Catherine Parkin serves as Clinical Assistant Professor, Department of Rehabilitation Medicine at NYU Grossman School of Medicine, She co-authored the book, Medical aspects of disability for the rehabilitation professionals in 2017 by the Springer Publishing Company.
Mary Regina Reilly has served as the Clinical Director of Speech Language Pathology at Rusk Rehabilitation, NYU Langue Health for the last ten years. Her Master’s Degree is from Columbia University and she did her fellowship at Montefiore Medical Center in the Bronx, New York. Clinical concentration has focused on pediatric dysphagia with medically complex infants with additional efforts in developing specialty programs for adults with acquired neurogenic disorders. She was instrumental in assisting in the development of the Masters of Science Program in Communication Sciences at Yeshiva University and has served as an adjunct professor at both Mercy College and NYU Steinhardt.
Dr. Angela Stolfi is the Director of Physical Therapy, Director of Therapy Services at Rusk Ambulatory Satellite Locations, Site Coordinator of PT Clinical Education, and Director of PT Residency and Fellowship Programs at Rusk Rehabilitation, NYU Langone Health. Dr. Stolfi holds a faculty appointment in the Department of Rehabilitation at NYU School of Medicine and regularly lectures in the physical therapy programs at both NYU and the University of Scranton. The focus of much of her current and recent research relates to mentoring and education of student physical therapists. She is also an Associate Editor of the Journal of Clinical Education in Physical Therapy (JCEPT).
Maria Cristina Tafurt is the Site Director at the Rusk Institute NYU Langone Medical Center, Hospital for Joint Diseases. She has been a licensed occupational therapist for over 30 years receiving her Bachelor’s degree from the University of Rosario in Bogata Colombia, and her Advance Master’s degree from NYU University. Her clinical experience has varied with an emphasis on brain injury rehabilitation, pain management, hand therapy, and orthopedics. She holds a faculty appointment in the Department of Rehabilitation Medicine as a Clinical Instructor and has authored or co-authored sixteen articles, abstracts and international presentations in her field.
The discussion covered the following topics: influence of artificial intelligence, and research endeavors pertaining to occupational therapy, physical therapy, and speech-language pathology.
[MUSIC] >> Welcome to Rusk Insights on Rehabilitation Medicine, a top podcast featuring interviews with thought leaders in the field of PM and R from Rusk Rehabilitation at NYU Langone Medical Center and other prominent rehab medicine institutions. Your host for these interviews is Dr. Tom Elwood. It will take you behind the scenes to look at what is transpiring in the exciting world of rehabilitation research and clinical services through the eyes of those involved in making dynamic breakthroughs in healthcare. So listen, learn and enjoy. [MUSIC] >> I would like to welcome back our listeners to pot four of an interview with Kate Bakken, Mary Riley, Maria Tafford and Angela Stolfi. So welcome to you also. Let's begin where we left off at the end of the first pot of the interview. Last time, a discussion included your views on the use of informal caregivers, such as family members of patients in the provision of key healthcare services. Artificial intelligence is being applied throughout the healthcare domain. Has your profession been influenced by this development? And if not currently, and you anticipate how it might be employed in the future. >> So it's interesting Tom, it's been a hot topic in many of the meetings I've been in for the last several months. You know, AI feel is here to stay and our role is to think about how do we use it so that we are maximizing what it can do for us. But also ensuring that our own professional practices, our own interactions with clients and patients, is not lost. The expertise that healthcare providers bring to the table is so critical. That relationship is so significant in terms of healing and recovery and the diagnosis and everything that has to do with medicine. So a couple of things that we've started to look at and think about. And certainly NYU as an enterprise is very involved in looking at how do we use this properly. Again, I think if we don't think about it and work towards how we can use it, we're behind the eight ball. You know, when I look at all of the documentation that therapists have to do, right? So the patient is seen, evaluated, treated. And there's a lot of documentation that has to occur to ensure that what they've done is written down. It's in the medical record. And it also was part of what demonstrates the need for continued or discontinuing services. And so are there ways that we can look to document more effectively, still being the clinical documentation that is from the professional who provided the care. You know, some of the tasks that have to happen that are, you know, logistical tasks. You know, how do we schedule our patients? I've worked with the billing department here at NYU and how do we look at denials from insurance companies? And how do we use AI with different billing codes to ensure that we work to get paid for all