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8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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INAPTA Central District Meeting
mailto:[email protected]:[email protected]:[email protected]8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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photo via Sadie Hernandez
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If you care for your patients, dont you
want to know whether your interventionsreally work? The only way we can know isthrough clinical trials with controls. In avery real sense, we, like other health careprofessionals, abuse the trust of ourpatients when we give the impression ofknowing more than we do.
- Jules M Rothstein, PT, PhD, FAPTA32nd Mary McMillan Lecture
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photo via jdhancock
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Physical therapy, by 2020, will be provided by physical therapists who aredoctors of physical therapy and who may be board-certified specialists.Consumers will have direct access to physical therapists in allenvironments for patient/client management, prevention, and wellness
services. Physical therapists will be practitioners of choice in patients'/clients' health networks and will hold all privileges of autonomous practice.Physical therapists may be assisted by physical therapist assistants who areeducated and licensed to provide physical therapist directed andsupervised components of interventions.
Guided by integrity, life-long learning, and a commitment tocomprehensive and accessible health programs for all people, physicaltherapists and physical therapist assistants will render evidence-basedservices throughout the continuum of care and improve quality of life forsociety. They will provide culturally sensitive care distinguished by trust,respect, and an appreciation for individual differences.
While fully availing themselves of new technologies, as well as basic andclinical research, physical therapists will continue to provide directpatient/client care. They will maintain active responsibility for the growthof the physical therapy profession and the health of the people it serves.
Vision 2020
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Looking forward, I am profoundly
uninspiredby such a narrow, inwardlydirected vision for our future as aprofession. Today, Vision 2020 isneither bold nor visionary, and asDuncan stated in her 2002 McMillanLecture, it sounds self-promotingand self-aggrandizing.
- Alan M. Jette, PT, PhD, FAPTA43rd Mary McMillan Lecture
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We need to shift dramatically
our focus from optimizingparts to focusing on our role inthe changing systems and
society in which we practice.
- Alan M. Jette, PT, PhD, FAPTA43rd Mary McMillan Lecture
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11/119photo via JD Hancock
http://www.flickr.com/photos/jdhancock/4100030094/http://www.flickr.com/photos/jdhancock/4100030094/http://www.flickr.com/photos/jdhancock/4100030094/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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PASSreframed our traditional
focus on the physical therapistand the patient/client to one in
which physical therapists are anintegral part of a collaborative,
multidisciplinaryhealth careteam with the health careconsumer as its focus.
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First, therapists must become interested in
data.Second, they must become skilled inthe ability to devise solutions for the
system problems that data and experienceuncover. Third, the physical therapyprofession must develop the ability toimplement at scale - the ability to get
therapists along the entire chain of care
unctioning in concert, in collaboration.
- Alan M. Jette, PT, PhD, FAPTA
43rd Mary McMillan Lecture
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Frances WestleyBrenda Zimmerman
Michael Patton
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Frances WestleyBrenda Zimmerman
Michael Patton
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Frances WestleyBrenda Zimmerman
Michael Patton
Maybe comes with no
guarantees, only a chance.
But maybe has always beenthe best odds the world hasoffered to those who set out
to alter its course...
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Frances WestleyBrenda Zimmerman
Michael Patton
Maybe is not a cautiousword. It is a defiant
claim of possibilityin theface of a status quo we
are unwilling to accept.
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photo via martinak15
http://www.flickr.com/photos/martinaphotography/6838181589/http://www.flickr.com/photos/martinaphotography/6838181589/http://www.flickr.com/photos/martinaphotography/6838181589/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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Complete,
longitudinalinformation that
follows the consumer
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Care that is
value-basedandcoordinated
across settings
photos via meddygarnetand brykmantra
http://www.flickr.com/photos/meddygarnet/http://www.flickr.com/photos/brykmantra/http://www.flickr.com/photos/brykmantra/http://www.flickr.com/photos/brykmantra/http://www.flickr.com/photos/meddygarnet/http://www.flickr.com/photos/meddygarnet/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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Health decisions madewith information tools thatassist and guide
Have youconsidered
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Results
Fewer errors, waste, variationsConsumer-centered care
Lower spending
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Healthcare is an informationbusiness. The quality,
effectiveness, and efficiencyof care depend on our abilityto manage information. You
ust can't do it without EHRs.
Bill Tierney, AMIA 2011 Keynote
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To do this, well need
information systems that are
WAY more than justelectronic documentation.
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Meanwhile,back on planet Earth
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Fundamental challenge:
local systems have idiosyncraticways of identifying the same
concepts
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Patients move
fasterand furtherthan their healthinformation
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photo via pfarrell95
http://www.flickr.com/photos/65005341@N03/http://www.flickr.com/photos/65005341@N03/http://www.flickr.com/photos/65005341@N03/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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What does this look
like in the wild?
photo via bm.iphone
http://www.flickr.com/photos/bmiphone/http://www.flickr.com/photos/bmiphone/http://www.flickr.com/photos/bmiphone/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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photo via noshaMcDonald et al. Canopy Computing: using the Web in Clinical Practice.JAMA. 1998;280(15):1325-1329.
