Peterson Report Finds Value in Virtual Musculoskeletal Solutions

In March 2024, the Peterson Health Technology Institute (PHTI), which began conducting independent evaluations of health technologies, published an evaluation of digital diabetes management tools that concluded that the technologies do not offer significant clinical benefits and lead to a increase in health spending. Now PHTI has published a report finding that, for people with a variety of musculoskeletal (MSK) conditions, many virtual solutions offer clinically significant improvements in pain and function.

Based on its review of scientific literature, PHTI said evidence indicates that many of these solutions offer clinical benefits to patients that are comparable to in-person physical therapy (PT). These solutions also have the potential to improve access to therapy, reduce healthcare spending, and offer greater convenience compared to in-person PT.

PHTI’s analysis uses an evidence-based framework and a review of more than 2,000 articles, including 53 submitted to PHTI by companies evaluated in the report. PHTI received input from a number of experts and individuals, including licensed physiotherapists, clinical advisors, MSK patients and other stakeholders.

According to the report, physical therapist-led solutions show the most promise and overall value, improving patient outcomes in pain and function compared to in-person physical therapy, with a net decrease in spending. For many conditions, it is possible to reasonably substitute in-person therapy. This category includes Hinge Health, Omada Health, RecoveryOne, Sword Health, and Vori Health. In terms of economic impact, the report estimates that if 25% of in-person physical therapy users with low back pain switched to these platforms at a price of $995 per year, the annual savings could total approximately $4.4 million per million people with commercial insurance. .

“Treatment of musculoskeletal disorders can often be challenging. Many minor injuries will improve without any treatment, but early participation in rehabilitation exercises will get people back to exercise sooner with less risk of reinjury. It is essential to balance these two facts with costs in mind,” report contributor Adam Bennett, MD, assistant clinical professor of family and community medicine and orthopedic surgery at Northwestern University Feinberg School of Medicine, said in a statement.

Additional findings from the report include:
• App-based exercise therapies, including solutions from DarioHealth and Kaia, may improve pain and function compared to usual care, but are unlikely to be effective as full substitutes for in-person physical therapy. However, they may be effective solutions for providing extensive virtual care to lower acuity patients who may experience clinical benefits, and the economic impact will depend on price.

• While there is a limited evidence base for physical therapy solutions augmented with remote therapeutic monitoring used between in-person therapy sessions, findings indicate that this category may provide better clinical outcomes on pain and functional improvement compared to physical therapy in person alone. However, even after accounting for the health benefits these solutions provide, it was estimated that annual healthcare spending would increase because savings from lower utilization do not offset increases in billing.

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