the services that we provide? So I think as an institution, it's really critical to do that. So from a therapy standpoint, I know that again, we are working in a variety of ways to help us think about this. I was just at a meeting with a couple of other folks on this call earlier today with regards to even things like, if a patient messages in my chart to their provider, whether it's the physician or the therapist, and if AI is used to respond with some guardrails around it to the message that the patient has sent, you know, what are some of the implications of that with regards to accuracy, obviously, with regards to content, with regards to the patient-provider relationships and, you know, yet the volume of work that has to happen to ensure that those responses are provided back in a timely fashion. So lots of ways we're thinking about this and certainly welcome my colleagues to add to what I've just commented on. I would certainly add that new technology trends are shaping how all of us connect and communicate and interact. AI tools in the field of speech-language pathology are really helping us to bridge some of the gaps in our services. So in practice day-to-day, we are starting to use AI to analyze patient data to assist with generation of patient-centered goals. And exercises are therapists are regularly using AI to translate tools that are only available for us in English to others who might not be native English speakers for home exercise programs. We are exploring the use of AI to really look to how we can specifically improve efficiencies with documentation. And I think one of the more exciting things that we are looking at is speech-language pathology are using AI advancements in voice synthesis to create more natural and expressive speech for those patients that have had challenges. So, for example, if a patient still has a voice and might be at risk of losing it, like we might see in a patient with ALS, therapists are working together for voice banking so that it can be tapped into for future communication. If the patient has lost the ability to speak when they arrive to us, we're exploring voice cloning for them. And this provides our patients with a voice that feels both personal and authentic to them. We've also with our patients with cognitive communication disorders are utilizing AI tools such as voice notes that assist patients to be able to record a conversation. And then it summarizes with nuances the high points of the conversation, so that the patients that might have challenges in understanding or takeaway during the conversation can look back at key points for reference. So, that's very exciting. I do think it's important to stress that although AI has made significant advances in tech, we do need to be mindful of the ethical concerns in regards to informed consent, privacy, and intellectual property as this becomes more and more robust in our field. Thank you. Yeah, I think in physical therapy, we're just beginning to learn how AI could be used. We've heard reports from, you know, not at our institution, but there are groups that are using AI to write daily treatment notes. And I think that that could be good, but also could have some, you know, problematic elements as well. So, I think about student physical therapists a lot and the people who move from learner role as a, you know, a new professional into, you know, really developing their skill. And I think that too many tools like that might make it difficult for them to really develop their clinical reasoning and things like that. So, well, that will remain to be seen some areas where, you know, I know that it could be really helpful is I think about things like those letters of justification to insurance companies. Physical therapists are really good at identifying what they have to evaluate for a patient and potentially determining what a patient needs. But do we have to be the most eloquent, you know, the best writers to write a letter that could take a lot of time that we could be seeing another patient. So, you know, I think that there are some ways that we can use it to reduce some of our administrative burden. I even have seen that a little bit in my role as an administrative leader here for a clinical discipline. I go to a lot of meetings and sometimes AI is summarizing the meeting and writing the meeting notes these days and that's helpful. So, I wouldn't have a lot more to add. AI is still in exploratory mode. I think the American Occupational Therapy Association has made and has many forms in which people are talking about the potential use for what Angela was describing and Mary was describing note writing, reducing and becoming all of us more efficient and effective at writing our notes since the government wants us to do a lot more with a lot less. So, becoming efficient and effective at writing a note will be interesting. I think in the future AI could also help us do certain part of treatments if we have smart cameras that can evaluate movement and, you know, we have eyes. But the cameras and the AI, we're looking through a lot of information can help us identify best approach for a particular problem that we might be observing whether in an adult and the pediatric population. I think that AI has the potential to use many brains at once and might