Brian Rodriguez, PT, DPT, OCS, is the owner of Utah Physical Therapy Specialists in West Jordan, Utah. There, he treats a variety of orthopedic conditions, specializing in sports injuries, spine problems, headaches, auto accident cases, geriatric problems, and work injuries. A WebPT Member since 2012, Brian’s clinic was one of the first to put WebPT Outcomes to work. In this interview-style post, Brian provides his two-cents on the importance of outcomes tracking, explains how he built a successful outcomes program in his practice, and talks about how he envisions using outcomes data to drive even greater success in the future.
When did you first start tracking patient outcomes in your practice?
I have been tracking outcomes since 2002. I worked for a large healthcare organization that implemented an awesome outcomes database in the early 2000s. After opening my own practice in 2007, I immediately created my own simple outcomes database in Excel, and I used that until WebPT offered their outcomes tracking system as part of their documentation. When WebPT launched this outcomes system, I immediately signed up and have been tracking outcomes through WebPT ever since.
Why did you decide to start tracking patient outcomes?
Initially, my employer expected all therapists to participate, so I did. Back then, I didn’t completely understand the full value of this data, but having fully incorporated outcomes tracking into my daily practice for over 15 years now, I have come to realize the significant value it provides me as a clinician. I honestly cannot imagine practicing without leveraging this data! I actually collect outcomes data on every patient at every single visit.
How did you achieve staff buy-in to collecting patient outcomes data?
This has not been difficult at all. I have a small practice, which makes it much easier and faster to implement changes and improvements. Additionally, the PTs who work in our clinic recognize the importance of evidence-based practice (EBP), and collecting outcomes is a natural part of EBP.
How do you ensure staff accountability for outcomes data collection (i.e., how do you make sure everyone on your staff collects this data consistently and accurately)?
Early on, the issue I had to address was setting a rule for how often patients had to complete the questionnaires. I wanted to make sure that I had an initial and final outcome for every single patient. I did not want to miss a single data point! I knew that if we only provided the test on the first and last visit, we would end up missing a lot of outcomes, because—among other reasons—the front desk would have a hard time tracking when to administer the forms, our clinical staff would forget, or patients would self-discharge. I realized that, in order to accomplish my goal of having an outcome score at both intake and discharge (i.e., the last visit), I really had to collect outcomes at every single visit. At first, I thought that if we asked patients to complete the forms every time they came in, we’d get a lot of “push back.” However, that really didn’t happen. Occasionally, some patients will complain, but all of our patients and staff understand the process. Overall, it works very well to collect outcomes at every single visit on every single patient. That way, our process is simple and consistent—and we rarely ever miss any.
How have you used your outcomes data to effect positive change/results within your practice (e.g., to enhance patient care, improve staff performance, or identify clinic strengths/opportunities)?
This is one of the great benefits of outcomes collection, analysis, and tracking! Tracking our outcomes for each individual patient allows us to assess a patient’s response to our therapy intervention from one visit to the next. If a patient is improving per the outcome score, we feel the patient is responding to our intervention—and we continue his or her treatment with the expectation that he or she will continue to improve. If a patient’s outcomes are not improving as anticipated, then it’s an indication that our therapists need to re-assess the patient, determine the reasons for lack of progress, and make important adjustments to the plan of care. We then continue to re-assess at every visit. Outcomes scores also serve as a key indicator for discharge.
Outcomes tracking also allows clinics to assess overall effectiveness in treating various body regions and conditions—low back pain, for example—and benchmark with other practices. This is something that I have not been able to do until WebPT provided this great information. Since we started benchmarking with other WebPT clinics, we’ve been able to identify areas where we are strong and areas where we are weaker. We are in the process of analyzing the data and figuring out how we can use it to improve our weak areas. This wouldn’t have been possible without benchmarking, as we would have no idea how we compare. This motivates us to improve.
Have you used your outcomes data to your advantage externally (e.g., to negotiate better payment rates or better market your practice to consumers and referring physicians)?
Our benchmarking data showed that we’re really good with upper extremity conditions, so I have used that to market to local physicians. I have not yet used the data to negotiate better payment rates, but I hope to do so in the future.
Why do you believe tracking outcomes data is worthwhile?
Tracking outcomes is critical to providing optimal patient care, because it creates a sort of “score card” that therapists can use to assess a patient’s progress, evaluate the effectiveness of therapy intervention, and provide rationale for continuing with a care plan (when a patient’s scores are improving) or making important adjustments to the care plan (when the outcome scores are not improving as anticipated). Essentially, tracking individual outcomes assists the therapist in making clinical decisions every visit. Additionally, a therapist can drill down to assess individual questions on the outcome forms—such as those related to sitting, standing, and/or walking—and work on interventions that can improve the specific areas where the patient is struggling.
Clinics can use outcomes data to identify areas where individual therapists are strong—and where they are weak. They can then design clinical education and individual improvement programs to enhance skills in weak areas. Finally, they can re-assess the data to see if the clinical improvement plan was effective.
What would you say to a rehab therapist or therapy practice owner who is on the fence about collecting outcomes data?
Don’t wait any longer to get started! Start simple. It really is not as overwhelming as you might think. The benefits of the information you will get will far exceed any early discomfort and challenges with implementing the process. It really is worth it!
What features should rehab therapists look for in an outcomes tracking software?
A good outcomes tracking software program should track pain, outcomes scores (Oswestry, NDI, etc.), patient satisfaction, number of visits, and cost (if possible). Data collection should be a natural part of your office and clinical workflow—and the software should align with that as well. The reports should be very user friendly and easy to read, and they should provide you with the ability to benchmark with other clinics and a scorecard that shows how well you are doing.
Are you considering implementing an outcomes tracking program in your practice? What questions do you have? Or, if you’ve already started tracking outcomes on a regular basis, what tips do you have? Share your thoughts in the comment section below.