linedanceAI’s advisor Alex Bryce applies his experience as a strength and conditioning coach for world-class athletes and now a physical therapy doctoral fellow, to offer a 21st century point of view on patient engagement and satisfaction.
I’ve found in working with patients that there are two distinct but related communication problems:
Helping patients understand what we – the practitioner – see.
Connecting patient expectations with goal-centric care plans.
Outpatient rehabilitation practitioners such as physical therapists (PTs), are movement experts. We work to improve patients’ movement function every day. We rely on subjective, yet specialized judgement to determine a patient’s movement quality. This type of observational analysis is standard practice in most clinical settings, but it isn’t always the most reliable, or timely, and requires years of practice to become most proficient.
How Do You Know if Patients ‘Get it’?
While I have years of skilled experience and education, I can ask questions and think I’m ‘reading’ someone well, but I’m still not certain that they are understanding what I see in their movement and why it needs to change. We’ve never seen movement quantified objectively in a way that can transfer provider observations to basic patient-level understanding in clinical practice management. This makes aligning their expectations and my care plan, challenging.
There are a variety of tests and measures for functional performance of patients with musculoskeletal (MSK) conditions. Whether the Berg Balance Test or Timed Up & Go or Functional Lower Extremity Evaluation, through test and re-test validation process, validity of these tests indicate that an improvement in patient scoring corresponds to an improvement in performance. However, scoring only goes so far.
Let’s say the patient is recovering from a knee injury. Questions I look to answer in my tests and measures include:
How much are they limping during the test?
How much knee flexion is occurring during the swing phase of gait?
How much knee extension is present during heel strike and weight acceptance?
How much more symmetrical is the patient’s gait now, compared to the first physical therapy session?
How far away is their current movement from their personal goals?
This type of information is paramount to determining movement optimization of the patient, balance and fall risk (information I need for the EMR and payer) but unfortunately, it has little meaning to patients.
Using Movement as Data to Open the Doors of Communication and Understanding
What if patients could see an optimal test performed side-by-side to their results, along with graphical information about how and where in the movement pattern they were different?
What if a patient was able to see progress from their first test (from three weeks ago) and their progress after doing their home exercise program (HEP) and two other intervention sessions with their PT?
What happens when movement becomes a part of a physical therapy data strategy and can be reflected to patients in a form they understand? I think it would lead to more “ah-ha!” moments with their practitioner. Or they ‘get it’ when they see progress from one session to the next while their own movement is visualized and aligned with the words of their practitioner. I think patient engagement and satisfaction happens in these small moments. The result being patients staying with their full course of care, and they reach their expected functional outcomes.
Making Movement Real
We need to make movement real and actionable for the benefit of both practitioners and patients. Effective care relies heavily upon our ability to create a therapeutic alliance . We do this with soft skills, professional skills and proper patient education, all of which play important roles in the perceived value of our sessions. Emerging PT specific technology solutions incorporating patient movement as data offers a promise to accelerate this process and turn our expert observations into digestible information for patient engagement and satisfaction.