The Evolution of PORi

The journey from Oncology Rehab to PORi

Anatomical illusatration of female torso with lymphatic system
WHO WE ARE

What is PORi?

The Physiological Oncology Rehabilitation Institute (PORi) was established in 2014 as the education and consulting arm of Oncology Rehab. Today, PORi is our primary focus. While Oncology Rehab staff continue to treat patients, our mission has expanded to supporting excellence in cancer rehabilitation for health systems across the U.S. and internationally.  PORi offers oncology rehabilitation program development, center of excellence accreditation, and continuing education courses in oncology rehabilitation for Speech Language Pathologists (Speech Therapists), Physical Therapists (Physiotherapists), Occupational Therapists, Physical Therapy Assistants and Occupational therapy Assistants.

Our institutional clinical experience from treating over 30,000 cancer rehab  patient visits annually at Oncology Rehab is combined with the latest evidence-based research and a thorough scientific understanding of the physiological impact of cancer and its related treatments to form the foundation of PORI’s educational curriculum, our COE accreditation and program development services for facilities.

The Journey to now... Oncology Rehab & PORi

Julia Osborne, PT, CLT-LANA
Board-Certified Specialist in Oncological Physical Therapy
"Oncology Rehabilitation is my life's work - I have poured everything into my clinics and PORi - patients with a cancer diagnosis deserve the best we can offer" - Julia

​Specialized Courses

We combine a deep understanding of the physiological impact of cancer treatments on the body with practical clinical skills to help mitigate these effects. Some courses focus on specific diagnoses, while others, like the Chemotoxicity & Cancer Exercise Management course, take a sequelae-centric approach across multiple oncology diagnoses. All PORi courses are interlinked, building on one another to equip therapists with the knowledge and hands-on skills needed to treat this complex patient population.

A Standard of Care

Oncology Rehabilitation must be included in the scope of practice for Physical Therapists, Occupational Therapists and Speech Language Pathologists. However, it must be implemented responsibly, safely and effectively, and with a consistency within the "Standard of Care" across the professions. The PORi courses provide the necessary information and clinical skill sets for our professions to be able to blaze the trail forward in this new entity of care.
In early 2002, a Denver oncologist needed a physical therapist to provide rehabilitation for a patient who was battling with the effects of breast cancer treatment. After calling multiple PT practices, the oncologist came across the clinic where Julia Osborne was working and asked if any of the therapists would be prepared to treat an oncology patient. With her vast clinical experience, Julia accepted the patient, and while she was able to help, she was struck by the lack of clinical rehab guidelines for this population. The experience for Julia was so inspirational and impacted her so much, she decided to dedicate her entire professional career to treating this population, and so began a passionate 22-year quest to make oncology rehab the norm across the world.

She went on to pursue her lymphedema qualifications, then developed a novel breast cancer treatment protocol that amalgamated these lymphedema treatment methodologies with other evidence-based "traditional" physical therapy techniques such as trigger point release, joint mobilization, and myofascial release.  This new treatment protocol proved to be both revolutionary and extremely successful for the breast cancer population that she quickly became known for treating.

Between 2002 and 2009 the demand for Julia’s care exceeded her capacity so she decided to open her own clinic with a view to bringing on one or two therapists to help her.  At that time the clinic’s focus was still on breast cancer, but with big dreams to one day serve the ever-growing, ever-diverse population of all cancer diagnoses, it was rightly named Oncology Rehab. Over the ensuing years, Julia established the Physiological Oncology Rehabilitation Institute (PORi), a comprehensive system of oncologic rehab management, which now has international acclaim and is the most sought-after certification course for oncology rehab among physical therapists, occupational therapists, and speech therapists. Her growing practice caught the attention of a nearby Hospital Corporation of America (HCA) hospital, who was looking to add a comprehensive oncology rehab program.  The result was a long-standing partnership with the area hospital, the first of its kind, which greatly increased patient access to cancer rehab and advanced Julia’s vision of rehab for all cancer patients.

Meanwhile, as Julia was growing her clinic and developing the treatment protocols, Rachel Larsen was forging her path in oncology rehabilitation in San Antonio, TX. Her career in oncology rehabilitation began in 1997, when she was tasked with starting a lymphedema clinic at the hospital where she was working at the time. She became certified in lymphedema management then launched and managed the growing clinic for 5 years until establishing her own lymphedema-focused clinic in 2002. During this time, she attended one of Julia’s courses and immediately incorporated those protocols into her own practice and expanded her oncology rehab services beyond lymphedema. Over the next 17 years, Rachel’s clinic, Forte Rehabilitation and Wellness Center remained the premier center for breast cancer patients needing rehab. Then, in 2019, on the brink of COVID, Rachel and Julia were reintroduced by the leadership at HCA.

