By About MaryRose Cusimano-Reaston, Ph.D., Co-Founder, Chief Science Officer, Emerge Diagnostics
Telemedicine has truly revolutionized the healthcare industry. Not only has it increased access to care exponentially, but in some cases it’s actually resulting in better diagnosis and treatment than an in-office visit could.
A case in point is the remote capability of bringing the latest technology for diagnosing and treating soft tissue injuries to injured workers anywhere on the globe. Organizations using it report dramatic outcomes — in terms of better diagnosis and treatment for their injured workers, return-to-work rates, and cost savings. The marriage of this FDA-cleared system with telemedicine has produced unprecedented results
Electrodiagnostic Functional Assessment, or EFA, is a game changer in and of itself. The technology behind the EFA provides objective information, which allows providers to better evaluate the elusive soft tissue injuries.
It’s not nearly as ‘new age’ as it sounds. The EFA is a noninvasive, painless diagnostic test that evaluates musculoskeletal and soft tissue pathology and functionality by combining and enhancing five medically accepted tests:
- Range of Motion
- Functional Capacity Evaluation
- Grip Test
- Pinch Test
Using electrodes placed on different muscle groups of the person, while simultaneously monitoring complex range of motion and function, it monitors muscle and spinal reactions to movement and function. The output helps establish the location, nature, age and extent of an injury. By providing this information better treatment options are identified.
About a year ago, we decided to incorporate telemedicine into the EFA program. We wanted a way to be able to deliver the services to any injured worker, regardless of location. We develop strong partnerships with our client companies and we really go all out to support them. We want to ensure employees have access to better diagnosis anywhere. Providing all their workers the best care possible can be difficult when workers are outside metropolitan areas. It just doesn’t make sense to ask an injured worker to drive an hour each way, especially for a second visit.
This is especially true with musculoskeletal injuries. These are very difficult to diagnose without proper evaluation as to the extent, location and nature of the Injury — they are hard to treat. Since the EFA is specifically designed for just this reason we wanted to find a way that all injured employees could benefit from the service.
Brick and mortar facilities for healthcare may be going by the wayside for that very reason. Not that they will disappear entirely, especially for life-threatening or severe traumatic injuries such as fractures, lacerations or severe head injuries. But for most work-related injuries, which involve soft tissue, telemedicine could probably replace them.
The other reason we looked to telemedicine is because we wanted to ensure that providers who are specifically trained to use the EFA could have better patient access to provide the technology to a broader patient base. One never knows where a workplace injury will occur. The best way to be able to get immediate care to all injured workers is to educate expert physicians in the EFA technology and provide quicker access using telemedicine.
Until the use of the EFA, telemedicine was two dimensional; that is, at best, a screen and video conference. But with soft tissue injuries a hands-on objective approach is better. So we incorporated the EFA evaluations with a telemedicine visit, making it a 3-D approach. This allows the physician to see the patient and evaluate the injured body part at the earliest point after the injury and, at the same time, oversee the EFA test
Advantages of Telemedicine
Studies have shown that getting expert medical treatment to patients as soon as possible results in much better outcomes and telemedicine allows us to do that. Any bruising or swelling that occurs with the injury would normally be gone by the time a board certified physician sees the patient, days or weeks post-injury. Having a neurosurgeon or orthopedist able to see someone right after the injury, while it is still in the acute phase, is critical for getting the best treatment.
As an example, even with an in-person visit a doctor cannot palpate several muscle groups simultaneously while assessing range of motion. With the EFA, 24 muscle groups can be monitored with range of motion at the same time for a full picture, agonist and antagonist muscles monitored for rest, ischemic changes, muscle spasms, recovery and usage, and it targets individual muscle groups. We take that to the next level and provide it with telemedicine and a specialist!
Better patient delivery, better diagnostics; less time for unnecessary treatment and less reliance on medications such as opioids are the results we are seeing with our proprietary telemedicine visits because they are conducted while a specialist monitors the patient with the EFA and goes beyond the surface to be able to evaluate musculoskeletal activity and see the patient while the patient is also being assisted at their end by another medical professional.
For example, someone with spasm and hyperactivity in their hamstring would need sight-specific therapy and massage; but doing some other therapy, such as electrical stimulation could make the condition worse. Or, if the person has a pulled back muscle, a mild muscle relaxant and anti-inflammatories would be appropriate; whereas prescribing hydrocodone is not the right medication. The wrong treatments can exacerbate the problem or cause complications. These issues are resolved with the EFA Telemedicine program.
Combing EFA with telemedicine enables providers to be much more accurate in their diagnoses and treatment plans. That results in the injured worker getting the right treatment for his injury immediately and returning to work that much sooner.
About MaryRose Cusimano-Reaston, Ph.D.
As the Co-Founder and Chief Science Officer of Emerge Diagnostics, in Carlsbad, CA., MaryRose has been instrumental in the development and commercialization, marketing and governmental acceptance of advanced Electrodiagnostic testing instrumentation and has devoted her entire professional career to developing better diagnostic techniques for the evaluation and management of soft tissue injuries. She is a proven industry leader in bringing new technologies to market, and establishing regulatory, legal, payer and medical acceptance. The Electrodiagnostic Functional Assessment, (EFA) service and underlying technology was commercialized under her direction. She also developed the EFA-Soft Tissue Management (STM) program.
MaryRose has held extensive leadership roles in the medical diagnostic technology and service arena. She has testified before OSHA and Congress on the need for more objective assessments for soft tissue injuries and is the published author of several peer reviewed papers on better diagnosis of soft tissue injuries. She is classified as an expert witness for Electrodiagnostic technology and techniques.
About Emerge Diagnostics
Emerge Diagnostics is a California-based company focused on the diagnosis of soft tissue injuries, with twin goals of better patient outcomes and reduced costs. Using Emerge’s Electrodiagnostic Functional Assessment (EFA), employers and payers can achieve early resolution of claims and enhanced treatment options for injured workers, while reducing healthcare costs. With its years of experience applying electrodiagnostic medicine toward workplace injuries, Emerge leads the way with technological development and ongoing innovation. Emerge’s technology enables a more accurate diagnosis allowing targeted, site-specific treatment recommendations that improve outcomes and return-to-work times.