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photo via noshaMcDonald et al. Canopy Computing: using the Web in Clinical Practice.JAMA. 1998;280(15):1325-1329.
The rain forest canopy is aseamless web through which
arboreal creatures efficientlymove to reach the edible
fruits without any attentionto the individual trees.
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41%of ED visits are for patients with
data at another institution
Finnell JT, Overhage JM, Grannis SJ. All Health Care is Not Local: An Evaluation of the Distribution of Emergency Department Care Delivered in Indiana. AMIA Annu Symp Proc. 2011;:409-416.
Connectedness among IN EDs
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Connectedness among IN EDs
Finnell JT, Overhage JM, Grannis SJ. All Health Care is Not Local: An Evaluation of the Distribution of Emergency Department Care Delivered in Indiana. AMIA Annu Symp Proc. 2011;:409-416.
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Similar name, different meaning
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Similar name, different meaning
meerkat meerkat mere cat meerkat
photo via Caption Time
http://captiontime.tumblr.com/http://captiontime.tumblr.com/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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MEASUREMENTS
US
R
photo via puuikibeach
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photo via Ed Yourdon
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photo via Ed Yourdon
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photo via Ed Yourdon
ICF: walking short distances
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photo via Ed Yourdon
Walking speed: 1 m/s
6 min walk distance: 600m
Fall risk: Mod
ICF: walking short distances
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photo via Ed Yourdon
Walking speed: 1 m/s
6 min walk distance: 600m
Fall risk: Mod
ICF: walking short distances
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photo via Ed Yourdon
Walking speed: 1 m/s
6 min walk distance: 600m
Fall risk: Mod
ICF: walking short distances
http://www.flickr.com/photos/yourdon/http://www.flickr.com/photos/yourdon/http://www.flickr.com/photos/yourdon/8/13/2019 2012 10 09 - Maybe is Not a Wary Word
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2 Key Ways EHRs can Help
Accelerate that VisionSeamless web of data
Decision support
photo via OiMax
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photo via liber
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1968!
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1968!
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Do PTs today
really use EHRs?good question...
APTA 2010 Member Survey
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28%
33%
38%
1%
Yes, all electronicYes, paper and electronicNo
Dont know
Got EMR?
APTA 2010 Member Survey
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Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
0 10 20 30 40 50 60
EHR Satisfaction
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Most common
complaint?anecdotal
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photo viajaneandd
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A journey.
Not a destination.
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photo via Justin Ornellas
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Adopt interoperable
Electronic Health Records,but be mindful of the
complexity.
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apta.org/EHR
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apta.org/EHR
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Physical therapisteducation programs
should incorporate coreinformatics competencies
into their curricula.
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Although most health
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Although most health
professionals use IT dailyin their work,fewknow
how to adapt their rolesand work processes to
incorporate IT for thegreatest benefit.Stead WW, Searle JR, Fessler HE, Smith JW, Shortliffe EH. Biomedical informatics: changing what physicians need to know and how they learn.Acad Med. 2011 Apr;86(4):429-34. PMID: 20711055
We have frequently heard the
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Silverman H, Cohen T, Fridsma D. The evolution of a novel biomedical informatics curriculum for medical students. Acad Med. 2012 Jan;87(1):84-90. PubMed PMID: 22104049
q yopinion from both faculty and
students that medical studentsalready possess all the basic skillsnecessary to function effectively in
an information-rich environment.
We have frequently heard the
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Silverman H, Cohen T, Fridsma D. The evolution of a novel biomedical informatics curriculum for medical students. Acad Med. 2012 Jan;87(1):84-90. PubMed PMID: 22104049
q yopinion from both faculty and
students that medical studentsalready possess all the basic skillsnecessary to function effectively in
an information-rich environment.This is similar to assuming that a
student proficient in the use of aword processing program knows how
to write an award-winning novel.
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photo via JOPHIELsmiles
Physical therapist education
programs should partner withhealth informatics professionals
in evaluating the efficacy ofinformatics interventions in
physical therapist practice,education, and research.
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photo via JOPHIELsmiles
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photo via IMLS DCC
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Human
+Computer
Human
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I didnt see it then, but it turned out that
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I didn t see it then, but it turned out thatgetting fired from Apple was the best
thing that could have ever happened tome. The heaviness of being successfulwas replaced by the lightness of being a
beginner again, less sure abouteverything. It freed me to enter one ofthe most creative periods of my life.
- Steve JobsStanford Commencement Speech 2005
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photo via scragz
Though Wooten's basses
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photo via scragz
Though Wooten s basses
receive much attention, hismost frequent and consistentresponse when asked by hisfans about his equipment isthat "the instrument doesn't
make the music ...you do".
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photo via scragz
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