Transforming Musculoskeletal Health: A Deep Dive into Risalto

Today we sit down with Risalto’s Allison Schoeneck, Vice President of Clinical Product, and Molica Anderson, Director of Clinical Implementation, to go deep on using technology and an evidence-based approach to create a better experience with better outcomes for musculoskeletal patients.

We’ll start out with an easy one: what’s Risalto all about?

ALLISON: We’re a digitally-focused musculoskeletal health company that helps patients get the highest quality, most evidence-based care possible to help them get better. 

We work with patients through their employer or through their health plan via telehealth. Risalto’s expert physicians take a hands-on, patient-centered, and team-based approach to care, thoroughly understanding the context of the patient’s condition and utilizing our proprietary clinical tools to align on the appropriate next steps for the patient. Partnered with our Care Navigators, Risalto physicians guide patients step-by-step through the process —  everything from ordering and interpreting images, sharing recommendations for self management and coaching on pain management, to referring and coordinating them to more escalated or interventional care as warranted. 

And you also help patients thinking about surgery, right?

ALLISON: Yes. For patients who are interested in or are actively considering surgical intervention, Risalto performs a full patient work-up integrating current symptoms, disease progression, and treatment history to date, together with an assessment of the patient’s individual risk for surgery driven by comorbidity, activation, and lifestyle factors. With that in hand, we then move through a proprietary decision making process with them so they understand what surgery will – and will not – do for them, including educating them on potential alternatives to surgical care.

Why is this process so important for both patients and clinicians?

ALLISON: This process is a win for both patients and doctors in an industry where care really costs a lot. Too often, patients are pushed right to surgery or interventional care – and it often produces very marginal gains, if the procedures work at all. For patients, it’s often about increasing their literacy around musculoskeletal problems so they understand what’s possible. And it’s incredibly convenient – if they end up in front of a surgeon after working with us, it’s because they most likely really need that level of intervention so it shortens the time it takes to get it done.

For surgeons, it’s a win because typically they spend a lot of  time with new patients, the majority of which are not surgical. That means they’re investing time in people who really need redirection to more conservative care options. It’s not a good use of a surgeon’s time or skills. But when patients come to them from Risalto, these surgeons can feel confident that surgical intervention is warranted.

Sounds like there’s a real struggle with knowing the right path to take and that Risalto’s approach helps patients. Can you share a bit more about what the typical patient goes through?

MOLICA: This is definitely an area where the status quo fails the patient in terms of building basic health literacy, meaning that patients are often in significant pain but don’t know what that right next step is. They think that a high pain level means equally high disease progression, which isn’t necessarily true. They’re convinced that something is broken with them and that a surgery or an injection will be this miracle fix-all. 

No one has explained to many patients that these interventions are not always necessary and can lead to complications. They often don’t know that sometimes things like Physical Therapy can produce really powerful results. So, we’re walking them through a step-by-step process that’s evidence-based, clinically appropriate, and conservative, based on what they’ve tried previously. When we make referrals, it’s to the right providers – whether that’s a therapist, orthopedic surgeon, physiatrist, you name it – and they get better outcomes.

How does Welkin’s technology support Risalto’s patient care?

ALLISON: We came to Welkin when we were looking for a patient relationship management platform – and we didn’t want to do it ourselves or go with a Salesforce-sized company. We liked the ability to customize it ourselves and encode our clinical logic into the platform itself. Our proprietary scored patient assessments have to be integrated to provide the level of care that’s our standard. Additionally, we are using Welkin as a platform to integrate in the other digital tools that power our ecosystem — everything from our patient application to our EMR to our external provider-facing portal.   

MOLICA: I worked for another startup prior to this where we tried to create our own platform from scratch. All the coding took a lot of time and effort, so it was a bit of a sigh of relief to have a platform that’s organized to keep up with patient status, has an easy user interface, and will be simple to apply to our  patient-facing app.

So obviously telemedicine is having a moment as a result of COVID-19. Why do you think Risalto patients will embrace this model?

ALLISON: As the pandemic continues, telemedicine is clearly the safer, more convenient option. Post-pandemic, it may be that patients end up preferring it because it is so easy. It’s a lot more convenient to do a home exercise program than it is to drive in for your physical therapy session, for instance.

From a musculoskeletal lens, telemedicine opens up access to the best physicians. Now if you’re in a rural location, you don’t have to drive two hours to see a decent specialist when you just log on from home to see an outstanding one.  

MOLICA: It’s also ideal for the patient population that hasn’t sought care for their complaints but should. Telemedicine helps them check in and get evaluated sooner than they otherwise would have.

What’s the ultimate benefit of getting patients to the appropriate level of care?

MOLICA: We’re helping the patient to have more autonomy, to be an active participant in their own care and recovery. As they learn that simple exercises will pay dividends, they learn that the things they can do on their own are valuable to their health. It means less reliance on external experts and interventional procedures and a greater individual ownership of their own musculoskeletal pain management and overall health.

Interested in learning more about Risalto? Check them out here

Know a healthcare or technology expert whose point of view is fresh, informed and relevant? Get in touch – we’d love to consider them for our “Deep Dive” blog feature. 

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