Dr. Ashok Gupta of Theranow: “Providing instruction”

Staying connected with the patients securely is another advantage of telehealth and is very important. When you are easily approachable to your patients through in-app secure messaging, they have more confidence and faith in you. They no longer have to wait for the next office visit if they have a minor concern like not being […]

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Staying connected with the patients securely is another advantage of telehealth and is very important. When you are easily approachable to your patients through in-app secure messaging, they have more confidence and faith in you. They no longer have to wait for the next office visit if they have a minor concern like not being able to perform an exercise in the desired way/prescribed amount, and this takes healthcare delivery to a whole new level.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Dr. Ashok Gupta of Theranow.

Dr. Ashok Gupta is the COO of TheraNow. He has had a very versatile professional career of over 15 years and has held various responsibilities as a doctor of physical therapy, a health expert, and an entrepreneur. His vision and leadership have helped TheraNow achieve a new summit in the field of TeleHealth and TeleRehab in the US Healthcare System. He heads the company’s on-shore and off-shore teams of IT and health professionals.

Born in India Dr. Gupta attended Rajiv Gandhi University of Health Sciences earning a Bachelor of Physiotherapy and his M.D. in 2007. His studies also included physiotherapy at the prestigious National University of Medical Sciences where he earned his DPT — Doctor of Physical Therapy degree; yoga at the Prakariti Yoga & Meditation Center, where he earned his Certificate of Study in Yoga Therapy (CYT); and neurological and psychosomatic disorders at the City College of Physiotherapy where he earned his Masters of Physiotherapy. He began his professional career at the Fareed Rehabilitation Center as a physiotherapist. He soon went onto become the head of the physiotherapy department at Prakash Hospital where he oversaw a staff of twelve. Always passionate about fitness, Dr. Gupta then took a break from physical therapy as the manager of staff training for the Gold’s Gym franchises throughout India. Dr. Gupta moved to the US and back to physical therapy in 2014. He founded TheraNow in 2017. Ashok’s efforts have led TheraNow to achieve a strong customer base, solid valuations, and recognition as a leader in telehealth and pain management in just this short time.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

Well, telling about me, I am a doctor of physical therapy from India. I came to the USA with big dreams to work for good employers and grow in 2013, but over the last eight years, a lot has changed. During these years, I have seen many ups and downs personally and professionally, but the best thing that happened to me is my wife, who stood by me and kept me going. She helped me overcome the hurdles, and we made new dreams together of bringing significant positive changes in the field of physical therapy. When working with the VA in my initial days in this country that we call home now, I used to see patients traveling 2–3 hours to receive treatment. Even then, scheduling visits was not easy for them. That’s when it occurred to me that quality healthcare is a basic right and should be conveniently accessible to people when they need it. I have spent restless nights trying to identify the root cause of the problem. Good healthcare facilities were not available in the remote locations, and keeping up with physical therapy treatment, where you need regular visits, was a nightmare, primarily due to logistics. This made most people drop out of their therapy program before a complete recovery. We started brainstorming on how to deal with this situation, and that’s how our journey began.

Can you share the most interesting story that happened to you since you began your career?

Sure, I would love to. This one incident always motivates me to do better and make life easier for our patients. If I recall correctly, it was somewhere around 2015, and I was happily employed as a senior physical therapist. One of my close friends twisted his ankle while going to work. Due to terrible snowstorms, the physical therapy offices in his town were all closed, and the pain was killing him. He was alone, and nobody was available to take him to the hospital. He called me up since I was the only person he knew who could advise him medically. I told him I needed to see the part before I could recommend him anything. We face-timed, and after some quick assessment, I was sure it was just a ligament sprain, and he was going to be okay. I told him how to immobilize and educated him on when and how to start his exercises gradually. Within a couple of days, he started feeling better and returned to his regular activities in no time. That’s when it struck me; telehealth was the solution to help more people receive quality and effective treatment. We partnered with our friends also Physicians and co-founded TheraNow. Since then, we have been blessed to help many people get back to an active and normal life. Whenever we have felt low or have hit a roadblock, we count our patients’ blessings, and it motivates us to improvise and help more people.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

