Telerehab takes major step

PITTSBURGH - How to best serve patients who live in rural areas has been an age-old problem for rehab providers. Cuts to Medicare reimbursement last year and the requirement that ATP-certified therapists perform evaluations for certain power wheelchairs beginning in 2008 have exacerbated the situation. Providers may have hope, however, in the form of a telerehab study that's picking up speed at the University of Pittsburgh's Center for Assistive Technology. The center began testing videoconferencing recently as a way for its ATPs to help conduct evaluations. "Before we were involved in the study, we had patients who would make do with the equipment they had because they couldn't make the trip to the nearest wheelchair clinic," said Mike Morelli, a rehab specialist with St. Mary's Pharmacy Home Health Care in St. Mary's, Pa. "As providers, we were doing rehab--but not at this level." In November, the center conducted its first videoconferenced evaluation with a regional hospital in DuBois, Pa., about 120 miles from Pittsburgh. Since then, it has conducted evaluations with the hospital every other Wednesday. Soon, it plans to bring another hospital into the fold. By the end of the study, the center will have conducted 50 videoconferenced evaluations. (It's about a year and a half shy of completing the study, which is funded by the National Institute on Disability and Rehabilitation Research). Part of the study involves comparing the function and improvement of patients who receive videoconferenced evaluations with patients who receive in-person assessments at the center. "We're trying to show that getting an assessment with an ATP consultation over telerehab results in the same outcomes as coming down to Pittsburgh and seeing me at our clinic," said Mark Schmeler, an ATP and faculty member at the university. The center plans to take the results of its study to a university owned health plan and CMS. "(Our health plan) may take the lead and say, 'We're going to have a system in place so you can bill us for this,'" Schmeler said. "That can lay the groundwork for CMS." If approved by CMS and rolled out on a larger scale, Morelli believes providers would take advantage of telerehab. "It's the ease of knowing the documentation is correct and justified for the client," he said. "The provider can breathe a sigh of relief. With all the changes, that means a lot."