Clinical Outcomes
Frequently Asked Questions
- What are Functional Outcomes?
- How does CareConnections differ from other systems?
- How many subscribers currently use CareConnections? What is the geographic distribution?
- How large is the database?
- What does CareConnections measure, and how can I use the data?
- Is CareConnections approved by the Joint Commission?
- How is Outcomes data collected?
- What about HIPAA?
- What kinds of reports will I receive?
- What kind of training and support services does CareConnections provide?
- What about reliability and validity?
- Does CareConnections conform with the latest CMS documentation requirements for outpatient PT?
- What are the contractual requirements for CareConnections?
- What do some of your current subscribers have to say about the CareConnections Outcomes System?
What are Functional Outcomes?
Functional outcomes describe what happens as the result of therapeutic intervention. If a patient receives therapy at your facility, do they get better? How has their function improved? This is what functional outcomes
tell you.
How does CareConnections differ from other systems?
CareConnections differs from other systems primarily due to its simplicity and cost effectiveness. The CareConnections tool is simple, efficient, and diagnostic-specific, and it is easy to use, easy to administer, and easy to understand. In regard to cost, CareConnections charges a yearly subscription fee that covers unlimited data entry. Some systems charge a fee for every record you enter, which can be a deterrent to entering outcomes data.
Subscribers will receive outcomes information categorized by seven diagnostic groups. This allows you to discuss function as it relates to utilization by diagnostic groups when meeting with referral and payer groups.
Data collection reports are user friendly and easy to interpret. The impact on therapists is only to use the data to write functional goals and assess the efficacy of treatment.
How many subscribers currently use CareConnections? What is the geographic distribution?
Approximately 525 facilities currently subscribe to CareConnections.
Subscribers are mostly outpatient rehabilitation clinics and hospital-based outpatient clinics.
CareConnections subscribers are located in 32 states: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Missouri, Montana, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Washington, and Wisconsin.
Four statewide physical therapy networks are represented: Midwest Rehabilitation Network (Wisconsin), Northeast Rehab Health Network (New Hampshire, Massachusetts), Northwest Rehab Alliance (Oregon, Washington), and Southern Physical Rehab Network (Louisiana).
How large is the database?
Approximately 85,000 episodes were represented in 2006. CareConnections typically
averages between 21,000 and 22,000 records per quarter.
What does CareConnections measure, and how can I use the data?
CareConnections provides seven data points:
- Functional Index
- Perceived Pain
- Perceived Improvement
- Work Days Lost
- Work Status
- Utilization
- Acuity
Outcome data is used in the national database for comparative information. Additionally, it may be used as part of the CareConnections database for research articles or presentations.
Subscriber utilization of outcomes may include:
- Identification of efficacy of intervention
- Quantifiable patient progress for referral sources
- Identification of best practice
- Guide for therapist continuing education
- Data for referral sources and payers on effectiveness of treatment
- Marketing for contract negotiation with payers
- Performance appraisals
Is CareConnections approved by the Joint Commission
CareConnections Outcomes Instrument has met the criteria for inclusion in the accreditation process and is included on the Joint Commission's list of acceptable systems.
CareConnections is committed to meeting future criteria established by the Joint Commission.
Although outpatient rehab outcomes are not yet required by the Joint Commission, site surveyors have responded positively to hospital departments using CareConnections in their outpatient clinics.
How is Outcomes data collected?
The subscriber collects data via patient worksheet that is completed by the patient on initial and discharge visits. Office staff scores the patient worksheet and inputs the results on CareConnections Web site.
Time involved in collecting and submitting data is approximately five minutes per episode. All data collection and input is done by the front office.
Therapist involvement is only in the application of the information: to set patient goals, to discuss patient input on their condition, and to assess patient status.
Internet-based data entry and Outcomes reports.
What about HIPAA?
Therapeutic Associates meets the criteria for a Business Associate under the HIPAA regulations. Subscribers will be provided with a Business Associate Addendum to supplement our base CareConnections Participant Agreement.
Under the HIPAA privacy rule, covered entities may disclose protected health information regarding their patients for health care operations. This includes disclosures to CareConnections that help the subscriber evaluate the performance of their staff therapists and the overall effectiveness of their services to facilitate improvement and become more efficient with care.
The CareConnections Web site is secure and has been developed to comply with the impending HIPAA security rule deadlines.
What kinds of reports will I receive?
Quarterly Outcomes reports include (click on the link for a sample report):
Comparative report shows patient demographic information and overall outcomes scores in the areas of pain, function, and improvement.
