The increasing ubiquity of electronic medical records (EMR) has opened new avenues into monitoring, assessing, and analyzing data. As more and more patient records become digitized, healthcare providers have increasingly been facing new challenges that arise from storing, sorting, and making good use of this abundance of patient metrics.
In this article, we will discuss how big data techniques on patient metrics impacts healthcare, particularly physical therapy.
While there are no agreed-upon standards for sorting and analyzing physical therapy metrics as of yet, a categorization standard has arisen that sorts these data set into three sub-groups: billing, productivity, and referral data.
Billing information is used on the financial side of a medical practice and will not be discussed further in this article. Vanity metrics are loosely defined as data that is collected that has no immediate use for monitoring or improving patient progress. Action metrics are the data sets that are most useful for healthcare providers when monitoring, diagnosis, and analyzing patient progress in a physical therapy setting.
Electronic medical record systems allow for the capture of patient data on a scale never seen before in the medical world. While many healthcare practitioners might argue that there is no such thing as inconsequential or vanity metrics, generally a number of data sets are considered to have less value, including:
Visits per case – Certainly, some actionable information can be gained from identifying how many times a particular patient receives in-office physical therapy treatment. Generally, however, most types of physical therapy follow a standardized course of treatment that results in a relatively flat set of data sets with roughly the same number of in-house visits per case. Nonetheless, it may occasionally be useful to monitor these datasets in order to identify outliers or to set standards of practice goals in order to provide physical therapy benefits more efficiently. With more productive visit/successful termination of physical therapy outcomes, medical practitioners will benefit from more positive feedback from patients and have more office hours to dedicate to new cases.
Incomplete data sets – Even with the most rigorous classification schemes, some aspects of physical therapy will always remain unquantifiable or immune to statistical analysis and thus cause the collection of incomplete data sets. Physical therapists gain no actionable intelligence from data sets like the n-show or cancellation rates of their patients as the underlying motivation for these events neither reflects the level of care provided nor are they the results of (in)action on behalf of the physical therapy provider. Furthermore, an incalculable number of factors outside the control of the physical therapy provider play a role in determining these rates, including hours of operation, traffic, weather, etc. Nonetheless, monitoring rates such as cancellation or no-show can provide a general idea of the overall success of complimentary campaigns like marketing and branding.
While some real value may be lost by discarding or ignoring so-called “vanity” data sets, it must be understood that the real danger lies in allowing these metrics to gain a significance that they do not deserve. Paying undue emphasis on “vanity” metrics can lead to focusing on these datasets at the expense of much more important and actionable data.
The way to separate “vanity” metrics from “action” metrics is to first identify and create key performance indicators (KPIs) before data collection begins. As more and more data is collected, successful KPI strategies will help give the proper weight to the categories of data being collected in order to manage marketing campaigns, evaluate the efficiency of the health care being provided, and improve patient experience and satisfaction.
The opposite of “vanity” metrics are action metrics, the data sets that provide tangible information to help improve efficiency, performance, and the levels of patient satisfaction with treatment outcomes.
By adhering to a well-designed set of Key Performance Indicators to determine valuable physical therapy metrics, healthcare providers can make the most of the actionable data sets to demonstrate value to their patients and referral sources.
Plan of Care to Discharge (POCD) – Not always tracked by every healthcare provider, these physical therapy metrics can provide invaluable insight on monitoring essential data points as patients progress through the spectrum of care provided. In an ideal setting, physical therapy goals identify a target number of visits, identifiable steps in monitoring progress, and an end point when functional limitations are resolved. When the physical therapy provider and the patient have a POCD action plan, there is a better focus on behalf of the provider in maintaining adherence to the plan and patients feel more in control over the care they are receiving. Improved patient satisfaction results in not just intangible rewards but in greater profitability as satisfied patients will spread positive feedback about your caregiving to others that result in garnering more referrals.
Units/visit – Often thought of as belonging strictly for use in creating data sets for billing and financial purposes, units/visit is a great metric for ensuring that the appropriate types of care are being provided on every visit, not just in total. Furthermore, monitoring units/visit is extremely useful in preventing inadvertent cases of over-billing or raising statistical red flags that might provoke an audit. Lastly, data on units/visit is also an invaluable tool in forecasting income and budgets for a healthcare provider’s office/clinic.
Functional Outcome Measures (FOMs) – The “meat and potatoes” of actionable data sets, these data points refer to measuring and quantifying every component of the POCD plan. With every single visit or stage in the physical therapy process, accurate FOMs should be recorded and stored for later use in understanding the efficacy of care based on patient population type. Furthermore, FOMs are critical for creating functional limitation reports that are later shared with referral and consulting healthcare providers in order to effectively communicate the efficacy of the standards of care being practiced.
New patients per provider – While these data sets are not actively collected by all physical therapy providers, they can provide key insight to patient perceptions of care on a macro level. When patients are actively seeking out care from a specified physical therapist, this generally correlates with greater patient satisfaction levels, better feedback, more referrals, and better adherence to POCD plans.
When physical therapy metrics are collected, analyzed and interpreted correctly in total across the whole of a company or clinic, they can provide numerous beneficial insights into understanding the efficacy, patient satisfaction, and profitability of the care being provided.
Avoiding the temptation to bore down too far on the micro level with an unwarranted focus on less- or no-value data sets (“vanity” metrics) and adhering to a well-designed set of KPIs, every physical therapy clinic or company can learn to leverage meaningful and actionable data into improved standards of care, a greater number of word-of-mouth referrals, more positive feedback, better collaboration with referral sources, and increased profitability and career satisfaction.
Understanding how to interpret, weigh, and use data sets captured by electronic medical records is one of the most important lessons that any practicing physical therapist can learn.
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