Tools for the Tool Box

The SIMPLE system of diagnosis was born as a Medicare compliance program for a Medicare Part B Physical Therapist in Private Practice.

I was the Compliance Officer and I was in the bulls-eye when the Medicare auditors would come knocking (they haven't yet, knock wood).

After surveying the current marketplace I felt that there were not sufficient tools that I could bring back to my staff to help them get to where I thought we needed to be.

At that point in time my main goal was to get a good nights sleep without worrying about a Medicare audit.

I wanted a tool that would enable my physical therapists and physical therapist assistants to become able note writers, goals-setters and intervention selectors without having to memorize all of the Medicare Benefits Policy Manual, Transmittal 63 (~ 45 pages).

Autopilot

The physical therapist's clinical decision-making and critical thinking skills should be focused on patient care, not on how to best write a legal note in the chart.

I developed the SIMPLE system as an answer to this problem.

The SIMPLE system allows the therapist to spend time with the patient collecting data and building the therapeutic relationship. Once data collection is completed selecting interventions and goal setting are automatic.

Diagnosis is the first step in the system that derives naturally from data that is easily obtained using skills familiar to the new graduate as well as the seasoned expert.

Diagnosis is communicated in standardized language that is familiar to the doctor, the nurse, the PTA and to the patient.

The SIMPLE system helps the physical therapist arrive at a diagnosis by measuring a standardized set of movements that reflect the patient’s ability to generate strength and move through a range-of-motion.

SIMPLE tries to capture data about the lower extremities and the lumbar spine.
Physical therapy diagnosis may include other body parts. The final section of Part 1: Clinical Skills describes Supplementary Positions and Measurements that can be used to diagnose other conditions commonly seen in physical therapy practice.

To study the SIMPLE system for free go to www.SimpleScore.com and view the videos.

Tim

Resource list for Physical Therapy Diagnosis

1) Cyriax’s Illustrated Manual of Orthopedic Medicine, 2nd edition. Butterworth Heinmann, London. 1993.

2) Medicare Benefit Policy Manual. Pub 100-02, Transmittal 63. 29 Dec. 2006.

3) Local Coverage Determination for Rehabilitation Therapy. Blue Cross and Blue Shield of Florida and Connecticut. 2007.

4) Guide to Physical Therapy Practice, 2nd Edition, Phys Ther. Vol. 81, No1. Jan 2001.

5) Commission for the Accreditation of Physical Therapist Education (CAPTE). Accreditation Handbook, April 2004.

6) Sandstrom RW. The Meanings of Autonomy in Physical Therapy. Phys Ther 2007; 87: 98-110.

7) Amato A. Value Purchasing in Outpatient Physical Therapy. IMPACT. Volume 3. Issue 10; 8-12.

8) Carter S. Outpatient Physical Therapy for Musculoskeletal Conditions. Phys Ther. 2007; 87(5): 498- ?

9) Coffin-Zadai CA. Disabling Our Diagnostic Dilemnas. JOSPT. 2007; 87(6): 641-653.

10) Newman D, Allison SL. Risk and Physical Therapy. JOSPT. 2007; 37(6): 287-289.

11) Department of Health and Human Services, Office of the Inspector General, Compliance Program for Individual and Small Group Physician Practices. Federal Register, Vol. 65, No. 194. 2000.

12) Defensible Documentation for Patient/Client Management. American Physical Therapy Association. Web Accessed 12/11/2006.

13) Norton BJ. Diagnosis Dialogue: A Progress Report. Phys Ther 87(10): 1270-1273. October 2007.

14) ? Phys Ther Vol. 87 (1). Jan 2007. pp. 9-23. (reference nerve root impairments)