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Ian Oppel of RestoreSkills: “Build in extra time to allow for a patient-centered approach”

Build in extra time to allow for a patient-centered approach. It is critical to learn a client’s interests, preferences, habits, tendencies, work history, family history, etc. in order to gain their trust and agreement before being able to effectively complete an assessment, develop a treatment plan, or note progress. It also helps to humanize the […]

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Build in extra time to allow for a patient-centered approach. It is critical to learn a client’s interests, preferences, habits, tendencies, work history, family history, etc. in order to gain their trust and agreement before being able to effectively complete an assessment, develop a treatment plan, or note progress. It also helps to humanize the virtual experience when a client senses you are truly trying to understand what is most important to him/her.


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 Ian Oppel.

Ian Oppel is a healthcare executive with over 25 years of post-acute healthcare leadership experience providing expertise in rehabilitation, fiscal and clinical operations, memory care, senior living, reimbursement, and regulatory compliance. Ian is currently the Co-Founder and Chief Clinical Officer for RestoreSkills, a leading edge therapeutic gamification and telehealth company.


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?

Absolutely, my clinical background is in occupational therapy and let me take a moment to thank all my OT colleagues for their incredible efforts always, but in particular throughout the pandemic! You help our loved ones to regain the skills necessary to get back to doing the things they value, advocate for their independence, and ease caregiver burden.

My grandmother and I held a special relationship. While I was in high school she began to exhibit early stage Alzheimer’s disease. Our relationship certainly felt the strain of her diminishing cognitive function and I wanted to pursue studies in a profession that would help me to promote and maintain her best quality of life. Let’s just say my grandmother was an artist and we helped her maintain her physical and cognitive abilities to paint beautiful artwork through her 93rd birthday.

I have been an OT for 25 years and a dementia care specialist for over 20 years working primarily in the skilled nursing and senior living healthcare space. I have held numerous clinical and operational leadership roles. Almost 2 years ago, I had a cup of coffee with Eran Arden, CEO for RESTORE-Skills, and we discussed developing a digital-health technology that would gamify skill-building for older adults. Today, I am the Co-Founder and Chief Clinical Officer of RESTORE-Skills on a mission to change the way therapy is being delivered for a next-generation patient experience. Our on-demand skill-building platform simply requires an internet connection on a device with a webcam. We can then turn that device into a skill-building station with games and activities addressing mobility, range of motion, coordination, cognition, life skills, and more.

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

At one of the very first skilled nursing facilities to implement RESTORE, I was introducing the gaming platform to an 88 year-old patient who was recovering from congestive heart failure. She wasn’t enthusiastic about video games, but was a good sport and willing to try with a goal to increase her standing activity tolerance. 1 minute into the game, her two great-grandchildren ran into the room shouting “Grandma, Grandma we want to play!” She sat down with a huge smile on her face. She handed over the controls to one of the grandsons, while the other sat patiently on her lap before taking his turn. The boys’ mother came over to me and softly asked “what is this and how do I get it for my home?” Before I could answer, she continued with tears in her eyes “my son sitting on her lap is autistic and this is the first time he’s ever entered the room with my grandmother let alone allowed her to embrace him.”

To have played any part of that magical moment was incredible and to this day motivates me to do everything I can to help customers and clients to experience successes both large and small.

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

Winston Churchill — “It is no use saying, ‘We are doing our best.’ You have got to succeed in doing what is necessary”.

As a clinician, operator, innovator this quote has helped to define my drive and passion for achieving excellence. More importantly, it helped me realize that there are many situations where my efforts alone will fall short. The key to doing what is necessary is to be humble enough to collaborate with others, combine our experience, and together we can do what has never been done before.

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 great 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?

Trust is the most important component in a professional relationship. I find it significantly easier to gain trust and agreement in person. To be able to modify my approach, minimize environmental distractions, and provide physical and not just visual/verbal cues indeed helps accelerate that process.

It humanizes the professional encounter. Patients’ demeanor can easily range from highly anxious to disinterested. This is more readily appreciated when in person and you can meet that patient where they are and bring them to where you want them to be by the end of the session. There is no risk of being turned off or losing a technical connection. You can conduct a more comprehensive assessment in person and not have to rely as often on others gathering information for you.

Technologies are not here to replace the human connection when it comes to caregiving, but they can enhance and support the experience. When we discuss new developments for our platform I make sure to remind us that we are here to empower the therapists-patient connection and that this relationship is the most important factor in the patient’s success.

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 feel my previous answer incorporates a response to this question

In 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.)

Trust is more difficult to establish. Be on time and do not rush through the telehealth visit. Being late to start a virtual session leaves the client wondering if they have done something wrong on their end. I know when I am the patient and the professional I am to virtually see is late, I exit and rejoin the session several times in case the error was on my end.

Build in extra time to allow for a patient-centered approach. It is critical to learn a client’s interests, preferences, habits, tendencies, work history, family history, etc. in order to gain their trust and agreement before being able to effectively complete an assessment, develop a treatment plan, or note progress. It also helps to humanize the virtual experience when a client senses you are truly trying to understand what is most important to him/her.

