RTM Doesn’t Suck—If You Do It Like This

WEBVTT

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down a little bit you're listening to the

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pg pinecast where smart people in health

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care come to make noise here's your host

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jimmy mckay all right i think we're live

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I think we're being broadcast right now.

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I want to know if people can hear

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us.

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So I need someone to comment if the

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audio is actually coming through,

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because how come we can't actually?

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What?

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There we go.

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There we go.

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Let's do a little quick test.

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Live from Graham Sessions here.

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This is PT Pinecast.

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You prefer Steven or is it Steve?

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It's actually a story to that if we

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have time.

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What's the name?

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All right.

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So I was ten years old and at

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soccer practice.

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And a coach called me Steve,

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and my mom turned on a dime.

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I named him Steven for a reason.

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And that has stuck with me for my

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entire life.

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Well, then Steven it is,

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because I don't want Mom Cohen coming

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through the live show.

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No, not Mama Bear.

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This I asked on LinkedIn a few weeks

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ago.

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because you want to test you want to

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test the profession what you assume to be

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true is not always true we know this

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so i think i asked on linkedin and

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i'll find the poll results who here knows

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what graham session is and like here is

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also biased this is my network or who

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can see this right so i assumed because

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i've been here before

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A lot of the people in my network

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have been to Graham Sessions before that a

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majority of them know what it was.

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It was ninety percent plus had like had

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never been to Graham,

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not just had never been to Graham

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Sessions,

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did not understand what what I was talking

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about.

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So how do you describe who's here and

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the purpose of Graham Sessions?

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Because you're here with Sarah Health and

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we'll get to that.

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I mean, I'm still learning myself, right?

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Like,

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if it wasn't for Max at WelcomeWare

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saying, hey, you should come to this,

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I wouldn't be here either.

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All right.

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But then you asked a few questions,

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and here's how I describe it.

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And you tell me if it's the same

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feel that you got, which was,

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I think this is twenty years ago,

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Patrick Graham, Steve Anderson,

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and some other people said,

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we need a very small meeting.

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We have PPS.

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and we have CSM,

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we need a smaller meeting.

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Okay, what's the goal?

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We want a bunch of people in the

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room to really hash out.

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We want to be able to hold this

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meeting in one room and these are the

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change makers,

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whatever you want to call them,

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to solve the problems that we're dealing

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with now.

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Twenty years ago,

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And today, we still have problems.

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Hopefully,

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we solved some of those problems.

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Now, we're dealing with new problems.

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And the crux or the twist of this

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idea for Graham Sessions is whatever is

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discussed here, it's like Vegas.

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It stays here.

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Well, kind of.

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Who said the thing, not what was said?

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You're allowed to say, hey,

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we brought up this problem.

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This solution was brought up.

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You...

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You can out yourself.

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You can say, I said that.

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But you can't say someone else said that.

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And that's to sort of, I mean,

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for lack of a better term,

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like safe space.

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It's like, dude,

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you want to be able to say the

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things.

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I've been to bars with PTs.

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They say things that they would never say

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on a stage because that's how the world

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works.

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So this is supposed to be as close

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as you can to get with no repercussions

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in a good way.

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I mean, that makes a lot of sense,

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right?

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I think it was Lawrence Benz and one

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of his pre-PPS, you know,

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heads up to everybody that the truth serum

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starts flowing at the bar.

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And so it's like, hey,

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why don't we just have these conversations

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sober for eight hours and probably get

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somewhere further than a bottle of pint

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glass.

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Right.

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The other thing is, when this started,

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and I don't know what the procedure is

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now, but you had to be invited.

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It was like, listen,

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and we want to cherry pick.

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Hey, you know,

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and it was sort of the way I

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looked at it.

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It was sort of like, hey,

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I see what you're doing over there in

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that little corner.

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We want to bring you here.

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We want other people to see what you're

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doing.

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We want to hear from you.

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We want you to hear from other people.

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And, you know, cross-pollinate.

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We want these ideas to leave.

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The purpose is...

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to have some ideas look at things

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differently and then have the ideas of the

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those things leave the room so i can't

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tell you who the hundred fifty people are

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i'll turn the camera around because i

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don't want to out anybody this is a

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super secret meeting even though ninety

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eight percent of people have been saying

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on linkedin i'm going to graham sessions

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um you looked at the syllabus or whatever

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Anything on there?

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What excites you about what's going to be

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discussed?

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And maybe my follow-up question will be,

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what are you like, hey,

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where's that thing?

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So what's one thing that you're excited to

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hear this next couple days?

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You know,

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there's a talk coming up later around what

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the PT industry can learn from the

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dentistry industry around MSOs, IPAs.

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and collective bargaining and

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negotiations.

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Really excited for that.

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Why you?

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You got a background.

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I didn't know this about you until about

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a couple weeks ago when we recorded

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something.

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You got a little bit of a different

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consulting background.

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So you look at the world differently.

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You just do by your nature.

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Yeah.

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Spent seven years at Deloitte Consulting.

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So everything from helping Caterpillar

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employees be able to be more efficient on

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the line to negotiating software contracts

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and like

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the eBay PayPal when they split.

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Negotiated, I don't know,

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a few hundred million,

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almost a billion dollars in contracts.

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I couldn't say that so casually.

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It was fun.

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It was a lot of fun.

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Well, they spent a lot of money.

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As I'm driving into Arlington last night,

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we're in Alexandria right now.

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There's a Deloitte building overlooking

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D.C.

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and I'm like, oh yeah.

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They pay for that because they do a

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lot of work with big companies and make

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a lot of money, right?

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Yes, that is exactly it.

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And so that,

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but also I am the administrator of the

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Private Practice Network, IPA.

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So it's a PTOT speech IPA in New

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York State.

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We have six hundred,

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I think maybe seven hundred now,

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providers across the state,

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a few hundred locations.

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And we're starting to actually get

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contracts for our group members.

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And

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seeing that, touching that, feeling that,

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like seeing that contract,

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I've printed it out.

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Like that is a real contract that is

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paying well.

