• Topp R
• Greenstein J
• Etnoyer-Slaski J

• Artificial Intelligence
• Health Status
• Mobile Applications
• Open Access Document
• Patient Compliance

Objective: Digital Health tools are becoming a common approach to providing rehabilitation to treat musculoskeletal disorders (MSDs). A challenge to treating MSDs whether face-to-face or through digital health is the patient’s low levels of adherence with the prescribed care plan and high likelihood of self-discharging from their care plan. To address this challenge a phone-based App (EMBODI) was developed to increase adherence with physical rehabilitation through incorporating AI and theoretical behavior change constructs. This project compares the number of appointments kept, and the revenue generated, among patients attending a chiropractic and physical rehabilitation clinic who did and did not choose to adopt a phone-based App (EMBODI) to complement their treatment. A secondary purpose was to determine if the number of appointments kept, and the revenue generated, were different among patients who were self-discharged versus doctor-discharged and did or did not adopt the App.

Methods: A retrospective analysis of all new outpatient electronic medical records at a multisite chiropractic and physical rehabilitation clinic were evaluated between January 2023 to December 2024. Beginning in January 2023, all new adult patients admitted to this practice were offered the opportunity to download the EMBODI phone-based App, to complement their treatment. Patients who downloaded the App self-selected into the App User group. Patients admitted to this practice during this same time who did not download the App self-selected into the No App User group. Each patient’s medical record was evaluated 4 months following their initial visit to determine the number of prescribed appointments kept, and the revenue generated as a result of their treatment in the practice. Patients were classified as completing prescribed chiropractic and physical rehabilitation care plan and being discharged by their provider (doctor-discharged) or not completing their prescribed care plan and self-discharging themselves (self-discharged). Also, extracted from each patient’s electronic medical record were the number of appointments attended (appointments kept) and the total amount of revenue generated from treating the patient.

Results: Independent t-tests revealed that the App User group (n=1,851) exhibited significantly greater appointments kept (9.76 vs 7.21), and greater revenue generated from treatment ($1,363 vs $1,193) compared to the No App User group (n=527). Patients who self-discharged in the App User group exhibited significantly greater appointments kept and generated greater revenue compared to patients who self-discharged in the No App User group. As well, patients who were doctor-discharged and in the App User group had a greater number of appointments kept but generated similar revenue to patients who were doctor-discharged and were in the No App User group.

Conclusion: This data demonstrates an app-based approach to care was associated with more appointments kept among patients who were self-discharged or doctor-discharged and greater revenue among patients who were self-discharged from a chiropractic and physical rehabilitation clinic. 

Author keywords: Health Status, Patient Compliance, Mobile Applications, Healthcare Costs, Patient Retention

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