Functional Limitation and FOTO

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Part 3: Athletes and #PToutcomes

Our most recent chat took a twist. Obviously self-report measures were used by the participants, but participants also commented on the important role of performance measures

Although the majority of participants shared their perspective on the clinical relevance of performance measures, not all team members involved in the treatment of athletes may appreciate the value of performance testing. Apparently German arthroscopic surgeons do not focus their attention on knowing how athletes are performing. 

Functional performance tests are frequently used after anterior cruciate ligament repairs. The majority of tests were designed for return to sport. Apparently though, the tests still require a bit more research with regard to predictive validity.

An interesting performance test for readiness for return to sport is the Vail Sport Test. A nice aspect of this test is the detailed observations. With applications like Ubersense and Coach’s Eye, clinicians have a bit more easier ability to capture movements for detailed analysis.

No one brought up another aspect with readiness for return to sport - the concept of prevention. After injury, athletes often require rehabilitation. The end point of rehabilitation is return to sport. Clinicians will progress to sport specific activities and use performance measures to help determine readiness for return to sport. Is something missing if injury prevention is not also concurrently considered?

Stay tuned for Part 4 when we share as much as we can on performance tests for the upper extremity. 

Until next time…

Oct 7

Part 2: Athletes and #PToutcomes

During our most recent chat, we delved into the topic of athletes. The twist of the discussion involved self-report measures versus performance measures.

Interestingly, those participating observed that most athletes who have lower extremity problems demonstrate consistency between self-report measure results and performance measure results.

Consensus indicates this group of physical therapists who treat athletes rely on both self-report measures and performance measures when determining return to sport. 

Stay tuned for future posts discussing the various performance measures teamed with the self-report measures to help determine return to sport.

Until next time…

Oct 4

Part 1: Athletes and #PToutcomes

Last night we hosted a chat focusing on a very narrow patient population: athletes. The discussion took a few twists and turns revolving around self-report measures and performance measures. For those of you interested in the details of the conversation, the link to the transcript will be shared at the end of this post!

In planning these chats, we are *so* dependent on having committed participants! The conversation can’t happen without you! Thank you to Daphne, Matt, Stephanie and Jarad for immediately saying yes!

@daphnescott  Daphne Scott with Athletico Physical Therapy 

@MattHar18320043 Matt Harris with Mountain States Health Alliance - Johnston Memorial Hospital

@swheeler1220 Stephanie Wheeler with FlexPlus Physical Therapy

@JaradMiller Jarad Miller with Alegent Creighton Health Lakeside OP Physical Therapy

We also had a few surprise participants who added insight and questions into the discussion! Thank you @FisioPratoUS @AlpineAthlete @E_S_Christensen and @MattDeBole.

Without further ado… the transcript!

Until next time… 

10/3/2013 #PToutcomes Chat 9-10 pm EST Athletes and Outcomes

This evening we’ll be focusing on measuring outcomes for a specific population: athletes! As clinicians, the best final outcome obviously is return to sport. We’re interested in hearing from you about what is happening in the world of athletics with regard to measuring and managing outcomes through the rehabilitation process.

This evening we have quite a couple of physical therapists who indicated interest on the topic joining us tonight!

@daphnescott  Daphne Scott with Athletico Physical Therapy 

@MattHar18320043 Matt Harris with Mountain States Health Alliance - Johnston Memorial Hospital

@swheeler1220 Stephanie Wheeler with FlexPlus Physical Therapy

@GridironRehab09 Eric Tamura with Gridiron Rehab and Athletic Fitness

@JaradMiller Jarad Miller with Alegent Creighton Health Lakeside OP Physical Therapy

Please join these physical therapists in a discussion on capturing change in functional status and measuring outcomes for the athletic population! Everyone is welcome to join! The discussion will be moderated by @SnippetPhysTher Remember to use #PToutcomes with your tweets!

For those of you new to tweet chats, check out this link. And for those of you using Tweetdeck, you’ll find this link helpful.

A transcript via Symplur will be available after the chat within a follow up blog post!

Until next time!

Part 3: #PToutcomes Data and Worker Compensation

What’s the first thing that comes to mind when you hear worker compensation? From the recent #PToutcomes chat, those participating highlighted the importance of self-reports in making clinical decisions and also discussed using data to negotiate payment for services. Is that the first thing that comes to your mind though?

Do you think of an injured worker who doesn’t want to return to work? How can that situation be addressed? Probably the first step is to establish why. One tool that may capture a potential reason is the Fear Avoidance Belief Questionnaire - worker subscale. 

It was mentioned that the clinical approach for someone being treated for a work injury might be different.

It seems patients who have been injured at work add an extra bit of clinical complexity to the picture for physical therapists. Successful outcomes depend on clinicians not only focusing on the diagnosis, but also thinking about various flags and addressing them. Using self-report measures adds another layer of information from which clinicians can track response to treatment and alter clinical decisions.

