1. Ready, Set, FOTO: Clinical Implementation and Cultural Integration The Rehab Associates Way

2. 15 th ANNUAL OUTCOMES CONFERENCE Ryan Webb, PT, DPT, OCS, CSCS Joshua Bailey, PT, DPT, OCS, CSCS, CPed

3. LEARNING OBJECTIVES Initial implementation…it matters Why putting in the effort makes you better Implementation for a multi-site business Day to Day clinical integration Quarterly review and how to use scorecards to drive success Strategic planning with outcomes

4. Rehab Associates of Central Virginia Began in 1965 26 PTs, 16 PTAs with emphasis of outpatient orthopedic PT 12 facilities in Central Virginia centered around Lynchburg

5. Why FOTO? Collected outcomes data for several years in our EMR system but it was useless! Lack of consistency with which outcome tools were used within the plan of care Functional reporting G codes Most of us believed we were good….but we couldn’t prove Some weren’t sure they were good enough…until they proved it

6. On Your Mark!

7. Who should do the FOTO roll out? Develop a FOTO Champion! Preferably not a shareholder Minimize variability Maximize Data collections Integrating Data into daily work flow o Frequency o What to do with the data o Make the right thing be the easy thing Common source of information

8. BEST PRACTICES FOR FOTO ROLL OUT Educate, EDUCATE, EDUCATE ! o What is it? o How does it integrate into documentation? o What does it mean to me? What does it mean to the practice? o How does the Computerized Adaptive Testing (CAT) work? o How do I get my patients to participate? Modeling and scripting o Avoiding the passive participator o How to utilize staging within FOTO

9. A TECHNIQUE FOR FOTO ROLL OUT Rolled FOTO out 1-2 clinics per week o Be present and available: Clinicians Front desk staff Patients o It MUST add something positive to the workflow

10. Daily Clinical Integration of FOTO

11. Focus On Therapeutic Outcomes This is what we do! o Focus on patient outcomes It is where our focus needs to be So who cares? o Patients o Referral sources o Insurance companies

12. Rehab Associates Best Practices  Intake  Status Reports  Documentation  Goals  Targeted Treatments  Frequency

13. Intake Completed with PT Completed with PT – Why?  Help the patient understand  Accurate medical history  Opens dialogue between patient and PT about function  Eliminates problems with tablet  Verify the condition and impairment

14. Intake When When? At what point in eval? Using the PSFS Using the PSFS Get patient’s goals Part of satisfaction survey Comparable sign D/C When to use D/C? If incorrect medical history +/- 10% from FOTO mean? Import PDF into EMR/EHR– no paper!

15. Completed with clinician Completed with clinician – why? Previous intake or status is open for reference Patient may need cueing to think of their presenting conditions vs other limiting factors Clarify the patient’s answer to better understand their continued functional limitation Import PDF to EMR/EHR – no paper! Status Reports

16. Split Screen

17. Documentation Copy and Paste from PDF into assessment for Evaluation and Progress Note EMR integration is the future Update Goals regularly Document change in FOTO score and specific functional change Document change in FABQ

18. Goals PSFS – gives you 2 functional and specific goals! Preload common goals into your EMR system FOTO provides expected functional levels if patient reaches FOTO mean Staging – make sure it is appropriate

19. Goals

20. Targeted Treatments FOTO guides targeted functional treatments Tie exercises to patient goals (PSFS) Improves overall functional outcome Patient performs the activity in the clinic Improves patient’s perceived value Improves patient satisfaction

21. Frequency Every 4-5 visits o More accurate functional status o Determine effectiveness of treatment more quickly o See plateaus Frequency reminders

22. Front Desk Patient Care Coordinator or Origination Specialist o Creates patient case when patient is scheduled o Chooses appropriate condition o Chooses appropriate impairment o Import PDF into EMR/HER o Complete staff D/C

23. REHAB ASSOCIATES’ TIPS FOR SUCCESS Complete the Intake and Status with the patient Refer back to previous survey Have the patient do the activity in the clinic Discuss function, not pain, with the patient Complete every 4 visits

24. FOTO is a tool Use other measures to explain FOTO Do we D/C if patient reaches FOTO goal? Don’t forget clinical judgment! FOTO can be a great tool!!

25. MAKING THE DATA WORK FOR YOU Quarterly FOTO Summary reports

26. QUARTERLY FOTO SUMMARY REPORTS Individual reports provided to each PT o GoToMeeting recording Directed review o Efficiency o Effectiveness o Utilization Comparison o FOTO mean o Company standards Immediate Feedback o Opportunities o Praise o Education planning Easy to store for later reference

29. QUARTERLY SUMMARY DATA Consider providing FOTO awards o Overall o Each body part Advertise o Using the website widgets o Blogs o Direct mailer marketing

30. THE WIDGET

31. FOTO OUTCOMES FOR STRATEGIC PLANNING Include FOTO in formal employee evaluation processes Developing continuing education opportunities Using the data for contracting

32. QUESTIONS???

33. Ryan Webb PT, DPT, OCS, CSCS Josh Bailey PT, DPT, OCS, CSCS, CPed