Body Part Analysis report shows outcomes broken down by anatomical region. Individual facility data is compared to a network and the national database. The network would be defined as the subscriber's clinics for a multi-site operation or a defined network group. If you do not belong to a multi-site operation, you are automatically compared to the other single entity clinics subscribing to CareConnections.
Therapist Outcomes report provides therapist outcomes categorized by anatomical area.
Work Data graph compares lost work information for the subscriber's clinic and breaks it down by payer type.
Summary/Marketing report shows anatomical and overall Outcomes scores for current quarter. This report is most commonly used for marketing purposes.
Clinical Comparative report (for multi-site subscribers).
Reports are posted online by the fourth week of the month following the end of the quarter. The final deadline for Outcomes information is the 10th of the month following the end of the quarter.
Custom reports are available upon request. Common requests are reports that show outcomes by diagnostic group (ICD-9), by referring physician, or by insurance group. The subscriber must submit parameters for customized reports.
Dependent on volume, the subscriber should have meaningful data during the first quarter the system is implemented.
What kind of training and support services does CareConnections provide?
CareConnections is a very user-friendly system with minimal training required. A user's manual will provide information on implementing the gathering of data and data input. The Outcomes System was specifically developed to have minimal impact in clinic operation, thereby enhancing compliance and maximum benefit for the clinician and patient.
Should the subscriber require additional training, phone or e-mail support is available. For multi-site operations, onsite training may be arranged.
Once your account is activated, support services are provided on request from subscriber.
What about reliability and validity?
Reliability and validity information is detailed in the article TAOS Functional Index: Orthopaedic Rehabilitation Outcomes Tool, published in the Journal of Rehabilitation Outcomes Measurement, May 1998 (J Rehabil Outcomes Meas, 1998, 2(2), 55-61 © 1998 Aspen Publishers, Inc.).
The CareConnections Outcomes tool is also listed with the National Quality Measures Clearinghouse (NQMC) and has met the criteria for inclusion in the accreditation process for the Joint Commission.
The CareConnections Outcomes System is a self-reporting system; therefore, rater reliability is not an issue and does not require a credentialing process.
Does CareConnections conform with the latest CMS documentation requirements for outpatient PT?
In the December 29, 2006 Transmittal 63 from CMS, information was provided regarding the Outpatient Therapy Cap Exceptions Process for Calendar Year (CY) 2007. Within section 220.3 - Documentation Requirements for Therapy Services, the transmittal recommends documenting the results from 1 of 4 measurement instruments in the patient’s evaluation. The CareConnections outcomes instrument was not one of the listed systems, however, the transmittal states qualifications for other outcomes instruments on pages 28-29.
The CareConnections (formerly TAOS) outcomes tool does meet the criteria for being a tool that “indicates objective, measurable beneficiary physical function.” CareConnections allows for the functional assessment of individual items (such as individual functional questions) and for the assessment of summary scores that compare initial and intermediary or initial and discharge functional ratings. The CareConnections tool also meets CMS criteria in that it is validated in professional literature (Schunk C and Rutt R. TAOS Functional Index: Orthopaedic Rehabilitation Outcomes Tool. J Rehabil Outcomes Meas, Aspen Publishers Inc., 1998, 2(2), 55-61), it has been proven to be appropriate for the condition/function being measured, and it can be used for measuring progress toward goals in functioning in the home/work environment at the conclusion of an episode of care.
What are the contractual requirements for CareConnections?
Subscriber is expected to pay all fees on a timely basis, to return signed agreement upon receipt of CareConnections materials, and to report data by indicated deadline for each data quarter.
CareConnections agrees to provide subscriber with instructions, training, technical support, quarterly reports, and customized reports as requested.
Depending on the subscriber's needs, modification of the contract can be considered.
Subscribers will be invoiced annually based on date of initial subscription.
What do some of your current subscribers have to say about the CareConnections Outcomes System?
“We selected CareConnections Outcomes System because of its simplicity, cost, and efficiency for therapists. We were also impressed that it measures patient's desired outcomes and perceived improvements and NOT arbitrary clinical measures.”
- Midwest Rehabilitation Network
“As a hospital based multi-clinic therapy facility, we have used CareConnections functional outcomes reports for seven years. Using these reports has allowed us to greatly enhance our marketing program to our physician base and third party payers. CareConnections has provided prompt and accurate responses to our requests for additional diagnosis-specific statistical reports, and our functional outcomes have become a cornerstone of our practice.”
- Portland Adventist Medical Center
“It is easy for clinics to say they are the best. Actually everyone does. But our CareConnections users have substantive proof to back up that statement.”
- Southern Physical Rehabilitation Network