Access 

Some of the AI apps I’ll discuss later allow patients and PTs access to one another and their info in real time. However, mixing essentially all-hours access with a healthcare profession that is already severely burnout is a recipe for disaster. This could be rectified by PTs or clinics as a whole setting expectations of contact hours through an app. However, even if standards were set, we all know there would be patients. . . and even PTs, that wouldn’t be able to help themselves.

In some ways this kind of communication could add on to the workload of PTs. Not only would PTs  still have to keep up with all their current duties, but they’d also be responsible to check and reply to messages in the app. And what would be the mental load of having access to your patients’ info at all times? Whether it’s answering messages or just checking to see if they’re being compliant with their HEP in real-time.  

Bias, It’s Even in Your Algorithm 

If you do use an AI program or are thinking of using one, make sure you do your homework. There’s quite a bit of research out there on the bias in healthcare AI algorithms. Racial minority groups are usually the most affected. Any underrepresented gender, race, or socioeconomic class in the subset your AI is based on can suffer. It can be difficult to find this info. However, to best serve your patients you have to make sure the subset of your AI is similar to that of your patient population. 

Obviously there’s some potential risks to AI, but they don’t entirely outweigh the potential benefits of integrating AI into practice.

Benchmarking – Patients and Business 

AI may not be able to instruct a patient in good squat form, but it can pull, analyze, and synthesize data A LOT faster than we can. The info AI can provide us could have immeasurable benefits to PTs, patients, and clinic owners by helping us make decisions. 

Clinically AI could provide info about a patient’s progress to help PTs make an informed decision about their treatment approach. It could also provide info about a PT’s clinical outcomes overall. For example, AI might find a PT’s clinical outcomes are good for shoulder patients, but not so great for hips. This info may prompt the PT to evaluate where they fall short, maybe take some continuing ed, and hopefully overall lead them to giving better care. The best part is AI would be able to tell them if it got better! 

For clinic managers and owners, AI can provide invaluable info. This includes coding and billing, revenue, costs, patient retention, and other KPIs to track progress as a business overall. This can then be used to help make decisions about the business that ultimately save money, increase revenue, and/or improve patient outcomes. AI can also help businesses streamline processes such as managing appointments or answering frequently asked questions through the use of AI bots on the clinic’s website. This decreases staff burden and burnout so they can focus their energy on more important tasks. 

HEP Compliance 

Remember earlier how I said PT’s having access to their patients’ info could be a bad thing? Well, it could be a really good thing too. HEP compliance is one of the biggest battles we have with our patients. Many AI PT programs can real-time track and give feedback to a patient’s home exercise routine. 

How much more compliant would patients be if they KNEW we could see if they’d done their exercises or not? It’s easy for them to not do it, then say they did. Especially when the only thing attempting to keep them honest is a handout of exercises and us asking them at the next visit. 

We are HIGHLY addicted to our phones. The use of an AI mobile app could serve as a better reminder and be more motivating to patients. I mean, we listen to our phones when they tell us to do another Tik Tok dance or Instagram challenge. So why not a home exercise program?! Not to mention the patient knows they won’t be able to “slyly” look away, nod their head, and say “yeah the exercises went good” because we’ll be able to see if they did it or not. 

AI apps could also ensure patients complete home exercise programs correctly through motion tracking. I mean, how many times has someone returned for a session saying they’re not sure they’re doing an exercise right? Or say it hurts really bad even though it was fine when they tried it in the clinic? Then you have the patient demo the exercise to find out they’ve been doing some cracked out version of what you showed them. There goes days of rehab wasted on incorrect performance. Ain’t nobody got time for that. 

Documentation

Anybody else have trouble stringing two coherent sentences together during afternoon documentation? I think AI has the potential to fix that. Everyone’s documentation should have almost the same info, but everyone has their own style or common phrases we use over and over. Now I’m sure this exists, but I could not find anything about it being used in PT documentation. Imagine this … an AI program built into your documentation system that learns your common phrases, formats, and words over time. 

Hitting that afternoon slump and can’t find the words? Let the AI program auto-populate suggestions when writing notes to help you get your doc done and get home! What better use for AI than to simplify one of THE WORST parts of the job? Seriously, if this doesn’t exist and someone has the ability to make it happen here is your free million dollar idea. If you get rich, please don’t forget you got it from your favorite PT blogger. Nothing says “thank you” like a big fat check…I’m kidding…sorta. 

