Proving the value of your physiotherapy practice


APA Innovation Advisor Barry Nguyen explains how data has the potential to improve overall business performance.

Tracking patient-reported outcome measures is now more important than ever given the gradual consumerisation of healthcare, the shift of the national healthcare system towards value-based care, and the increasing recognition that ‘data is king’ and is the currency of modern healthcare.

Physiotherapists have been using experience and outcome measures for many years—some more routinely than others. There is a growing public expectation that physiotherapists should provide high-quality and safe healthcare services, with a data-driven approach to decision-making.

Data from tracking patient-reported outcome measures is one of the most powerful ways to demonstrate value and effectiveness of your clinical performance to patients, payers and referral sources. In addition, this data can be potentially used to improve business performance, administrative processes and treatment plans.

Anecdotal evidence and patient stories often win the hearts of patients and their loved ones, but with significant advancements in clinical research and accessibility to information via the internet, the modern patient will less likely be convinced by such approaches in isolation.

So what exactly are patient-reported measures?

Patient-reported measures can be broken into two categories:

PREMs and PROMs enable patients to provide direct and timely feedback about their health-related outcomes and experiences to drive improvement in the delivery of clinical services. Recent research has shown that PREMs often directly correlate to clinical health outcomes.

PREMs allow patients to provide direct feedback on the services you provide them; for example, net promoter scores, qualitative and quantitative surveys, third party internet reviews and patient focus groups.

PROMs allow patients to report their perception of their health; for example, symptoms, quality of life, functional levels, standard clinical outcome measures (Oswestry Disability Index, Orebro Musculoskeletal Pain Questionnaire).

Some key benefits of collecting patient-reported measures include:

  • demonstrating the practical application of evidence-based care through monitoring patient outcomes objectively
  • enhancing communication with patients, health insurers, regulatory bodies and referral sources
  • improving financial viability of your practice through outcomes-based accountability
  • assisting in differentiating your practice from others
  • assisting in the improvement of patient satisfaction and experiences
  • advocating for your profession with real-world data.

Electronic PREMS and PROMs can help streamline data collection and eliminate some practical barriers to using a paper-based version. These emerging solutions are often integrated with popular physiotherapy practice management software. Patient compliance rates associated with completing initial and follow-up surveys are critical considerations to understanding a patient’s profile, your clinical workflows and context. It is also important to note that on occasion, paper-based outcome measures may be more appropriate for certain patient populations.

It is similarly important to use electronic PROMs in line with the latest evidence-based guidelines, and to consider your clinical context.

Emerging clinical data standards are currently being established nationally and internationally. In due course, your practice data can be used to benchmark against national and international standardised datasets. For example, the International Consortium for Health Outcomes Measurement collaborates with patients, providers, payers, regulators and researchers to create a global standard for measuring patient outcomes by medical condition.

There are an increasing number of electronic PROM solutions in the market including Physitrack, MyScoreIt, PROMIS, The Screening Lab and ViMove.

Some of the current key challenges in collecting patient-reported measures include:

  • industry consistency and standardisation of outcome measures collection by diagnosis
  • adding to workflow inefficiencies due to the time-poor nature of clinical practices
  • cultural change at the practice level
  • risk-adjustment considerations (eg, age, pre-existing medical conditions and co-morbidities)
  • concurrent treatments while collecting outcome measures may influence results.

To conclude, routinely collecting patient-reported outcome measures is one of the best investments you can make in your practice’s long- term sustainability from both commercial and clinical perspectives.

It explicitly signals to the public that your clinic strives to achieve excellence in the clinical service delivery of quality, value and safety.

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Disclaimer: This material is intended for general information purposes only and does not constitute legal advice or meet the specific needs of your clinical context.

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