Use the patient-centered information in a subsequent session to demonstrate you value your client. I had a patient who had just bought a beach house, but unfortunately experienced a medical condition preventing him from his first beach house visit. His spouse shared a few photos of the beach house with me and on my follow up visit I made one of the photos my virtual background. Additionally we completed a portion of our exercise program with a beach ball and made mocktails at the end working on self-feeding goals. I can still treasure his smile and appreciate his increased motivation during our sessions.

As in the above example, it is important to remember you are not only addressing the patient during a virtual session, but everyone with the patient helping to facilitate the session. You have to keep everyone interested and engaged from family members and friends to medical and technical assistants.

Technology happens! Release the need to be perfect. You will periodically experience technical challenges with internet connectivity, camera and microphone access, lag, screen sharing confusion, etc. Stay composed and have a plan for troubleshooting or rescheduling. Also, no one can hear you when you are on mute!

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

I was assisting a clinician during a telehealth session with a patient who had suffered a stroke. The patient was part of a large, supportive family who lived near Atlantic City, NJ. He was an avid gambler and the family would make a monthly visit for a weekend of slot machine play. RESTORE-Skills has a game called Jackpot, which is a virtual slot machine with settings that can be adjusted based on a patient’s physical and cognitive ability level to ensure success. The therapist coordinated a virtual session to include the patient’s brother and sister. Initially they observed the session and offered encouragement to their loved one as he played his favorite game. They began to reminisce about the last time they were in the casino together. Then it clicked for the sister as she noticed an improvement in how her brother was moving his arm while pulling the lever of the slot machine (which moved to the opposite side after each pull to challenge his range of motion and coordination). “That’s great exercise and you’re doing something you love at the same time. This makes me so happy” she exclaimed. The therapist was then able to provide the family members with a code that enabled them to all play together on the same screen in a five minute slot tournament. After the session was complete, the therapist noted that it was the longest the patient had stood while performing activity and that it was clear interactivity from his family was key in providing added motivation.

Telehealth evolved out of the need for greater access, flexibility, and demand. Access to quality health providers. Access to reliable transportation. Flexibility for busy schedules/lifestyles. Providers can better meet the increasing demand for patient visits when provided virtually from a single location.

Covid-19 has certainly accelerated the use and scope of telehealth services. At RESTORE-Skills, early on we identified that perhaps an even greater risk than covid for our clients was the challenge of mitigating the risks of social isolation for patients as visitation in senior living came to an abrupt halt. We introduced a new feature, RESTORE-Together, which enabled clinicians working with a patient in their room to invite family members, friends, or even connect with other patients/residents during treatment sessions. They were able to offer visual and verbal encouragement, as well as interactively play on the same screen from the safety of their own homes or rooms.

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?

Video conferencing applications are rapidly competing to add new features and enhance the user experience. As virtual communication has become a necessity for many during the pandemic, there is less anxiety surrounding both the willingness and ability to participate (just don’t forget to turn the cat filter off). Real-time data capture, analytics, and reporting; as well as, remote monitoring capabilities all help to accelerate the credibility of the professional and provide the patient with what is most important, results.

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

User friendliness is the most important feature for telehealth and ongoing efforts should be made to analyze, improve, and simplify the user experience. My mother, despite her best aspirations, would have to agree that she is not tech savvy. Whenever possible I trial new features and content with her. I can certify RESTORE-Skills is “mother tested, kid approved”.

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?

Digital health and telehealth expects that clients will take advantage of electronic communication methods for correspondence, having a question list, sharing exercise or home monitoring logs, etc. before, during, and after sessions. This is a wonderful evolution from trying to save up information for an in-person exchange, where something might not get asked or answered. Clinicians appreciate being able to answer client questions and correspond when it best fits their day and hope that the client will feel the same way.

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?

It ALL excites me lol! I also understand that it intimidates many and therefore they resist technology adoption. One thing I have come to understand is that technology today is developing faster than ever to work around those who are resistive to technology. I implore you to be open to the consideration of adoption of innovative technology into your clinical practice before it works around you. High performing teams partnered with the right, innovative technology are breaking through barriers and achieving what has never been thought could be done before. This is a fact and not a fad.

I am truly excited about the emergence of video games that can be used for advanced diagnostics and even treatment. Last year The Food and Drug administration gave marketing approval for some children with attention-deficit/hyperactivity disorder (ADHD) to receive treatment through use of a game-based digital therapeutic device, EndeavorRx. I mentioned that my grandmother developing Alzheimer’s was a catalyst for my professional studies. Sea Hero Quest, is a specifically designed digital game which researchers are studying its ability to detect people at risk of Alzheimer’s. Early diagnostics and treatment can have a profound impact on quality of life.

How can our readers further follow your work online?

Please visit our website, restoreskills.com and enjoy our blog.

My profile on LinkedIN

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