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I don't think I can say exactly what,

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but it's paying well.

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And our members are going to be able

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to benefit from that.

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And I don't think there's anything

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necessarily like unrepeatable about what

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we're doing.

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And then the conversation at the bar last

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night at the welcome reception is people

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are talking about MSOs,

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people are talking about IPAs.

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And I really think that's a great way

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for groups to be able to have negotiating

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power and get it to the table.

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And payers are much more willing to listen

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now than they were prior because

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musculoskeletal is, it is their cost.

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Like that's it,

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especially as more get into managed care.

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If you can help that Medicare Advantage

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patient not have a fall,

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just from simple time value of money,

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if you can push that off for a

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year,

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there's about a thousand dollars in net

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benefit to the payer.

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That's easy.

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And we like that.

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Yeah.

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You're not only the hair club client,

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you're also the president.

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So you're here as a sponsor as well.

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So you look at our profession from a

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different lens again with this thing that

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I feel like it popped up on my

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radar or when people started talking about

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it two years ago, three years ago.

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I know it was before that,

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but I think people really started to take

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it seriously.

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And that was remote therapeutic

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monitoring.

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For people who still don't know,

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because there are.

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You talk about this a lot,

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but there are people who still don't know.

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Give me a quick re-rack,

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just a quick context on what it is

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and how Sarah Health people do it.

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Easy, simply,

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pays for itself and then some.

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You know, I think the, I will,

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I will answer your question.

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But I think just like ninety percent of

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patients that could get PT don't.

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I think there's ninety percent of

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practices out there that are doing the

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work required to build the codes.

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They're just not building.

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Closing the loop.

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Exactly.

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And so if you think of RTM as

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payment for or a funding mechanism for

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time and technology in between visits,

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you're ninety nine percent of the way

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there.

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Right.

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Like.

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And I'll talk about this later when we

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get up on stage for a bit.

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To me,

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RTM is there to help patients complete

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their plan of care,

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stay adherent to their home program,

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and have a better outcome.

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That is what it's for.

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That is the purpose.

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It's not six codes.

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And if you're looking at this like, oh,

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well,

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I'm only going to be able to generate...

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Forty dollars from ninety nine seven

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seven.

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If the only way you're looking at RTM

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is going to hit your P&L is by

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those six CPT codes,

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you're missing the forest for the trees.

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So walk me through where else it touches,

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because it sounds like butterfly effect.

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But if you're only looking at the forty

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dollars, you're not looking downstream.

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Yeah.

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Where should they should look at the forty

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dollars and where?

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uh so plan of care completion uh so

00:08:28.213 --> 00:08:31.076
we did a retrospective analysis someone

00:08:31.096 --> 00:08:32.216
got mad at us for calling the study

00:08:32.456 --> 00:08:34.557
uh because we didn't publish it uh for

00:08:34.697 --> 00:08:36.339
four hundred eighty patients six months

00:08:36.359 --> 00:08:38.860
six i know right we we may make

00:08:38.899 --> 00:08:40.341
a big deal about the dumbest things we

00:08:40.360 --> 00:08:42.261
keep going yeah that's dumb but yeah i

00:08:42.282 --> 00:08:45.124
agree and across the different uh outcomes

00:08:45.163 --> 00:08:47.024
measures like lefs coos etc

00:08:48.264 --> 00:08:51.287
They saw a nineteen to sixty two percent

00:08:51.706 --> 00:08:53.447
increase in plan of care completion.

00:08:54.128 --> 00:08:54.427
Why?

00:08:54.567 --> 00:08:55.469
Just go to the human level.

00:08:55.528 --> 00:08:56.710
Because I felt connected.

00:08:56.929 --> 00:08:57.330
I understood.

00:08:57.350 --> 00:08:58.129
It's a better relationship.

00:08:58.190 --> 00:08:58.890
It's a better relationship.

00:08:58.910 --> 00:08:59.951
There's greater therapeutic clients.

00:08:59.971 --> 00:09:01.412
It's not a transaction.

00:09:01.491 --> 00:09:01.892
Exactly.

00:09:01.991 --> 00:09:02.231
Got it.

00:09:02.251 --> 00:09:02.652
Exactly.

00:09:03.452 --> 00:09:05.673
And so that lower cancellation rates.

00:09:06.769 --> 00:09:08.532
And just even those two, right?

00:09:08.552 --> 00:09:09.673
You start thinking about what that would

00:09:09.692 --> 00:09:11.234
do for your P&L if you're able to

00:09:11.254 --> 00:09:13.056
go from six point two to six point

00:09:13.096 --> 00:09:14.177
seven visits per case.

00:09:14.236 --> 00:09:17.279
If you're ones and twos, that one,

00:09:17.299 --> 00:09:18.802
two visit patients that didn't drop off

00:09:19.062 --> 00:09:20.102
become fours and fives,

00:09:20.943 --> 00:09:21.583
which is what they saw.

00:09:21.604 --> 00:09:22.404
And that was dramatic.

00:09:22.544 --> 00:09:23.725
Yeah, it's a big difference.

00:09:24.005 --> 00:09:25.668
You think about it even against your

00:09:25.687 --> 00:09:25.807
point.

00:09:25.827 --> 00:09:26.708
I think about it differently.

00:09:26.828 --> 00:09:30.032
Like I think about the cost to deliver

00:09:30.152 --> 00:09:30.852
a visit, right?

00:09:31.249 --> 00:09:31.469
right?

00:09:31.729 --> 00:09:33.669
And what your payback period is to even

00:09:33.690 --> 00:09:35.990
be able to be profitable as a clinic

00:09:36.090 --> 00:09:36.671
on a patient.

00:09:37.171 --> 00:09:39.850
And so when you're doing all the work

00:09:39.870 --> 00:09:40.951
on verification of benefits,

00:09:41.152 --> 00:09:42.131
you have to have your front desk,

00:09:42.152 --> 00:09:42.991
you have to have your EMR,

00:09:43.351 --> 00:09:44.633
you have to have all these things, right?

