The American Congress of Rehabilitation Medicine (ACRM) – the largest interdisciplinary rehabilitation research convention in the world – hosted its annual conference in Chicago in November 2022, with seminars on a number of focus areas including brain injury, spinal cord injury, telemedicine, amputations, data analytics and much more.
We attended both virtually from the UK and in-person through a member of our Global Liability and Defence team based in our Chicago office. Looking back over the various seminars, it is possible to pick out some recurring themes that collectively offer insurers and compensators an interesting insight into the future of rehabilitation. In our view, the main trends can be summarised as follows:
Person-centred rehabilitation
There is an increasing emphasis on developing person-centred care in rehabilitation settings, along with a drive towards self-management, empowerment and education.
As serious injury lawyers, we welcome such an approach; enabling patients to take control of their recovery with the aim of better health outcomes.
Ongoing telehealth experimentation
As a result of the COVID-19 pandemic, many clinicians and patients have seen that telehealth and technology are viable alternatives to the traditional application of therapies. However, there remain significant barriers to overcome including: lack of acceptance and familiarity from clinicians, lack of familiarity with available technology, access to reliable internet, patient dissatisfaction with use of the digital platform offering the particular service and the loss of in-person assessment. An effective practical compromise is to combine telehealth and in-person therapies at different points in the rehabilitation journey, for the best of both worlds.
Novel brain injury scanning techniques
New techniques are emerging for detecting brain injury by testing for adverse neuropathology or biomarkers. Nonetheless, in our view, these are unlikely to become commonplace in traumatic brain injury claims, for as long as mainstream radiology (alongside proven clinical indicators such as post-traumatic amnesia) remains the gold standard for diagnosis and itself continues to develop better imaging technologies.
Clinical trials of new treatment pathways
The conference reviewed a wide variety of emerging treatments, including repetitive transcranial gagnetic stimulation (rTMS) for improving executive function following brain injury, low intensity focused ultrasound pulsation (LIFUP) to treat post-traumatic headaches, and spinal cord stimulation for pain management and bladder control following spinal cord injury. These and others are competing to build a sufficient research base to attract wider attention and adoption by clinicians.
The promise of big data
The topic of ‘big data’ and in particular, the opportunity for data analytics in examining large volumes of data to innovate and drive change in the rehabilitation sector, was a recurring theme at the conference. The proliferation of personal devices and wearable technology, and the pooling of data within consortia of aligned providers, is generating a mass of data, that will require new industry standards or protocols for standardisation of data format in order to facilitate integrated analytics and create a sufficiently robust dataset for precision medicine and predictive outcomes. For compensators, big data analytics offers a future with better returns on rehabilitation investment and better claims forecasting.
Comment
Overall, having attended and reviewed a variety of seminars and presentations, we feel positive about ongoing innovation in the rehabilitation sector. Over the next few years, we expect to see an increasingly flexible and personalised approach, where patients have greater choice between in-person or remote providers, and conventional or experimental treatments, depending on individual preferences.
In the medium-term, big data offers exciting potential for measuring the effectiveness and economics of different treatments, tailoring specific therapy prescriptions on a case-by-case basis, and ultimately analysing feedback from similar patients or injuries to build predictive models regarding longer-term outcomes and lifestyle.
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