Though its pilot test will be delayed until June because of changes to the Physician Quality Reporting System (PQRS), the APTA Physical Therapy Outcomes Registry (PTOR) is becoming more of a reality each day, with workflows, sample data entry screens, and staff ready or nearly ready to proceed.
The APTA Board of Directors received an update on PTOR progress during its April 3-5 meeting in Alexandria, where staff outlined progress on one of the association's top priorities for 2014. Current plans are for PTOR to begin pilot testing in early June, and to make its official debut in conjunction with the 2015 APTA Combined Sections Meeting (CSM) in February.
When complete, the registry will provide a user-friendly system to collect uniform data on patient and client outcomes. That data will help guide best practices, help providers meet regulatory reporting demands, generate benchmarking reports, help shape policy, and contribute to emerging payment models. APTA believes that the overall impact of the registry will be to demonstrate the value of physical therapist practice and the ways it can transform society.
At the Board meeting, APTA staff described the standard elements of the system, which will include visit report forms, workflow and patient management lists, and a data exchange that provides real-time access. Users will be able to opt in to other features that would make it possible to run quality measures on patient populations and connect to other electronic health records (EHR) systems.
Board members also got a glimpse "beyond the build" to learn how APTA is managing the legal, communications, and marketing side of the project, including a logo—a clean design that will help create identity and recognition.
With most of the program creation elements in place, the registry will transition during the first half of 2014 from a project overseen by an APTA task force to a full-fledged association-managed product. Current plans are for the task force to conclude its duties in July.
The PTOR webpage includes a video dispatch created after Board deliberations in August of 2013. APTA will post updates and further information on the registry there as they become available.
To see the full discussion on this and other topics from the April Board of Directors meeting, watch the archived livestream of all open sessions.
Time marches on, and so does APTA's progress on its 2014 strategic plan.
An accounting of activities and achievements shared with the Board of Directors at its most recent meeting adds up to one bottom line: solid gains in each of APTA's goals around effectiveness of care, patient and client-centered care across the lifespan, professional excellence, and value and accountability.
During the Board's meeting April 4-6 in Alexandria, Virginia, staff and board liaisons outlined the work being done to achieve the objectives that support each of the association's 4 major goals. This work is tied to specific metrics that define individual activities and programs and identify timelines to measure progress. It's a long list of activities that ranges from the operational to the aspirational, and touches all of the association's major projects. Highlights from each goal area include:
Effectiveness of care
Patient and client-centered care across the lifespan
Value and accountability
The 2014 Strategic Plan is both an extension of the 2013 plan that was based on APTA’s former Vision 2020, and a “bridge” to the new, more outward-facing vision that APTA adopted at the 2013 House of Delegates—“Transforming society by optimizing movement to improve the human experience.”
The 2015 Strategic Plan will be based on the new vision.
A new clinical report from the American Academy of Pediatrics (AAP) asserts that the continued rise in anterior cruciate ligament (ACL) injuries in adolescent athletes could be partially countered by neuromuscular training to "preprogram" safer movement patterns before an injury occurs. Better training could be of particular benefit to female adolescent athletes, who could see their rates of ACL injury risk drop by as much as 72%.
The recommendation was part of the conclusions and guidance presented in a report (.pdf full text available for free) published in the April 28 edition of Pediatrics. The report addressed diagnosis, treatment, and prevention of ACL injuries in adolescent athletes, which have been on the rise over the past 2 decades due to growing numbers of children participating in sports and more intensive training programs, among other reasons. Intrinsic risk factors include higher BMI, subtalar joint overpronation, generalized ligamentous laxity, and decreased neuromuscular control of the trunk and lower extremities, according to the report.
While incidence rates among adolescent athletes are still lower than among college athletes (5.5 vs 15 per 100,000 athlete-exposures), the rates are increasing and rise more dramatically during puberty—particularly for girls. Authors of the report write that female athletes between the ages of 15 and 20 account for the largest numbers of ACL injuries among adolescent athletes, and that, overall, girls suffer ACL injuries at a rate 2.5–6.2 times higher than boys in gender-comparable sports.
The report cautions against surgical interventions for adolescent ACL injuries, particularly when the surgery may cause growth disturbances, but authors also acknowledge the role patient and parent cooperation play in this consideration. While nonoperative treatments such as braces, rehabilitation, and sports restriction are often recommended until skeletal maturity is reached, authors write that "many … athletes and their parents are less inclined to agree to restrict the athlete's activity," which can lead to additional injuries and early-onset arthritis. "Therefore, most recent literature now supports early surgery for pediatric athletes with an ACL-deficient knee and recurrent episodes of instability," they write. Certain techniques minimize the risk of growth plate injury.
More certain results can be achieved in prevention, where neuromuscular training can have an impact, according to the report. More so than bracing (which authors say is "unlikely" to reduce risk of ACL injury), the training has a preventive effect by helping athletes to "'preprogram' safer movement patterns that reduce injury risk during landing, pivoting, or unexpected loads or perturbations during sports movements," authors write.
Adolescent female athletes could see the biggest risk reduction, if this training is introduced in their mid-teens. Training that "incorporates plyometric and strengthening exercises, combined with feedback to athletes on proper technique, appears to be most effective," authors write. "Pediatricians and orthopedic surgeons who work with schools and sports organizations are encouraged to educate athletes, parents, coaches, and sports administrators about the benefits of neuromuscular training in reducing ACL injuries and direct them to appropriate resources."
Research-related stories featured in News Now are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.
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