My mother always used to say, “whenever you hit a roadblock, don’t try to push ahead. Stop and take a step or two back. You will be able to look at the greater picture and analyze which piece of the puzzle does not fit. Try to find the right piece or make your own. When things look better, move forward with greater force.” I have noticed this has always worked for me and has enabled me and our platform to reach greater heights.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I am grateful to all those who have helped us pave the path to our dream project TheraNow since the beginning, including our partners and staff and the providers and patients who had faith in us. But if I need to mention that one person who has been a constant source of motivation for me, it would be my wife. She is always full of energy, ideas, and advice. She is our most prominent critic, and that is what helps us achieve perfection in what we do.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them, of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can, of course, be very different than working with a patient that is in front of you. This provides an excellent opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

The past year has brought about unexpected changes. For most of us, the value of life and health has increased so much. Many providers have indeed started using telehealth to provide care to their patients remotely. However, at TheraNow, we have been providing physical therapy care to our patients remotely for over 3–4 years. It may seem evident that physical therapy must be a hands-on in-person appointment. However, if done right, telehealth can easily bridge most of the gaps a telehealth visit might cause than an in-person appointment and may even be a better healthcare delivery. The joy of meeting my patients in-person is something I look forward to always, as that personal human connection can never be replaced with any amount of technology. Also, assessments in an office setup are more accurate. But I would still not consider this a deal-breaker, except for some health conditions that come with their own set of limitations and cannot be treated remotely.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

I advocate for telehealth and genuinely feel very few challenges that may arise if the patient is not in the same space. The main challenge that I can think of is the accuracy of the assessment done by an expert physical therapist in an in-person visit will always be higher than the assessment done via telehealth. However, with specialized assessment tools like we have incorporated in our platform, these factors become negligible. Other than that, from the personal experience of a therapist who has been treating patients physically and remotely both over the last couple of years, I would barely point at something as a real challenge in this context.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You? (Please share a story or example for each.)

  1. Logistics: Now, this is where I would like to explain the potential of telehealth over the conventional ways. I want to start with the most common issue the patients face in a traditional setting, challenges faced due to logistics. In most cases, the patients cannot drive to the clinic for regular therapy appointments and are dependent on a caregiver or a friend/family to drive them to their appointments. That is when patients start missing out on the appointments as their ride was not available due to some reasons and eventually dropped out of the program. This increases the instances of re-injury, incomplete recovery, worsening of the condition, financial distress due to missed work, and so on. This can quickly be taken care of by remote access via telehealth. The patients can keep their appointments literally from anywhere using just their smartphones. I have seen my patients attending their appointment from some crazy places you could imagine for a doctor’s visit. Just a couple of days back, one of my patients was having a session with me from a café while he was on vacation.
  2. Assessment: It is best to have specially designed assessment tools for making assessments as easy and accurate as possible. The conventional testing methods may require to be modified a bit so the patient can perform self-assessment and still be able to pinpoint the underlying cause.
  3. Providing instruction: We don’t just do video calls with our patients. Through our platform, we also create customized exercise programs as per their needs, and they have access to these programs right from their smartphones. They can perform the exercises with the App in the right way with all the instructions, images, and exercise videos. 
    Outcome Tracking: Outcome tracking is another important factor for providers and patients. When the patient performs the assigned exercises and the App, it tracks the patient’s activities, creates a thorough report on the patient’s adherence to the program, and measures the outcomes over time.
  4. Continued Care: On the days of the appointments, the patients do the required exercises in the conventional setting but usually do nothing between appointments. In a telehealth setting, where the patient has received an exercise program that can be performed through their App, which also tracks compliance, the patient engaging in their care and keep moving is more probable.
  5. Staying connected: Staying connected with the patients securely is another advantage of telehealth and is very important. When you are easily approachable to your patients through in-app secure messaging, they have more confidence and faith in you. They no longer have to wait for the next office visit if they have a minor concern like not being able to perform an exercise in the desired way/prescribed amount, and this takes healthcare delivery to a whole new level.
  6. Bonus Tip — Ease of Scheduling: Last but not least is a crucial thing to keep in mind for the best care for your patients — scheduling appointments should be super easy. Our TheraNow platform, for example, enables you to book a session with your patients in just four button clicks.

