Limber Health: Empowering clinicians for remote monitoring for musculoskeletal care

Tech Brief

While other MSK solutions focus on the employer wellness space, Limber believes the best way to improve MSK care is to integrate new tools with physicians and physical therapists to enable them to remotely monitor and manage their patients’ care and implement evidence-based medicine. Limber provides an integrated solution that helps providers implement evidence-based MSK care -- with easy-to-use tools (risk stratification, monitoring of patient reported outcomes) -- enabling remote monitoring of patients’ therapy progress and appropriate triaging of care. The results: reductions in unnecessary services (e.g., opioids, surgeries), improved care for patients – at lower overall costs. Limber was specifically optimized for the new Remote Therapeutic Monitoring CPT codes that Limber worked with AMA to create and Medicare started reimbursing in 2022. For patients, the exercise therapy component helps people manage their back and joint pain in the convenience of their home, in coordination with their own provider. As shown in the Mayo Clinic RCT, Limber successfully helped patients reduce their pain/improve their function. Limber’s backbone is the incorporation of outcome measurement tool used at top medical institutions into its assessment, risk stratification and triage tool. None of our competitors do this. We won an award by the American Congress of Rehabilitation Medicine for how we matched exercises to PROMIS (PRO) scores allowing us to match patients to appropriate exercises. Other key differentiators: •Coaches trained in cognitive behavioral therapy to provide support to patients; •Highly engaging, follow-along videos; •Computer vision technology using 3-D motion capture to track adherence.

Problem Tech Solves

Musculoskeletal conditions (e.g., back and joint pain) impact one of every two people each year, are the most expensive of all medical conditions in the United States for both patients and payers, and are often mismanaged. Research shows exercise therapy, especially started right after an injury, significantly reduces the need for costly medical treatments, including opioids, injections, imaging, and surgeries – saving almost $3,000 per individual. However, less than 12 percent of people attend Physical Therapy. Challenges include high copays, travel distance (particularly in underserved areas), and time off from work. Providers also have limited access to real-time data, including whether their patients are adhering to therapy and whether their patients’ pain and function is improving so care can be escalated quickly, if appropriate. Providers need more digital tools to follow evidence-based MSK care. While Remote Patient Monitoring has been used in other specialties to improve quality of care, the new CPT codes – just introduced in 2022 and now covered by Medicare – enable monitoring to improve MSK care. Limber worked with the AMA on these new codes. Patients will greatly benefit from devices that would help them do home exercise therapy and enable their provider to track their adherence to therapy and changes in pain and function so that they have the most comprehensive information to oversee their care plan. Patient reported outcome measures – changes in pain and functional levels -- are used to determine efficacy in Orthopedics research. However, they are not used regularly in clinical care.

Validation

Limber has completed 2 clinical studies at the Mayo Clinic in Rochester, Minnesota. 1.Limber was found to be superior to in-person physical therapy at reducing pain and improving function in a randomized controlled trial published in the December 2021 Archives of Rehabilitation Research and Clinical Translation. The Limber group significantly surpassed the minimal clinical important difference. Patients were highly satisfied with Limber. The size of the cohort was 60. 2.Limber’s risk stratification and triage tool was validated with physicians and physical therapists with 20+years of clinical experience. The Limber algorithm correctly identified high risk patients in the clinical trial 100% of the time. An embargoed copy can be provided upon request. In other words, Limber (whose total cost is just a fraction of traditional Physical Therapy) was more effective in achieving results than in-person Physical Therapy. With many studies concluding early Physical Therapy is extremely effective in avoiding expensive medical treatments (such as opioids, surgery), Limber’s tool was shown to be very cost-effective. Examples of patient testimonials: •“This program has been very beneficial. Not only was I able to do it in the comfort and safety of my home, my muscles got stronger and I have a lot less knee pain.” •”Extremely effective. I have had physical therapy and personal training for years that was not nearly as effective as Limber.” Limber was awarded the 2020 “Most Impactful” new technology at the American Congress of Rehabilitation Medicine. Limber’s net promoter score is 81.