The Uber of Physical Therapy

Created out of need to streamline scheduling of therapists, Zuum is a new app that pairs therapists with patients. With the success of on-demand services like Uber, it was a no brainer that model could span across other industries.

Read about how the Zuum app is growing in Texas and the home healthcare services.

As is often the case, it was a nagging business problem that spurred Nate Foreman and several colleagues to fashion a solution with innovative technology.

Since Foreman’s home care physical therapy staffing company opened in 2011, it has grown into a $16 million a year business with 350 therapists in the field in Texas’ major cities, as well as in Michigan and Ohio.

The scheduling of those therapists—assigning them to make house calls with patients—became a bigger and bigger problem as the business grew, the 34-year-old Foreman says.

The solution they developed, an application called Zuum, was inspired by on-demand services such as ride-hailing Uber and Favor delivery, except in this case it’s physical therapists who take assignments instead of drivers.

Talking at Foreman Therapy Services’ office in a tower off LBJ Freeway, Foreman explained how the Zuum app works.

Foreman credits Zuum with easing the company’s recent growth, allowing it to scale up  without having to hire more people.
Therapists working for the company specify a service area—how far they’re willing to travel to work—and when Foreman Therapy is assigned a patient, a scheduler in the office puts out a message through Zuum. Therapists who cover the patient’s location respond whether they’re available to take the work.

The scheduler looks at the available therapists and chooses who might fit the assignment best based on factors such as experience, credentials, and work history.

“If you’re a home health agency, it’s so stressful getting patients staffed out,” Foreman explains. Before they began testing and using the app in October 2016, he explains, “We had to pull our map, a physical map, and ask ourselves which therapists covers, say, Rockwall. Then you’d text or email or call them and wait for a response. There’s always communication, so there’d be hundreds of texts and emails coming in.”

Under that system, the first therapist to respond typically got the assignment, which meant less attention was paid to finding the right therapist for the patient and ensuring the best quality of care.

From a manager’s perspective, Zuum increases accountability by fully documenting the scheduling and fulfilling of assignments, Foreman says. “There’s usually less accountability when you’re working with staff that is out and about,” he says. With the app, the therapist gathers an electronic signature from the patient and the event is recorded with a GPS location and time stamp.


Two Dallas startups have received a lot of attention for bringing the on-demand Uber model to patient healthcare and reviving that oldest of medical traditions: the house call.

Family Health On Call launched in September 2016 and through November 2017 made 408 house calls in its three service areas, all sub-parts of the Dallas-Fort Worth area. Their medical professionals serve both adults and children. Depending on the time of the day, anywhere from one to three physicians, physician assistants, or nurse practitioners staff the service areas, ready to make calls to patients who’ve requested them on the company’s app, company spokesman Scott Summerall explained. The company is partnered with Children’s Health Dallas.

PediaQ, another app-triggered service specializing in pediatrics, opened in 2015 and reported making more than 2,500 house calls in the Dallas and Houston areas in its first year in operation. That early success attracted $4.5 million in additional funding that the company has used to expand into other Texas cities. The company offers video consultation in addition to house calls, accepts most major insurance plans, and touts its prices as being lower than a visit to an urgent care clinic. Without insurance, a house call runs $175, including a $25 convenience fee.
Foreman credits Zuum with easing the company’s recent growth, allowing it to scale up business without having to hire more people on the scheduling side. He says Foreman’s headquarters staff numbers just eight.

Mark Rodriguez, director of business development at Foreman Therapy, says the company streamlined its processes and eliminated a variety of spreadsheet records when it adopted Zuum.

“Zuum makes any home health agency super-efficient,” says Manish Patel, director of technology for Argos Infotech, who helped develop the app.

That’s important, Foreman says, because a large part of income for a company like his comes from reimbursement from federal health insurance programs such as Medicare. And those programs are keeping payments to medical providers tight as a way to force more efficiency and innovation. (Foreman Therapy also charges customers who can then, in turn, bill their insurance or Medicare.)

Foreman, Patel, and Rodriguez are collaborating on Zuum, which is being developed as a startup apart from the physical therapy company, Foreman says.

After a year of testing and refining, they’ve started to pitch it to home health agencies, including the many that refer physical therapy patients to Foreman. “We’re self-funding now, but once we get five, 10 clients, we’ll need to start raising investment,” Foreman says. “We’re going to have to send people out to give demonstrations and show the technology, and that will take a bigger commitment.”

Written by Thomas Korosec in D CEO January-February 2018

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