00:09:44.653 --> 00:09:46.572
Like you have a certain amount of cost

00:09:46.633 --> 00:09:49.033
built into delivering an eval.

00:09:49.453 --> 00:09:50.695
And from there,

00:09:51.315 --> 00:09:53.955
when do you finally turn that over, right?

00:09:54.014 --> 00:09:55.056
You, in the startup world,

00:09:55.076 --> 00:09:57.015
there's customer acquisition costs,

00:09:57.096 --> 00:09:58.817
lifetime value, payback period,

00:09:58.836 --> 00:09:59.297
and all that.

00:10:00.091 --> 00:10:01.753
I think the same thing applies in PT

00:10:01.773 --> 00:10:02.533
too.

00:10:02.592 --> 00:10:03.552
Unfortunately, I'm very sorry,

00:10:03.572 --> 00:10:04.614
but we have to talk about it in

00:10:04.634 --> 00:10:05.594
those terms.

00:10:05.874 --> 00:10:07.674
No margin, no mission.

00:10:08.355 --> 00:10:09.715
Yes, that we are here for great care,

00:10:09.735 --> 00:10:11.735
but if we don't have a roof or

00:10:11.755 --> 00:10:12.716
we can't pay our people,

00:10:13.235 --> 00:10:14.576
we're not helping anybody.

00:10:14.716 --> 00:10:14.876
No.

00:10:16.197 --> 00:10:16.857
And then beyond that,

00:10:16.918 --> 00:10:19.638
I think RTM used to be looked at

00:10:19.697 --> 00:10:21.558
as the end point, like, okay, perfect.

00:10:21.778 --> 00:10:22.658
I'm doing RTM now.

00:10:22.678 --> 00:10:24.159
I'm billing it like I'm done.

00:10:25.629 --> 00:10:25.808
Well,

00:10:25.828 --> 00:10:27.490
I don't know if anyone checked what CMS

00:10:27.549 --> 00:10:29.070
released in December,

00:10:29.269 --> 00:10:31.931
but they released the Elevate program,

00:10:32.171 --> 00:10:33.350
the Access program.

00:10:33.410 --> 00:10:34.591
I believe before that was a Balance

00:10:34.611 --> 00:10:35.052
program.

00:10:36.111 --> 00:10:39.373
Access in particular is a value-based

00:10:39.413 --> 00:10:41.332
program that pays for improvement in

00:10:41.373 --> 00:10:43.254
musculoskeletal outcomes.

00:10:43.573 --> 00:10:45.595
So you're going to get paid based on

00:10:45.615 --> 00:10:46.195
your outcome.

00:10:47.099 --> 00:10:52.822
Now, if you can't keep patients in care,

00:10:53.221 --> 00:10:54.621
you're not gonna be able to get paid

00:10:54.682 --> 00:10:55.123
for that.

00:10:55.582 --> 00:10:56.682
So now, our team,

00:10:56.722 --> 00:10:58.283
I think what was the end point,

00:10:58.384 --> 00:10:59.184
looking at the end point,

00:10:59.205 --> 00:11:02.865
and I give folks that started in

00:11:02.905 --> 00:11:04.206
twenty-twenty-two, twenty-twenty-three,

00:11:04.246 --> 00:11:05.506
and like, hey, just didn't work.

00:11:05.528 --> 00:11:06.347
It's like, yeah,

00:11:06.388 --> 00:11:08.448
but the game has entirely changed.

00:11:08.469 --> 00:11:10.289
Like, yes, there were two new codes added,

00:11:10.809 --> 00:11:12.311
so it went from four to six.

00:11:13.211 --> 00:11:15.111
But the impact is going to be nonlinear.

00:11:15.451 --> 00:11:16.893
So it'd be like if you increase the

00:11:16.932 --> 00:11:19.735
size of a hockey goal by fifty percent,

00:11:20.434 --> 00:11:21.515
it'd be more than fifty percent more

00:11:21.556 --> 00:11:21.816
goals.

00:11:21.895 --> 00:11:22.155
Right.

00:11:22.235 --> 00:11:22.956
Yeah.

00:11:22.976 --> 00:11:23.996
You probably have taller goalies like

00:11:24.017 --> 00:11:24.977
there'd be all sorts of stuff that would

00:11:25.018 --> 00:11:25.158
happen.

00:11:25.197 --> 00:11:25.557
Wider.

00:11:25.677 --> 00:11:25.878
Yeah.

00:11:25.918 --> 00:11:27.379
Wrestlers would now be goaltenders.

00:11:27.479 --> 00:11:28.919
I think you'd have to go straight to

00:11:28.940 --> 00:11:30.581
Japan.

00:11:32.562 --> 00:11:34.923
So when someone thinks about, OK, cool.

00:11:36.083 --> 00:11:38.668
tactically how do i do this like i

00:11:38.687 --> 00:11:39.629
remember the first time someone was

00:11:39.649 --> 00:11:41.030
explaining rtm to me i was like oh

00:11:41.091 --> 00:11:42.352
i can see pts sitting there at their

00:11:42.393 --> 00:11:46.118
desk with uh uh post-it notes or they're

00:11:46.138 --> 00:11:48.081
making their own spreadsheets to track

00:11:48.120 --> 00:11:49.943
these things and then eventually you hit a

00:11:49.964 --> 00:11:51.525
point where you're like dude this sucks

00:11:52.326 --> 00:11:53.407
This is too complicated.

00:11:53.868 --> 00:11:56.748
But now we have apps and all these

00:11:56.768 --> 00:11:57.428
different things.

00:11:57.649 --> 00:11:59.989
So specifically with Sarah Health,

00:12:00.089 --> 00:12:01.629
if someone's still nodding and listening

00:12:01.669 --> 00:12:02.889
along, they're going, okay,

00:12:02.929 --> 00:12:03.711
how does this work?

00:12:03.730 --> 00:12:06.730
Do I have to invent more stuff or

00:12:06.811 --> 00:12:07.591
track these things?

00:12:07.611 --> 00:12:08.932
Do I have to hire one more person?

00:12:08.951 --> 00:12:09.631
That's a legit question.