The goal was to form a partnership with an HCA hospital in San Antonio like the successful model in Denver. The plans were delayed because of COVID but the association between Rachel, Julia, and Julia’s business partner, Guy Osborne, grew during this time. Over the next 2 years, all therapists at Rachel’s clinic became PORi certified, and Forte Rehab and Wellness became a Bronze Level PORi Center of Excellence. An immediate jump in revenue was achieved and Forte enjoyed a 50% increase in patient visits. As the collaboration with the nearby hospital began to take hold, clinical pathways and internal processes were put into practice, which elevated Forte to a Silver level Center of Excellence.

Finally, in 2022, Rachel and her clinician team joined Oncology Rehab and a formalized collaboration and eventual partnership with the local HCA facility gave Rachel and her team in San Antonio unprecedented access to physicians, navigators, and hospital leadership in the form of tumor boards, cancer committees, and cancer work groups, elevating the clinic to Gold Status PORi Center of Excellence, resulting in over a 100% increase in patient visits with no signs of slowing down.

With Rachel's experience complementing the existing leadership team, PORi is leveraging the unique talents of each, ensuring program congruency, a unified vision, and the ability to reach new markets.

Today, the work continues at the local level, but the vision that all cancer patients have access to specialized oncology rehab has been the driving force behind the expansion of Oncology Rehab services worldwide; supporting clinicians, oncology rehab facilities, and health systems as they launch and sustain oncology rehab programs in their own communities.

Building Programs rooted in specialist clinical care

Historically, consulting companies helping health systems develop an oncology rehabilitation service line have predominantly emphasized developing oncology rehabilitation at a facility level, focusing on identifying patients for rehabilitation and navigating these patients into rehabilitation.  This, in effect, has been a “top-down” approach.  However, we feel that these types of programs did not sufficiently focus on the oncology-specific clinical skillset needed by PT/OT/SLPs to treat patients once they arrived in the treatment setting. Without clinical education specific to the needs of the oncology patient population, “generalist” PT/OT/SLP clinicians do not have the necessary knowledge and confidence to treat oncology patients in any phase of their treatment. PORi addresses this gap, which allows for a “bottom-up” approach.

PORi provides intensive, focused, in-person evidence-based teaching, as well as clinical hands-on experience with live patient models.  We are the only entity in the United States that offers this unique, patient-based clinical learning model and we ensure participant proficiency through both practical and written examinations. PORi was specifically created to provide therapists with the clinical skills to build a rehabilitation program from the bottom-up by focusing on patient care and patient functional outcomes.

Physicians will recognize the clinical value of clinicians equipped to deliver care with an oncology-specialized skillset and become fully engaged in referring their oncology patients to therapy. Physician engagement can be accelerated through separate physician education and/or reported outcomes from patient data collection and direct patient feedback. The program is rooted in clinical excellence and PORi strengthens the relationship between the physician and the oncology rehabilitation therapist (and the oncology exercise physiologist).

Setting the Standard.

Oncology Rehabilitation Courses

PORi provides a comprehensive Oncology Rehabilitation curriculum for Physical Therapists, Occupational Therapists, and Speech-Language Pathologists. With a strong focus on live patient presentations, practical clinical skills, and a deep understanding of oncology’s physiological impact, PORi equips therapists to effectively treat this unique and rewarding patient population.

Oncology Rehabilitation Certification

PORi's curriculum empowers therapists to develop expertise in oncology rehabilitation through an interlinked suite of Foundational, CORE and Adjunct Course Modules. Each course module is an assessment-based certificate program. Therapists who complete specific module combinations and maintain a consistent oncology practice earn the designation of PORi-certified Oncology Rehabilitation Specialist.

PORi Center of Excellence in Oncology Rehabilitation

A facility is designated as a Bronze PORi Center of Excellence when it has at least two PORi-certified Oncology Rehabilitation Specialists or at least one PORi Oncology Rehabilitation Therapist in each CORE course discipline.

Silver and Gold COE Accreditation are awarded based on meeting operational standards and integrating oncology services.

For health systems, when at least 75% of locations in a region achieve PORi Center of Excellence status, the entire regional system earns the designation.

Oncology Rehabilitation Service Line Development

PORi has a suite of services that we can offer health systems and facilities looking to develop or grow an oncology rehabilitation service line.

We can customize our offering to provide assistance at any stage of your oncology rehabilitation service line development.

If you are a HCA-affiliated or Sarah Cannon facility, we have already developed and grown programs in several divisions (Continental, TriStar, San Antonio, and West Florida) and have existing contracts we can leverage develop your comprehensive oncology rehabilitation service line.