Telehealth Survey Results

Three months ago, if you had asked me, “What is the application for telehealth in physical therapy?” I would have answered, “Very limited.” Up until then, I believed that for patients with no other options—like those in the remotest parts of the country—telehealth might be useful. But otherwise, not so much. Physical therapy is by definition physical. For it to be effective, the provider must be physically with the patient. Or so I thought.

Then, COVID-19 happened.


Beginning in March, easy and safe access to our practices which we had taken for granted was no longer a given. While most businesses were put on hold, the conditions that required physical therapy weren’t. Our patients still needed help treating their pain and injuries, but for many of them, coming into the clinic was no longer an option.

That’s when I began to reconsider telehealth. Within a week of the shutdown, all our physical therapists were trained on how to use our newly launched telehealth app. In less than three months, we went from having delivered zero telehealth visits, to twenty thousand.

In those three months, my views on telehealth have changed 180 degrees. I went from being a telehealth skeptic who thought it belonged on the fringe of care, to a true believer who thinks that telehealth should be a treatment option available to all patients, regardless of where they live.

My views about telehealth have been transformed by the outcomes I’ve seen in our practices, and by the results of the first of its kind patient survey we conducted in partnership with Northeastern University’s Department of Physical Therapy, Movement and Rehabilitation Sciences. Here’s what the survey and the experiences in our clinics taught me about telehealth:

  • Patients like the experience. When we started using telehealth, I feared that our Net Promoter Score (NPS) would take a big hit. Our NPS actually improved during COVID to 91, up from its historic average of 87. This reflects the results of our joint survey with Northeastern: telehealth patient satisfaction (95%) is nearly as high as in-clinic patient satisfaction (97%).
  • All patients are satisfied by the experience, regardless of age. Although older patients are sometimes considered less tech savvy, our survey shows that they are just as satisfied with telehealth as their younger peers.
  • No-shows have decreased. Prior to COVID, our arrival rate was 87%. With telehealth, that rate has increased to 92%. Clearly, telehealth is a far more convenient option for patients than driving to a clinic.
  • Cost of care decreases. Compared to last year, our average visits at discharge—or what some call “length of stay for care”—went down by 1 visit from 13.7 visits to 12.7 visits. In other words, with telehealth, patients completed their care of plan sooner, suggesting that telehealth helps patients be more adherent to their plans which lowers the overall cost of care.

Fortunately, at the outset of the COVID crisis, Medicare and most payers, just like me, overcame their longstanding skepticism of telehealth. For the first time ever, they started covering the costs of telehealth for physical therapy. This has given tens of thousands of patients access to high quality care that they otherwise would not have received. As the country slowly begins to re-open, there are some signs that Medicare and other payers might stop covering telehealth. That would be a big mistake for many reasons.

First and foremost, as our survey revealed, many patients (39%) are still uncomfortable returning to clinics—even if they get reassurances from their providers that all safety guidelines are being followed. By not covering telehealth, Medicare and other payers will be denying this sizable population convenient access to care. But there are many other people who could benefit from telehealth as well: frequent travelers, anyone with a fever or the flu, older patients with mobility issues, patients with compromised immune systems. Yes, most of our patients will likely come back to the clinic—especially those that benefit from hands-on treatment or treatments requiring sophisticated equipment. Telehealth, though, must remain on option for all others.

Although COVID has brought so many unforeseen hardships, it has brought with it a few bright lights. One of those is telehealth. I hope that private payers and Medicare see the light as I have, and cover the costs of telehealth moving forward. If they have any skepticism, then I implore them to dig into the data. With so many lives lost during COVID, it would be a shame to lose this opportunity to improve access and lower the overall cost of care.