00:12:09.892 --> 00:12:11.253
Hire one more person just to track all

00:12:11.273 --> 00:12:11.653
these things.

00:12:11.673 --> 00:12:12.793
Or do I have to take half of

00:12:12.832 --> 00:12:14.614
my front desk person's day to do this?

00:12:15.214 --> 00:12:16.073
Because if it is,

00:12:16.153 --> 00:12:17.215
they're asking the right question.

00:12:17.294 --> 00:12:18.355
Is the juice worth the squeeze?

00:12:18.695 --> 00:12:20.855
So is it Post-it notes?

00:12:22.351 --> 00:12:23.331
I think that's, again,

00:12:23.371 --> 00:12:25.312
part of like it's changed a lot since

00:12:25.373 --> 00:12:26.033
twenty twenty two.

00:12:26.133 --> 00:12:26.253
Right.

00:12:26.273 --> 00:12:28.052
When they came out is you're no longer

00:12:28.113 --> 00:12:29.013
customer number three,

00:12:29.072 --> 00:12:30.193
your customer number three hundred.

00:12:30.494 --> 00:12:31.933
And so there's been a lot of really

00:12:31.953 --> 00:12:32.833
good technology built.

00:12:33.173 --> 00:12:33.874
Like from what I've seen,

00:12:33.913 --> 00:12:35.375
what Sarah looked like on day one to

00:12:35.414 --> 00:12:38.774
now is almost unrecognizable in many ways.

00:12:38.794 --> 00:12:39.014
It should.

00:12:39.075 --> 00:12:39.436
It should.

00:12:40.655 --> 00:12:42.296
Part of that was we actually asked all

00:12:42.316 --> 00:12:43.735
of our clients early on and we still

00:12:43.775 --> 00:12:45.777
do like show me every spreadsheet you have

00:12:45.797 --> 00:12:46.317
to make for this.

00:12:47.017 --> 00:12:48.479
Cause we're just going to take it and

00:12:48.499 --> 00:12:49.038
then got it.

00:12:49.058 --> 00:12:50.541
You're going to ingest it and say, well,

00:12:50.581 --> 00:12:52.523
we'll do it better, faster, cheaper,

00:12:52.623 --> 00:12:53.004
exactly.

00:12:53.303 --> 00:12:53.745
Exactly.

00:12:54.205 --> 00:12:54.264
Um,

00:12:54.345 --> 00:12:56.467
and so the way that it works with,

00:12:56.908 --> 00:12:57.428
I'll talk about Sarah,

00:12:57.448 --> 00:12:58.910
but I want to give like value to

00:12:58.951 --> 00:12:59.311
everybody.

00:12:59.370 --> 00:12:59.471
Like,

00:12:59.490 --> 00:13:00.532
I don't care if you're using us or

00:13:00.572 --> 00:13:00.793
not.

00:13:01.413 --> 00:13:01.594
Um,

00:13:02.214 --> 00:13:04.514
have your front desk enroll the patients

00:13:04.534 --> 00:13:05.475
that check in for eval.

00:13:06.014 --> 00:13:06.775
So they're there.

00:13:06.995 --> 00:13:07.676
They're checked in.

00:13:07.796 --> 00:13:08.255
They're good.

00:13:08.395 --> 00:13:09.176
Enroll the patients.

00:13:09.917 --> 00:13:11.256
Don't call it RTM.

00:13:11.557 --> 00:13:12.518
Call it something else.

00:13:12.638 --> 00:13:13.857
A lot of our groups... To a patient,

00:13:13.878 --> 00:13:14.118
you mean?

00:13:14.197 --> 00:13:14.878
Yeah.

00:13:14.898 --> 00:13:15.298
Okay.

00:13:15.359 --> 00:13:15.599
Good.

00:13:15.678 --> 00:13:16.359
I like... Yes.

00:13:16.418 --> 00:13:17.318
Now we're going into marketing and

00:13:17.339 --> 00:13:17.599
branding.

00:13:17.639 --> 00:13:18.100
My world.

00:13:18.179 --> 00:13:18.460
Yes.

00:13:18.559 --> 00:13:20.139
If it has... And Tony Maritato knows.

00:13:20.440 --> 00:13:22.500
It sounds like I'm unreasonable on this.

00:13:22.541 --> 00:13:24.241
But if it doesn't have a name or

00:13:24.282 --> 00:13:24.981
has a dumb name...

00:13:26.188 --> 00:13:27.049
People don't attach to it.

00:13:27.289 --> 00:13:29.493
So what are good names that you've seen

00:13:29.513 --> 00:13:30.274
people call it?

00:13:30.333 --> 00:13:31.394
So a lot of groups call it their

00:13:31.434 --> 00:13:31.716
Connect.

00:13:31.956 --> 00:13:34.038
That's our typical Connect program.

00:13:34.458 --> 00:13:35.320
Unless you're on Raintree,

00:13:35.340 --> 00:13:37.241
because Raintree has a feature called

00:13:37.282 --> 00:13:37.942
Raintree Connect.

00:13:37.982 --> 00:13:39.965
So our Raintree customers call it

00:13:39.985 --> 00:13:40.505
something different.

00:13:41.647 --> 00:13:43.386
like the CareSync program,

00:13:44.067 --> 00:13:45.947
the Concierge program.

00:13:45.967 --> 00:13:47.488
Like we've seen a lot of really cool

00:13:47.508 --> 00:13:47.668
names.

00:13:47.687 --> 00:13:49.629
There's another group calls it the patient

00:13:49.649 --> 00:13:50.509
support co-pilot,

00:13:51.408 --> 00:13:52.749
which it'd be in the right part of

00:13:52.788 --> 00:13:53.389
the, you know,

00:13:53.428 --> 00:13:54.710
have the right demographic for that to

00:13:54.769 --> 00:13:54.990
work.

00:13:55.389 --> 00:13:56.750
But that's, that's it.

00:13:57.649 --> 00:13:59.909
And then we give a consent form to

00:14:00.071 --> 00:14:01.071
each and every one of our practices.

