"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

Sunday, November 13, 2011

Ten Commandments for Effective Decision Support in Physical Therapy

  1. Speed is Everything
  2. Anticipate the Physical Therapist's Need and Deliver Them In Real Time 
  3. Fit the Technology into the Physical Therapist's Workflow
  4. Little Things Make a Big Difference
  5. Recognize that Physical Therapists will Strongly Resist Stopping the Treatment
  6. Changing Directions is Easier Than Stopping
  7. Simple Interventions Work Best
  8. Ask For Additional Information from the Physical Therapist ONLY When You Need It
  9. Monitor Impact, Get Feedback and Respond
  10. Manage and Maintain Clinical Decision Support Systems for Physical Therapists
These commandments were originally written by Dr. David Bates in 2003 in anticipation of the electronic medical records revolution physical therapists and physicians are witnessing now.

They are surely as true now as they were then.

I would humbly suggest one additional commandment to add, in light of the recent, massive failure of the British centralized database of electronic medical records:
  1. Empower LOCAL decision makers (eg: physical therapists) to add to, delete or modify the decision support rules and allow interoperable CDS systems to "learn" from each other.
Right now, the ONLY CDS system that applies to physical therapists is a top-down government-mandated program that is, for the most part, paper-based.

I think we can do better.

What do you think?

Please comment.

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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 .

"Make Decisions like Doctors"


Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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American Physical Therapy Association

American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.