Can you share a few ways Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

Telehealth is a vast and emerging field of science that combines the power of technology with healthcare. Conventional healthcare delivery can never provide the ease-of-access that telehealth can provide to the users, be it providers or patients. Getting treatment from the comfort and safety of your home, easy appointment scheduling, customized home exercise programs with real-time outcome tracking, provider’s availability for secure messages for continued guidance and support are just a few of the ways patients benefit from telehealth.

Similarly, for providers, it creates an opportunity to increase their caseload and work more efficiently. Using telehealth as the preferred healthcare delivery model means reduced infrastructural costs. Compliance and outcome tracking help the providers in staying on track and set goals accordingly for quicker recovery time.

I want to talk about one of my patients here. She has had intermittent knee problems from arthritis for almost a decade. During the pandemic, she had a bad flare of her knee pain due to an injury. When her physician advised knee replacement, she kept delaying the surgery due to fear of catching the virus and rehab as she did not want to visit a PT office regularly. Her condition, on the other hand, kept worsening. That was when her physician suggested rehabilitation through TheraNow and was referred to her. Before starting the program, she was a little apprehensive about rehab online, but as we started the program, she returned to a more active lifestyle within 5–6 weeks.

So yes, that is the power of telehealth if done the right way.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences, which tools have been most effective in helping to replicate the benefits of being together in the same space?

Telehealth has evolved a lot in the last year, and I have seen many different platforms using different tools. However, from my observation and experience, Theranow’s proprietary “self-assessment tool” would be one of my favorites, which I am yet to see in any other software at the moment. It addresses the biggest challenge of a telehealth care delivery model, the assessment. After a lot of research and brainstorming, we have developed this tool that minimizes the lack of accuracy during evaluation compared to an in-person visit by activity modifications. Of course, I consider other tools necessary for a successful telehealth program, like the custom exercise builder with thousands of high-quality exercise videos and easy-to-follow instructions. The exercise reminder function can be integrated with your google calendar, forcing the patients to stay compliant. In short, if you have a great platform as we do at Theranow, you can quickly provide better care than the conventional method.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

We’ve done it! We have already created Theranow, a nearly perfect telehealth platform for patients and providers alike. It is a fantastic platform for telehealth.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

Properly educating your patients on their health condition, talking about the prognosis, understanding their expectations from the rehabilitation program, and setting their goal is very important to engage the patients in their care. This way, they would know where they are in their program and will keep them motivated. Also, tools like the real-time outcome and compliance tracking give data-backed evidence of their current position on their road to recovery.

The technology is rapidly evolving, and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

There is. I am joyful to share that we are currently developing an artificial intelligence-based movement analyzer and trainer. Just for a teaser, the platform will analyze the movement pattern for each part of your body during a particular exercise or motion and provide you a detailed report. If your movement analysis is not your expectations, you can always use the goal-directed engaging movement trainer to learn and perform the exercise in the correct way. It is currently in the development phase, and we would be happy to share the details of the launch of this platform.

Is there a part of this future vision that concerns you? Can you explain?

Not really. I do not see much of a roadblock from where we are now implementing what we have targeted. However, creating this analyzer and trainer, feeding in all the correct and necessary data for each exercise, will be an arduous task. Still, I am sure our determination will help us sail through.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of significant influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

As a person who understands telehealth’s potential, I would like to promote telehealth for healthcare delivery, along with the help of more advanced and evolving technologies like IoT and artificial intelligence. I would also urge the providers to select the right platform based on their needs and use telehealth more for providing care to their patients with improved efficiency.

How can our readers further follow your work online?

I am a people person and like to connect with people a lot. Your readers can follow our latest advancements in the news section of our website www.theranow.com. Alternatively, if they have any questions/concerns/suggestions, we are easily accessible on 903–609–1609.

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

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