This is part 3 of my 3 part series on Outcomes in Physical Therapy.
Bang for the Buck
I believe that useful, meaningful outcomes analysis will only occur when we can get to what I call the “bang for the buck number”, i.e.: How much money does it take to get a certain population of our patients measurable, functional improvement over what they would achieve just left to their own devices?
To get to a reliable bang for the buck number we will need sophisticated reporting systems that can collect and analyze data from totally integrated EMR systems, controlled for comorbidity, and grouped in similar diagnostic and demographic categories.
The following data would be analyzed in such a system:
- Specific information on therapeutic interventions
- Clinical Results
- Standardized Condition Specific Patient Questionnaire data
- Appointment and visit data
- Financial information including charge and claim payments
Gather Clinical Information at Every Visit
One of the problems with some of the commercially available outcomes systems is that they rely on patient questionnaire data that is gathered at the initial visit and then at discharge. Unfortunately, it is often impossible to know which visit is the last visit with the patient. Patients often self discharge or discontinue treatment without a formal discharge evaluation. So, it will be critical that the information on therapeutic interventions, clinical results and patient self-report information is gathered at every visit.
Beyond the obvious infrastructure challenges, there is a lot of work to be done that will configure systems to require clinicians to use standardized and reliable clinical tests, use the same tests for certain patients, and standardize descriptions of clinical interventions.
I would love to get your thoughts on this. Please comment.