Until next time…

Part 2: #PToutcomes Data and Worker Compensation

We’re continuing the discussion from the most recent #PToutcomes chat on the special situation of a single payer source: Worker Compensation. In Part 1, we shared how clinicians were using self-report measures to assist with clinical decision-making and justifying recommendations.

A single question by Chris Mulvey took the evening discussion down a deeper, more complicated path.

 We’ll share a few tweets to help you understand how data is being used.

Worker compensation is about as messy as direct access here in the States. “Messy” meaning the rules and regulations are not standardized across the nation. Details for worker compensation regulations are important to know before considering the ability to negotiate payment for services. National Council on Compensation Insurance is involved in many states. Besides knowing the regulations, it is also imperative to know the medical fee requirements. Along with the regulations, it’s also helpful to be aware of situations of Negotiated Workers’ Compensation Programs.

FOTO Outcome Leaders may have more success with negotiating higher payment for services because they bring to the table more than just utilization information - they also have data on the effectiveness and efficiency of their services.

Until next time…

Sep 9

Part 1: #PToutcomes Data and Worker Compensation

The most recent #PToutcomes chat focused on the special situation of a single payer source: Worker Compensation. We’re pretty sure most clinicians would agree this is a special situation. From a clinical perspective, clinicians are often part of a larger team consisting of not only the patient, but also the occupational medicine physician, a case manager and an employer. Communication tends to occur more frequently.

With work related injuries, clinicians need to be aware of various “flags.” For those of you unfamiliar…. red, yellow, orange, black, blue and pink flags are relevant when treating patients who have work related injuries.

The FOTO system isn’t quite at the level to assist with all the various flags. We’d even suggest that a single tool might not readily capture all the various flags.

@YngcylcstPT suggested value in self-report measures:

To assist with this unique population FOTO has added optional tools (employment module, FABQ Work, etc), in addition to having the customary outcomes measures that have been risk-adjusted for the impact of workers’ compensation being the payment source. We will be having a quick webinar (on 9/10/2013) to address these tools. We hope clinicians value these tools and use them to assist with clinical decision-making and with patient discussions to better understand some of the flags that might impact care.

Until next time,

Sep 6

9/5/2013 #PToutcomes Transcript: Role of Data in Worker Compensation

The trend of high caliber discussions via twitter continues again! We love the quality of the conversations that have been occurring - less fluff & more stuff! The chat started off quite differently than what has happened in the past which seemed to create an even higher quality of discussion than had been anticipated!

Special thanks to those who shared their thoughts and insight, especially:

Michelle Young with Valley Health Wellness & Fitness @YngcyclstPT

Armin Loges with Restore Physical Therapy and Wellness @arminloges

Chris Mulvey with Florida Fitness & Rehabilitation @mulvey_chris

Steve Wilkinson with St. Luke’s Elks Rehab @swilkinsonPT

We were also surprised to have Eric Christensen with Chandler Physical Therapy @E_S_Christensen join the conversation between patients!

The details of the chat can be found in this transcript via Symplur.

Until next time,

Sep 2

9/5/2013 #PToutcomes Chat 9-10 PM EST The Role of Data in Worker Compensation

Physical therapists treat individuals who have work related injuries. Often times, in this situation, physical therapists not only work with the injured employee, but also with the physician, employer and case manager.

This evening we have quite a couple of physical therapists who indicated interest on the topic joining us tonight!

Michelle Young with Valley Health Wellness & Fitness @YngcyclstPT

Mike Cash with Proactive Physical Therapy @ (to be determined)

Armin Loges with Restore Physical Therapy and Wellness @arminloges

Chris Mulvey with Florida Fitness & Rehabilitation @mulvey_chris

Steve Wilkinson with St. Luke’s Elks Rehab @swilkinsonPT 

Please join these physical therapists in a discussion on what changes when a clinician has data, especially for the worker compensation scenario! Everyone is welcome to join! The discussion will be moderated by @SnippetPhysTher Remember to use #PToutcomes with your tweets!

For those of you new to tweet chats, check out this link. And for those of you planning on using Tweetdeck, you’ll find this link helpful.

A transcript via Symplur will be available after the chat within a follow up blog post!

Until next time!

Part 4: Marketing with #PToutcomes Data

WAY back at the beginning of the month, we hosted a chat on marketing using outcome data. From that chat, we learned how some of you are marketing with outcome data, heard about the elephant in the room and entertained the idea of stars. What we didn’t do is delve into how to emotionally connect with anyone as outcome data is shared. Which emotions do we want to trigger?

@DarcyLown shared a way to emotionally connect: 

@E_S_Christensen also points out what patients like:

Of course, it’s always good to see the brainstorming that happens during a chat..

We’ll leave you with those final thoughts. If your strategy includes mixing outcome data with something familiar and evokes emotion, you’ll make a connection with prospective patients. 

Then, of course, you can’t forget the power of word of mouth… 

Thanks for a great conversation!

Until next time,