00:14:01.091 --> 00:14:01.831
That's white labeled.

00:14:02.850 --> 00:14:04.191
And so patients don't know that Sarah

00:14:04.230 --> 00:14:05.272
exists, but there's no reason.

00:14:05.432 --> 00:14:06.371
We're just a vessel.

00:14:06.451 --> 00:14:06.591
Right.

00:14:06.631 --> 00:14:07.231
You want them.

00:14:08.011 --> 00:14:10.493
to feel the relationship with the

00:14:10.552 --> 00:14:11.274
practitioner in practice.

00:14:11.653 --> 00:14:12.053
Exactly.

00:14:12.794 --> 00:14:14.775
And so from there, gets enrolled.

00:14:14.855 --> 00:14:15.336
For us,

00:14:15.395 --> 00:14:16.876
patient gets a text within typically one

00:14:16.897 --> 00:14:18.017
to two seconds of the front desk

00:14:18.037 --> 00:14:18.457
enrolling.

00:14:18.937 --> 00:14:21.259
That is a great priming mechanism for the

00:14:21.298 --> 00:14:23.900
clinician, that PT, to talk about, hey,

00:14:23.941 --> 00:14:24.561
this is our

00:14:25.000 --> 00:14:26.902
connect program it allows me to be able

00:14:26.922 --> 00:14:28.481
to engage with you between visits because

00:14:28.522 --> 00:14:29.842
we know that you spend ninety nine percent

00:14:29.863 --> 00:14:31.842
of your time outside of the clinic so

00:14:32.183 --> 00:14:34.004
you're gonna get questions can you text me

00:14:34.024 --> 00:14:35.485
back because i'm gonna use that in your

00:14:35.504 --> 00:14:38.025
fault visits oh so you're not asking the

00:14:38.066 --> 00:14:40.265
patients to download an app no no because

00:14:40.285 --> 00:14:41.586
if i get asked to download one more

00:14:41.706 --> 00:14:44.148
app like literally to park at the airport

00:14:44.168 --> 00:14:45.927
i have to download an app to buy

00:14:45.967 --> 00:14:47.828
coffee it's like do you have your points

00:14:48.028 --> 00:14:49.448
app i'm like no like you might be

00:14:49.489 --> 00:14:50.610
giving up your points i'm like at this

00:14:50.649 --> 00:14:52.070
point lady i don't i would like the

00:14:52.110 --> 00:14:53.510
coffee i will give you money

00:14:54.712 --> 00:14:56.673
And what's the probably most used app on

00:14:56.734 --> 00:14:57.735
someone's phone anyway?

00:14:57.894 --> 00:14:58.774
It's the text message app.

00:14:58.794 --> 00:14:59.195
I mean,

00:14:59.414 --> 00:15:00.676
I want to avoid calling people as much

00:15:00.716 --> 00:15:01.275
as possible.

00:15:01.876 --> 00:15:02.937
So they're just using,

00:15:03.537 --> 00:15:04.357
they're just texting?

00:15:04.418 --> 00:15:05.077
They're just texting.

00:15:05.278 --> 00:15:07.359
So what we have is... Stunningly simple.

00:15:07.458 --> 00:15:08.320
You have to use a software as a

00:15:08.340 --> 00:15:10.400
medical device to be able to collect this

00:15:10.441 --> 00:15:10.740
data.

00:15:10.821 --> 00:15:10.961
Well,

00:15:10.980 --> 00:15:13.162
we went to the FDA back in twenty

00:15:13.201 --> 00:15:17.063
twenty three and have our letter for have

00:15:17.104 --> 00:15:18.725
them have them look at all of our

00:15:18.745 --> 00:15:19.085
functionality.

00:15:19.105 --> 00:15:19.605
What are you doing?

00:15:19.644 --> 00:15:20.586
They're going to tear it apart.

00:15:20.666 --> 00:15:21.025
Exactly.

00:15:21.725 --> 00:15:23.086
And they looked at it and said, hey,

00:15:23.106 --> 00:15:24.128
based on these two pieces of

00:15:24.168 --> 00:15:24.769
functionality,

00:15:25.349 --> 00:15:26.929
this is software as a medical device under

00:15:26.950 --> 00:15:27.770
enforcement discretion.

00:15:27.951 --> 00:15:30.513
And so we went through that process

00:15:30.552 --> 00:15:32.715
because we've been at this for almost ten

00:15:32.735 --> 00:15:33.735
years now.

00:15:34.395 --> 00:15:35.756
And we found early on,

00:15:35.856 --> 00:15:36.717
relatively early on,

00:15:36.758 --> 00:15:39.078
that we had patients and we were working

00:15:39.099 --> 00:15:40.080
with a lot of fire departments.

00:15:40.760 --> 00:15:42.402
And so we had a fire department,

00:15:42.922 --> 00:15:45.083
Plainfield Fire, Danielle,

00:15:45.604 --> 00:15:46.345
who I'll never forget,

00:15:47.065 --> 00:15:48.466
she was giving us feedback of why she

00:15:48.485 --> 00:15:49.106
wasn't logging into our app.

00:15:49.126 --> 00:15:49.206
Wait,

00:15:49.226 --> 00:15:50.687
why was the fire department using it?

00:15:51.977 --> 00:15:53.600
We were working with the PT and then

00:15:53.941 --> 00:15:55.663
PT groups that had some ATC as well,

00:15:55.683 --> 00:15:57.267
but PT groups that were directly

00:15:57.307 --> 00:15:59.471
contracted with fire and police.

00:15:59.490 --> 00:16:00.392
I love hearing stuff like that.

00:16:00.412 --> 00:16:01.214
My dad was a fireman.

00:16:01.234 --> 00:16:03.918
I'm like, firemen, typically cops too,

00:16:03.957 --> 00:16:04.879
EMT, will avoid...