If this does exist PLEASE drop it in the comments or my DMs is so I can get on my hands and knees to personally beg my boss to get it for our clinic.

In my research for this week’s post there were a few AI programs that I kept seeing mentioned or that caught my eye.

Everbility

So while I couldn’t find the exact AI documentation system I just described, I found something pretty dang close. Turns out there are several medical documentation AI systems out there, but Everbility is hands down the best.

Everbility is an Australian-based company designed by and for allied health professionals to streamline documentation. In Everbility, all you have to do is put in the basic info and it takes care of the rest. Everbility’s zero data retention, end-to-end encryption, and HIPPA compliance makes it safe for including patient info to use templates to quickly populate notes.

You also have the option to avoid inputting any identifying patient data by creating a note prompt and using Everbility’s “assistant” feature to write your documentation instead. I booked a free demo and within our 30-minute meeting they answered all my questions AND developed a prompt for me to use in the assistant feature. Everbility doesn’t stop at its documentation. It’s also able to voice record notes, audio record sessions, find research, and find clinical practice guidelines quickly.

Everbility costs A$50 a month for monthly subscription or A$420 (A$35/mo) for annual. This is AUSTRALIAN DOLLARS which translates to about 34 US dollars per month for the month-to-month plan and 288 US dollars ($24/mo) for the annual. BUT the awesome therapists behind Everbility have given me this link to get you A$10 off three months (101 US dollars) or A$30 off if you pay annually (263 US dollars).

Use the link to sign up. You’ll then get a free trial and once the trial is up you’ll have the option to choose your subscription plan! Still have questions? Don’t be afraid to reach out to them. They were SO helpful to me and responded super quickly. Everbility has made documentation so much less of a burden for me and definitely will for you too!

I spoke directly with one of Everbility’s founders and can honestly say they truly care about their mission. They want to use AI to our advantage and make the lives of allied health professionals easier. Which is what we’re all about here at The PT Page!

Exer Health

Exer Health is a mobile and tablet friendly app that uses motion tracking to guide patients through home exercises, while also taking ROM and assessing form. The app can even pick up compensations such as lateral lean during shoulder abduction and cue the patient to correct this. 

The patient’s ROM and performance during exercise is stored and shared with both the patient and PT. For example, a patient would be able to see they’re lifting higher on their SLR than last time. This gives them insight to their progress and motivates them to continue! A PT could see a patient was struggling with correct form on an exercise or stagnant in ROM and could work on this when they return for their next session. 

There’s no extra equipment required, all you need is a smartphone or tablet. I did a demo of the app using my phone and I will say you have to get the set up just right, but the app cues you to help with this. Once it’s set up where it wants you, it works pretty well! Exer also makes Exer Gait, to help with objective gait analysis in-clinic. This tool appears to be available through tablets only. 

Physi track

Physi track would hands down be my pick for any telehealth PTs out there. With secure video calling and messaging, HEP log, symptom log, HEP builder with sharing, and the ability to share other education materials this could easily be your one-stop shop for telehealth PT. If you work for yourself through telehealth you can get all these things at a good price point for only $14.99/month. 

Physitrack also provides beneficial solutions for private practices, hospitals, and larger healthcare systems. With a wide array of abilities in communication, progress tracking, and database outcomes storing they offer a little something for everyone. 

I did a demo of their HEP builder and it was very user friendly with a large selection of exercises. You also had the ability to add your own which didn’t seem like a feature many of the other programs out there have. 

This is all just the beginning. AI is here to stay. We can live in fear of it replacing us or realize its potential to make us better. There’s plenty of both bad and good to consider.  What are some things I didn’t talk about here that are on your mind? Let’s discuss those in the comment section.

I find it hard to believe there won’t come a time in the near future where we’re all using some form of AI in our daily practice. Some of us may already be using it. If you are, how are you using it? How did you integrate AI into your practice? And what’s been your experience so far? Drop in the comments for the rest of us. As always, share and subscribe using the links below! And if you need to get caught up on previous posts visit the blog page to read up on what you’ve missed! You can also follow on Instagram @the_pt_page to connect to more PT Page content. Hope everyone had a happy 4th of July! See you back here in a couple weeks for a new post!

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