Reflexion Health is expanding the use of its VERA platform to shoulder replacement and upper extremity such that patients recovering from these procedures can use its avatar coach to complete prescribed exercises at home.

As it fleshes out its tools for providing remote physical therapy, Reflexion Health is hoping to convince more insurers to cover its tech-based approach to post-acute rehabilitation.

The approach already is being used to provide in-home virtual therapy to patients recovering from knee and hip replacements as well from lower back and spinal injuries.

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This week, the company unveiled tools for people bouncing back from problems with their arms, upper backs and shoulders. That includes rotator cuff tears, which afflict about 500,000 Americans per year, according to Dr. Joe Smith, president and CEO of Reflexion.

The VERA avatar acts as a virtual PT to guide joint replacement patients through prescribed exercises at home

Based in San Diego, Reflexion has developed a mix of technologies — an FDA-cleared avatar coach, 3D motion-capture technology and remote monitoring that allow patients to undertake physical therapy at home while being guided and monitored remotely by a physical therapist. The  Virtual Exercise Rehabilitation Assistant, or VERA, aims to increase compliance with treatment plans, speed up recovery and lower costs. The technology is currently being used in 37 states. Users recovering from surgeries like knee replacement and now, shoulder replacement can follow the VERA avatar alongto complete their prescribed exercises that help to support their recovery — but remotely.

Reflexion’s sister company, The Learning Corp, offers an app, known as Constant Therapy, to aid in speech, language and cognitive therapy following a stroke, traumatic brain injury or similar neurological episode.

“The story really is about post-acute care recovery and making it patient-centered, data-driven and value-based,” Smith said.

Among the next steps for Reflexion is to work with insurers to cover the use of the Vera, which features motion sensors to gather data on how well patients are performing their exercises.

“We’re engaged deeply with a number of them as to how to roll this out to their insured cohort,” Smith said, arguing that VERA can lower costs while increasing patient satisfaction: Patients can engage in therapy at home without having to worry about transportation or other logistical worries.

The technology is typically available through hospitals or orthopedic practices. They bundle the cost of VERA as part of a value-based approach to care, in which providers get a lump sum to care for a patient’s condition overall rather than a fee for each service, according to Smith.

“The beauty of that is they’re directly incentivized to have the patient recover quickly and well,” said Smith.

Insurers that want to adopt VERA could rely on Digital Home Therapy, a physical therapy affiliate of Reflexion, as their in-network provider. Or, they could encourage their existing in-network PTs to adopt the technology, Smith said.

The challenges include persuading clinicians that VERA is not a threat. In a trial of the technology last year at Duke University, PTs shared two concerns, Smith said. One was that VERA would not do as well as in-person therapy. The second was that, if it did prove more effective, it would put PTs out of business.

The trial showed that VERA was as effective as traditional therapy but at a lower cost and with reduced risk of rehospitalization, according to a press release from Reflexion.

The technology does not replace the need for therapists, as they are still involved in monitoring and guiding patients in rehab, Smith said. In fact it could make them more efficient.

Indeed, VERA includes a telemedicine function that, among its features, allows both patient and therapist to watch and discuss videos of the patient exercising.

The company also sees its technology playing a role in the workers’ compensation world by ensuring injured workers stick to their treatment plans, accelerating their return to work, Smith said.

“Now that we’ve kind of filled out the body, it’s more about further driving adoption,” he said.