00:16:05.546 --> 00:16:07.888
medical care at their own detriment well

00:16:08.187 --> 00:16:09.369
because they don't want to be the one

00:16:09.389 --> 00:16:11.610
that's like off the truck like oh oh

00:16:11.831 --> 00:16:15.812
yeah we've yeah yeah my dad broke both

00:16:15.854 --> 00:16:18.495
pinkies at a fire and he was like

00:16:18.514 --> 00:16:19.716
trying to hide it and they're like you

00:16:19.735 --> 00:16:21.216
sort of need all ten fingers to do

00:16:21.256 --> 00:16:24.259
the saw uh so you have to you

00:16:24.299 --> 00:16:25.900
have to go away from work but anyway

00:16:25.921 --> 00:16:27.001
go ahead so all right so you so

00:16:27.022 --> 00:16:29.023
you started with plainfield fire yeah um

00:16:29.102 --> 00:16:30.683
and a bunch of fire departments uh but

00:16:30.864 --> 00:16:32.264
really danielle was really helpful because

00:16:32.385 --> 00:16:32.905
like hey

00:16:33.706 --> 00:16:35.548
She gave us a testimonial on like her

00:16:35.587 --> 00:16:37.409
recovery process and how much our app

00:16:37.450 --> 00:16:37.750
helps.

00:16:37.791 --> 00:16:38.812
And then it's like, look,

00:16:38.932 --> 00:16:40.793
I just don't need an app anymore.

00:16:40.833 --> 00:16:42.456
What I need is a way to talk

00:16:42.475 --> 00:16:44.057
to my PT and get reminded to do

00:16:44.077 --> 00:16:44.578
my stuff.

00:16:45.019 --> 00:16:46.461
Like, oh, you need a text message.

00:16:46.561 --> 00:16:47.061
And she's like, well,

00:16:47.100 --> 00:16:47.981
better be a good text.

00:16:48.643 --> 00:16:49.865
And that was what started.

00:16:50.144 --> 00:16:51.586
And then when the RTM code,

00:16:51.626 --> 00:16:53.609
that was twenty eighteen, twenty nineteen.

00:16:54.725 --> 00:16:56.025
And so we'd been at this for a

00:16:56.066 --> 00:16:56.385
while.

00:16:56.426 --> 00:16:57.908
When the RTM codes came out,

00:16:58.408 --> 00:16:59.908
we worked with a lawyer like, hey,

00:17:00.129 --> 00:17:02.392
we want to be like lock and stock

00:17:02.511 --> 00:17:04.073
if there's ever a records request.

00:17:04.693 --> 00:17:05.374
What do we need to do?

00:17:05.855 --> 00:17:06.536
Like, well, you need to...

00:17:07.280 --> 00:17:08.821
do this five thirteen G process.

00:17:08.862 --> 00:17:10.082
And so that's exactly what we did.

00:17:11.163 --> 00:17:12.742
We have had a customer who did get

00:17:13.003 --> 00:17:14.644
a records request for one of the codes

00:17:14.663 --> 00:17:17.484
we facilitated, gave all of our stuff.

00:17:18.105 --> 00:17:18.346
Done.

00:17:18.566 --> 00:17:19.026
Done.

00:17:19.086 --> 00:17:19.685
Wow.

00:17:19.705 --> 00:17:20.547
Good for you guys.

00:17:22.228 --> 00:17:24.608
What's the what's the what's the thirty

00:17:24.628 --> 00:17:26.568
thousand foot view in terms of adoption?

00:17:26.669 --> 00:17:27.630
Like, I know you don't have the day.

00:17:27.650 --> 00:17:27.890
I'm going to

00:17:27.930 --> 00:17:29.090
hold but if you were like i don't

00:17:29.111 --> 00:17:30.712
know my gut feels like five percent of

00:17:30.732 --> 00:17:32.955
the of pts who can be using this

00:17:33.155 --> 00:17:34.877
r or thirty i don't where are we

00:17:34.938 --> 00:17:36.160
are we at two percent are we at

00:17:36.299 --> 00:17:37.701
eighty i don't i am i am in

00:17:37.741 --> 00:17:39.844
the dark and it's an unfair question for

00:17:39.864 --> 00:17:41.046
me to ask i know you're making up

00:17:41.066 --> 00:17:43.269
a number here i based on what i've

00:17:43.308 --> 00:17:44.931
heard from some of the other leaders i

00:17:45.050 --> 00:17:45.070
i

00:17:46.291 --> 00:17:48.574
i would bet we're maybe at ten percent

00:17:48.953 --> 00:17:51.976
have an account with an rtm technology and

00:17:52.016 --> 00:17:54.637
is attempting this yep and that's only

00:17:54.678 --> 00:17:55.939
gonna go up i mean like you know

00:17:56.058 --> 00:17:57.759
five years from now six this is not

00:17:57.779 --> 00:18:00.021
a nice to have this is a need

00:18:00.041 --> 00:18:01.663
to again it's not the it's not the

00:18:01.722 --> 00:18:02.923
end point anymore it's just the starting

00:18:02.963 --> 00:18:04.404
line right to get into these other

00:18:04.444 --> 00:18:05.586
programs that are coming out and like

00:18:05.939 --> 00:18:07.519
If you think that CMS is going to

00:18:07.579 --> 00:18:08.980
stop rolling out new programs,

00:18:09.661 --> 00:18:10.622
I have a bridge to sell you.

00:18:10.741 --> 00:18:12.063
Yeah, it's in Brooklyn.

00:18:12.143 --> 00:18:13.463
Super cheap.

00:18:13.923 --> 00:18:14.183
Cool.

00:18:14.203 --> 00:18:17.205
We'll be checking in over the next couple

00:18:17.226 --> 00:18:18.267
of hours, next couple of days.

00:18:18.287 --> 00:18:19.248
This is the first time I've ever really

00:18:19.268 --> 00:18:21.048
done live streaming on site,

00:18:21.189 --> 00:18:22.470
but I live stream from my living room,

00:18:22.490 --> 00:18:23.450
so I'm like, how hard can it be?

00:18:23.470 --> 00:18:25.230
This is APTA headquarters in Alexandria,

00:18:25.250 --> 00:18:25.592
Virginia.

