Gathering and utilising musculoskeletal data from private physiotherapists to demonstrate the value of their services: a UK based project

Background: Clinicians are increasingly aware of the need to demonstrate and account for the delivery and quality of their clinical services. Standardised data collection (SDC) systems can be used to gather this information in a robust and accessible way. Physio First (the Organisation for Chartered Physiotherapists in Private Practice) commissioned the University to set up and maintain an online SDC system for their members. Purpose: To provide detailed information about current practice, patient demographics and outcome of care for patients with musculoskeletal (MSK) conditions treated within private physiotherapy clinics. Methods: All Physio First members who treat MSK patients in the UK could register for this project. Practitioners were asked to input data on newly referred MSK patients using the online SDC system. Data collected included patient details; diagnosis; body site & symptoms; referral source; treatment and discharge information (i.e. outcome of referral, goal achievement). The national dataset is downloaded and analysed three times a year by the University. All practitioners who input sufficient datasets receive an individualised report showing how their data compares to the national dataset, and Physio First receive a report of the combined anonymised national data. Results: 567 practitioners were recruited to the project. 32,469 patient records were uploaded between November 2014 and May 2018. The number of records input per practitioner varied depending when practitioners were recruited to the study. The mean age of all patients was 51.6 years ± 17.7 years. The majority of patients were ‘self-referred’ (74.6%), and paid for their own treatment (73.2%). More than half the patients (62.4%) were treated within 2 days of contact; with most patients (91.6%) treated within one week of contact. 90.2% of patients received three or more treatment modalities in the initial treatment session. The number of treatments per episode ranged between 1 and 10; the average number was 3.4 (SD 2.3). Goal achievement at discharge was achieved (significantly, fully or exceeded) for 77.4% of patients; goals were not achieved in 4.2% of patients. Improvements in physical/functional outcome scores were observed with a reduction in score from 5.6 (SD 1.8) initially to 2.6 (SD 1.6) on discharge. Only a small number of patients were unable to return to work following treatment (1.1%), or returned to work on restricted duties (3.6%). Practitioners reported in spite of the increased workload and time to collect the data, participating in the project had stimulated reflective practice, helped identify strengths and weaknesses and provided useful data for business management. Conclusion: SDC provides physiotherapists, clinics and organisations with useful information in terms of patient profiling, marketing, evidence of outcomes, benchmarking and identifying areas for personal learning and professional development. Current work includes the introduction of a validated online patient reported outcome measure (PROM) which will provide additional information about effectiveness and quality of care. Implications: Physio First and their clinicians have a growing database of patient data to demonstrate the value of their physiotherapy services. This is an ongoing project; the introduction of PROM data will further support them in the healthcare market.