"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Saturday, October 4, 2008

Predictive physical therapy: can questionnaires aide prognosis?

There is a new age of accountability (financial, regulatory and otherwise) in physical therapy.

Some examples...

Physical therapists are being asked to work and get paid based on their productivity rather than a fixed salary.

Medicare requires physical therapists to 'diagnose' their patients using objective, public-domain tools, like the OPTIMAL scale.

Now, physical therapists can predict whether patients will adhere to physical therapy after spine surgery. The test is called the Patient Activation Measure (PAM) questionnaire.
"Essentially, the test places patients on a continuum of activation ranging from those who don't see an active role on their part as necessary to those who are highly motivated to take an active role in their own health care." said lead author Richard L. Skolasky, Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
My professor in physical therapy school once told me that questionnaire data was 'soft' and that we needed 'real numbers' for good decision-making in physical therapy. In 1992, my professor called questionnaire data 'subjective' data.

Well, that was 1992 and this is 2008.

In 2008 and beyond, more of our physical therapy data will come from questionnaires. The good news is this... questionnaire data is good data.

The test that is destined to replace the OPTIMAL scale is the Activity Measure for Post Acute Care (AM-PAC). The AM-PAC produces good data.

Data is going to be necessary for physical therapists to demonstrate value to payers.

In 2006, the single largest purchaser of health care in the world, US Medicare, spent $3.06 billion on physical therapy.

Questionnaires can give us good data.

Good data can improve physical therapy accountability, diagnosis and prognosis.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

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