00:18:26.512 --> 00:18:27.273
Graham Sessions,

00:18:27.314 --> 00:18:28.976
which is put on by APTA Private Practice

00:18:28.996 --> 00:18:29.376
Section.

00:18:29.416 --> 00:18:31.398
Thank you guys for letting me set up

00:18:31.439 --> 00:18:33.301
my mobile studio in your living room here.

00:18:33.722 --> 00:18:34.683
I call it Avengers Tower.

00:18:35.104 --> 00:18:36.566
Sort of has Avenger Tower vibe.

00:18:36.586 --> 00:18:36.946
It does.

00:18:37.667 --> 00:18:38.849
That part could get blown up easily.

00:18:38.869 --> 00:18:39.611
Yeah, yeah, yeah.

00:18:40.971 --> 00:18:42.173
But the goal here is...

00:18:43.134 --> 00:18:44.715
I'll be asking everybody who's in a

00:18:44.796 --> 00:18:45.416
session right now.

00:18:45.517 --> 00:18:46.778
I'm speaking very quietly.

00:18:46.798 --> 00:18:47.420
Is there a session?

00:18:48.340 --> 00:18:49.843
But just a couple of big picture questions

00:18:50.262 --> 00:18:50.763
that I asked you.

00:18:51.183 --> 00:18:52.826
What is something you are excited to hear

00:18:52.865 --> 00:18:53.988
more about and you want to hear thoughts?

00:18:54.028 --> 00:18:55.690
What's something you wish we had?

00:18:55.710 --> 00:18:56.750
Oh, it's not on the docket.

00:18:57.132 --> 00:18:58.333
Why isn't that being taught?

00:18:58.594 --> 00:18:59.555
I was like...

00:19:00.435 --> 00:19:01.758
Where's all the AI stuff?

00:19:01.837 --> 00:19:04.441
I didn't see one thing on AI really

00:19:04.500 --> 00:19:04.781
in there.

00:19:04.882 --> 00:19:07.204
AI or even these new programs that are

00:19:07.224 --> 00:19:09.386
coming, like the Access program.

00:19:09.428 --> 00:19:10.188
I feel like there could have been a

00:19:10.208 --> 00:19:11.450
whole thing on that.

00:19:11.470 --> 00:19:11.730
Right.

00:19:11.750 --> 00:19:12.811
Because if you want to be in the

00:19:12.832 --> 00:19:14.193
first round, you need to apply by,

00:19:14.253 --> 00:19:15.154
I think, April first.

00:19:15.816 --> 00:19:16.576
Oh, we're in January.

00:19:17.843 --> 00:19:20.145
I will give APJPPS some grace.

00:19:20.306 --> 00:19:21.007
To put on a conference,

00:19:21.027 --> 00:19:22.648
you have to get speakers months in

00:19:22.689 --> 00:19:23.048
advance.

00:19:23.289 --> 00:19:23.710
I get that.

00:19:23.789 --> 00:19:24.590
And it came out in December.

00:19:25.092 --> 00:19:25.372
Right.

00:19:26.413 --> 00:19:28.556
So what I'm saying, though, is, hey,

00:19:28.736 --> 00:19:30.298
how do we shorten the cycle of

00:19:30.337 --> 00:19:31.960
conversations in places like this,

00:19:32.019 --> 00:19:32.840
having conversations?

00:19:32.861 --> 00:19:33.781
The answer is live stream.

00:19:34.542 --> 00:19:35.203
Why aren't we doing it?

00:19:35.223 --> 00:19:36.365
What are you doing in between Graham

00:19:36.384 --> 00:19:36.986
Sessions' meetings?

00:19:37.865 --> 00:19:38.767
You should be doing live streams,

00:19:38.807 --> 00:19:40.468
but I'll be asking big picture questions.

00:19:40.627 --> 00:19:42.069
So forgive me.

00:19:42.170 --> 00:19:43.150
I'm going to be blowing up your feed

00:19:43.190 --> 00:19:43.810
with that.

00:19:43.851 --> 00:19:44.070
Damn.

00:19:44.090 --> 00:19:45.592
Jimmy McKay is live again.

00:19:45.791 --> 00:19:46.093
Again.

00:19:46.173 --> 00:19:47.453
Usually it's like once or twice a day.

00:19:47.874 --> 00:19:49.315
Now it's thirty seven times and I have

00:19:49.355 --> 00:19:49.694
no idea.

00:19:49.775 --> 00:19:52.297
I DM to a bunch of people that

00:19:52.317 --> 00:19:53.858
I knew were coming and everybody was like,

00:19:53.878 --> 00:19:54.019
yeah,

00:19:54.058 --> 00:19:55.500
but I don't know who I'll be talking

00:19:55.519 --> 00:19:55.680
to.

00:19:55.700 --> 00:19:57.201
We're talking to one person at a time

00:19:57.280 --> 00:19:58.501
or we talk to a group.

00:19:58.942 --> 00:19:59.403
I don't know.

00:19:59.702 --> 00:20:01.403
But we have a tradition on the show

00:20:01.845 --> 00:20:03.105
and it is called the parting.

00:20:05.192 --> 00:20:06.313
This is the parting shot.

00:20:06.873 --> 00:20:08.253
One last mic drop moment.

00:20:08.933 --> 00:20:09.734
No pressure.

00:20:10.194 --> 00:20:12.316
Just your legacy on the line.

00:20:13.536 --> 00:20:14.497
Just your legacy on the line.

00:20:14.517 --> 00:20:15.696
What's your parting shot for right now?

00:20:15.876 --> 00:20:16.718
Something you just want to leave the

00:20:16.758 --> 00:20:18.098
audience as we kick off the live stream.

00:20:18.118 --> 00:20:19.439
Thanks for being our guinea pig,

00:20:19.459 --> 00:20:19.759
by the way.

00:20:19.919 --> 00:20:21.059
I literally just called Stephen over and I

00:20:21.079 --> 00:20:21.859
was like, hey, we're doing a lot.

00:20:21.980 --> 00:20:23.181
I got to see if this camera works.

