Dr. Randal J. Thomas

nurse practitioners, and others who can serve as medical supervisors of a rehabilitation program, particularly for the critical access hospitals that may not have doctors around. So all those things, those are all parts of things that are happening to try to expand in the reach of cardiac rehabilitation.

nurse practitioners, and others who can serve as medical supervisors of a rehabilitation program, particularly for the critical access hospitals that may not have doctors around. So all those things, those are all parts of things that are happening to try to expand in the reach of cardiac rehabilitation.

I'll mention a couple of others very briefly because there's some internal things that we can do. and definitely some external things. Internally, so for example, if you provide incentives to people, they would be more likely to come to rehabilitation and participate.

I'll mention a couple of others very briefly because there's some internal things that we can do. and definitely some external things. Internally, so for example, if you provide incentives to people, they would be more likely to come to rehabilitation and participate.

Yeah, so some simple, I'll give you a simple one and a more complex one. Simple one, we published on this a few years ago. So we did some very simple things. So at key time points, at session 10, at session 20, That's section 36. So a patient gets a T-shirt, they get a water bottle, you know, they get a book on nutrition. That's a complete rehabilitation. And they get encouragement along the way.

Yeah, so some simple, I'll give you a simple one and a more complex one. Simple one, we published on this a few years ago. So we did some very simple things. So at key time points, at session 10, at session 20, That's section 36. So a patient gets a T-shirt, they get a water bottle, you know, they get a book on nutrition. That's a complete rehabilitation. And they get encouragement along the way.

And we found a significant improvement in completion rates and participation rates. That's a simple thing. And a more complex way to do it was studied in Vermont, actually. You're talking about Medicaid patients before, too, and this was done in Medicaid patients in Vermont, Phil Ades and his group.

And we found a significant improvement in completion rates and participation rates. That's a simple thing. And a more complex way to do it was studied in Vermont, actually. You're talking about Medicaid patients before, too, and this was done in Medicaid patients in Vermont, Phil Ades and his group.

What they did was they took a group of patients who are Medicaid recipients who needed cardiac rehabilitation. That's among the lowest of the low participation rates of all the groups I've mentioned. And they built into the program and the incentive group. So the intervention group received incentives. They were financial incentives. So they received about $25 per session.

What they did was they took a group of patients who are Medicaid recipients who needed cardiac rehabilitation. That's among the lowest of the low participation rates of all the groups I've mentioned. And they built into the program and the incentive group. So the intervention group received incentives. They were financial incentives. So they received about $25 per session.

And then once they graduated, it was like $150, you know, some incentives. And they found that the participation rates went out the roof for those who are in the incentive group. And they found not only that, I think they were getting ready to publish these data, they found that the overall cost to the healthcare system was less in the people receiving the incentives.

And then once they graduated, it was like $150, you know, some incentives. And they found that the participation rates went out the roof for those who are in the incentive group. And they found not only that, I think they were getting ready to publish these data, they found that the overall cost to the healthcare system was less in the people receiving the incentives.

Because they were doing better staying out of the hospital, staying healthier. So those are some examples of some internal things that we can do potentially.

Because they were doing better staying out of the hospital, staying healthier. So those are some examples of some internal things that we can do potentially.

We've also looked at some things like report cards, performance measures, and we helped to put together some performance measures so that hospitals and medical groups are graded based on how well they do at getting people into cardiac rehabilitation. And that helped a little bit. That's helped a little bit. At least the referral to patients to cardiac rehabilitation has helped.

We've also looked at some things like report cards, performance measures, and we helped to put together some performance measures so that hospitals and medical groups are graded based on how well they do at getting people into cardiac rehabilitation. And that helped a little bit. That's helped a little bit. At least the referral to patients to cardiac rehabilitation has helped.

Yeah. And this is kind of getting into the future rehabilitation and really the present as well. So, Yes, there are options. In fact, there's a growing number of companies who are getting into this arena. There are apps, there are online options.

Yeah. And this is kind of getting into the future rehabilitation and really the present as well. So, Yes, there are options. In fact, there's a growing number of companies who are getting into this arena. There are apps, there are online options.

and there's there's some things that help with center-based care and there's some things that help with home-based care and there's some that do both it's more of a hybrid approach which i think is going to be the way to go in the future where you get some benefits of group interaction in person but the convenience of home and still some interactions and so forth but there are there are different applications and and programs are available

and there's there's some things that help with center-based care and there's some things that help with home-based care and there's some that do both it's more of a hybrid approach which i think is going to be the way to go in the future where you get some benefits of group interaction in person but the convenience of home and still some interactions and so forth but there are there are different applications and and programs are available