help people get more focused treatment and therefore we will become more efficient. So, a lot to wait for in this development for AI. Thank you. Just indicate any investigations that either you or other individuals at NYU Langone Health are participating in that pertain to your respective professions. So, so in terms of some research that we're participating in and we, in terms of the allied health professions right now, you know, we partner a lot with different. Different division of medicine so partnering with cardiology partnering with neurology partnering with oncology. One of the studies we're doing with oncology is with regards to individuals with pancreatic cancer and the impact exercise places on their recovery and pancreatic cancer is a horrific disease. But the impact that exercise can have while they are undergoing their chemo and radiation with regards to actually changing what's happening at the cellular level. So, it's been really instrumental for us to be able to partner with key leads in our cancer center with regards to that component. You know, with regards to, I'll just give one other example and then turn it to my colleagues, you know, with regards to wearable devices, you know, how we're looking at cardiovascular and cardiopulmonary health and endurance and people's motivation to move as we've all set exercises medicine. You know, moving on all different venues that includes, you know, walking or wheeling your wheelchair or anything you're doing to move your body. How do we do that and how do we capture that and its impact on people's health short term and long term, depending on what's going on with them. So, we've got some studies going on. We're partnering with, like I said, cardiology and pulmonology with regards to looking at wearables, looking at coaching sessions, looking at the short and long term impacts on their health and well being with wearables. So, those are just a couple of things that were involved with, but my colleagues I know can add to the conversation certainly. I cannot, talking about partnership, Kate and I have been involved in a partnership that might come to us in the near future for occupational therapy. There's an neurologist that just got an NIH grant and her work is working with surgery that implants a stimulator on the vagus nervous system so that then she's going to see how patients will improve in their upper extremity model area by participating in occupational therapy for several sessions. So, occupational therapy, I really enjoy very much working with this physician because she's passionate about what occupational therapy can do to improve the upper extremity for the stroke patients. So, we're designing the activities that are going to happen during these 12 sessions, 12 weeks in which the patient will be stimulated, for example, in the vagus nervous while they are performing the activities. It's already known that this improved the patients, but what does is not clear is about what happens in their brain so that she's interested in understanding those two pieces, and we're very excited that we are collaborating with care. Around me, I have people that I support in their research. We currently have an operational therapist that is doing here, PhD and she is working in understanding the gaps that might be in assessing the operating function and infants with hypoxic is chemic encephalopathy. And that has put this whole work in trying to understand what data is available currently or not in our epic system and that is beautiful because that helps us also to enhance the documentation for the future and have the appropriate documentation so that it facilitates research in the long run. I think the more we get to use our documentation system, the more we understand the benefits and how we can document to get even further along and doing research and retrospective studies about our intervention with the patients. From a speech perspective, we are additionally working with our partners in the cancer center, really looking on the integration with our patients with head and neck cancer and management of internal lymphedema to be able to maintain the patency of the airway when patients are swallowing food and managing their own saliva. So we know that there are both immediate effects from chemo radiation and late term effects from toxicity and being able to manage functional intake of food, which is so important for quality of life and for integrity of skin is one of our major focuses at the moment. This interview is occurring during your busy day, and we're now approaching a time when I'm sure some of you have some upcoming appointments you're going to have to keep with colleagues and patients. So what I'd like to do is thank Kate Parkin, Mary Riley, Marie Tafford and Angela Stolfi for sharing your valuable insights with all listeners about your work in occupational therapy, physical therapy and speech language pathology. It has been both an honor and a pleasure to have this discussion with you today, and I wish you all continued success and your upcoming endeavors again. Thank you very much. Thank you, Dr. Elwood. What a pleasure. Thank you again for joining us. You can learn more about RUSC at NYULangone.org/RUSC. Also be sure to follow this podcast on Twitter at RUSC Podcast. (upbeat music)
