A new outcomes registry may lead to improved care for injured workers. At least, it’s a step in the right direction.
The Physical Therapy Outcomes Registry was launched recently by the American Physical Therapy Association in response to the need for a better understanding of our practice patterns and outcomes. One hope is that the physical therapy profession can be better prepared for value-based payment models in the future, which focus on getting the best care for the injured worker. While the registry is brand new, it could be a way to get better information about specific PT-related treatments.
What it Is
The Registry, as it’s being called, is “for physical therapy, about physical therapy.” It collects and aggregates electronic health record data from participating PT practices to help make better clinical decisions and to track and benchmark clinical outcomes against nationwide data.
Once a therapist or practice has joined, the registry will take certain pieces of the data — how the patient is doing functionally, what the diagnosis is, the person’s age, things like that. The therapist can then look at their own data in an aggregated way. That’s very promising.
Right now there are vast amounts of data and research but much of it hasn’t been tracked or analyzed. Those of us in the profession hope this might make a substantial difference in our treatments and outcomes. It is us looking at our profession and saying, ‘OK, let’s start to track what we are doing in the real world.’ We need more and better information about PT.
The registry also provides a real-time source of data, which is key to improved outcomes. Guidelines based on medical research don’t always translate to what happens in the real world, when you have many different factors at play. The person’s sex, the mechanism of injury and the presence of comorbidities all factor into the outcome. Treatment requirements for someone with a knee sprain, for example, would vary greatly if the patient was a professional athlete, vs. a construction worker, vs. an office worker.
At this point, it’s somewhat unclear how specific the registry will be, but the more data points, the better for injured workers and payers. We’d like to see the data broken down by many categories — including injured workers vs. the general healthcare system. Treating an injured worker focuses on returning the person to work, while treating someone on Medicare, for example, might focus on a return to function, or even activities of daily living. So that information would be really important.
The APTA sees the registry as an adjunct to other established medical treatment guidelines. The organization is implementing modules, where they look at specific guidelines, adherence to them, and the outcomes. They would look at, for example, how adherence to certain treatment protocols affect return-to-work outcomes for injured workers.
There is a cost involved, which I fear might deter some therapists and practices from participating. APTA members pay $299 per year/ per provider, while non-members pay $399 .
What I like about this registry is that it is focused solely on physical therapy. We really need the ability to benchmark our outcomes and see what evidence-based treatment calls for, depending on the underlying factors involved in each claim. Many in the PT profession now have Doctorate Degrees (DPTs); so our industry should have the same level of clinical information available as other medical disciplines.
Also, the registry will enable more and better research in the future. The APTA envisions allowing researchers to request data from the registry and use it to better understand different treatments and outcomes.
One thing I hope the registry does is lead to more direct access for injured workers; allowing them to see a physical therapist as the first level of care. Many occupational injuries can be successfully addressed simply by seeing a physical or occupational therapist. Some states do have direct access, to an extent. We’d like to see that in all states. Perhaps the registry will help define parameters for certain injuries to be treated with PT immediately after the injury.
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