00:20:23.201 --> 00:20:23.941
And he was like, great.

00:20:23.980 --> 00:20:25.561
He didn't say, what are we talking about?

00:20:26.261 --> 00:20:27.063
Is this actually live?

00:20:27.103 --> 00:20:27.282
All right.

00:20:27.542 --> 00:20:28.303
What's your parting shot?

00:20:28.343 --> 00:20:29.763
What's just one little thing you want to

00:20:29.784 --> 00:20:31.505
leave with the audience?

00:20:31.585 --> 00:20:31.904
A story.

00:20:33.106 --> 00:20:33.748
And I'll tell it later,

00:20:33.827 --> 00:20:35.209
but I can say it again here.

00:20:36.570 --> 00:20:39.573
PT Indianapolis told me something that

00:20:40.954 --> 00:20:42.096
really changed the way I look at this.

00:20:42.916 --> 00:20:43.297
She said,

00:20:43.576 --> 00:20:47.760
I never thought I would save a life.

00:20:47.800 --> 00:20:49.241
Patient texted through Sarah,

00:20:49.762 --> 00:20:50.523
shortness of breath,

00:20:50.703 --> 00:20:53.306
three days post-op total knee.

00:20:53.346 --> 00:20:55.407
She gets that, has a quick conversation,

00:20:55.567 --> 00:20:56.690
ends up calling him an ambulance.

00:20:57.590 --> 00:21:00.571
Hospital, only one day, one night.

00:21:01.311 --> 00:21:02.051
Fluid on the chest,

00:21:02.771 --> 00:21:04.711
as benign as one night in the hospital

00:21:04.731 --> 00:21:05.212
stay can be.

00:21:05.813 --> 00:21:07.073
Went home with his family the next day.

00:21:07.992 --> 00:21:10.854
All it takes is one missed visit because

00:21:10.894 --> 00:21:11.634
he doesn't feel well.

00:21:12.094 --> 00:21:13.614
And that story ends a lot differently.

00:21:14.795 --> 00:21:19.255
So that is what that connectivity can

00:21:19.295 --> 00:21:19.535
mean.

00:21:19.675 --> 00:21:21.695
That's also why these payers are paying

00:21:21.715 --> 00:21:21.955
for it.

00:21:22.671 --> 00:21:23.991
Because that patient also could have been

00:21:24.332 --> 00:21:26.413
half million plus instead of thirty

00:21:26.452 --> 00:21:26.813
thousand.

00:21:27.373 --> 00:21:28.074
And the answer,

00:21:28.693 --> 00:21:30.835
the solution to that or the facilitator,

00:21:30.875 --> 00:21:33.316
that wasn't something terribly high tech.

00:21:33.455 --> 00:21:34.557
It was access.

00:21:34.676 --> 00:21:35.116
The text.

00:21:35.477 --> 00:21:38.358
It's access to someone when they needed

00:21:38.398 --> 00:21:38.519
it.

00:21:38.898 --> 00:21:40.159
The right person at the right time.

00:21:40.400 --> 00:21:40.700
Wow.

00:21:40.740 --> 00:21:41.299
That's powerful.

00:21:41.319 --> 00:21:42.019
And the right question.

00:21:42.180 --> 00:21:42.901
And the right question.

00:21:42.941 --> 00:21:43.260
Yeah.

00:21:43.280 --> 00:21:44.260
This doesn't feel right.

00:21:44.320 --> 00:21:44.942
What do I do?

00:21:45.021 --> 00:21:45.882
Wow.

00:21:45.922 --> 00:21:46.501
Red flag.

00:21:47.042 --> 00:21:47.663
Good for you.

00:21:47.942 --> 00:21:49.044
Where can people go to find out more

00:21:49.064 --> 00:21:49.624
about Sarah Health?

00:21:50.163 --> 00:21:51.025
SarahHealth.com.

00:21:51.065 --> 00:21:53.527
So S-A-R-A-Health.com.

00:21:54.347 --> 00:21:55.248
And then I'm Steven.

00:21:55.689 --> 00:21:58.451
So S-T-E-V-E-N at SarahHealth.com.

00:21:58.510 --> 00:21:59.852
Not Steve, as we talked about earlier.

00:22:00.152 --> 00:22:01.153
Don't do Steve, everybody.

00:22:01.212 --> 00:22:01.894
It's a way to put your foot in

00:22:01.913 --> 00:22:02.193
your mouth.

00:22:02.233 --> 00:22:03.015
Always make sure you know what your

00:22:03.035 --> 00:22:04.675
guest's name is before you start.

00:22:04.996 --> 00:22:07.238
Live from Graham Sessions atop the APTA

00:22:07.258 --> 00:22:08.838
Avengers Tower here in Alexandria with

00:22:08.858 --> 00:22:09.298
PPS.

00:22:11.646 --> 00:22:11.866
That's it.

00:22:11.886 --> 00:22:12.086
We're out.

00:22:12.106 --> 00:22:13.627
Boys, what the hell are you doing?

00:22:13.667 --> 00:22:16.490
Follow Tony Meritato on YouTube at Total

00:22:16.529 --> 00:22:17.570
Therapy Solution.

00:22:17.611 --> 00:22:18.611
Find Dave Kittle at

00:22:18.631 --> 00:22:21.813
conciergepainrelief.com and on YouTube at

00:22:21.853 --> 00:22:23.153
The Dave Kittle Show.

00:22:23.354 --> 00:22:26.476
And follow Jimmy McKay at PT Podcasts on

00:22:26.516 --> 00:22:27.656
YouTube, the socials,

00:22:27.757 --> 00:22:29.538
and wherever you binge podcasts you

00:22:29.557 --> 00:22:31.220
pretend are for CEUs.

00:22:31.519 --> 00:22:32.961
And hey, just a reminder,

00:22:33.441 --> 00:22:34.761
none of this was for advice.

00:22:34.801 --> 00:22:36.262
This was for entertainment only.

00:22:36.563 --> 00:22:37.943
Our lawyers say that counts.

00:22:38.023 --> 00:22:38.865
Thanks, Keith.