Quality Management

Clinical Outcomes

Clinical outcome report cards are a way for payors and case managers to see what sets a center of excellence apart from other spine treatment options. By presenting statistical data on patient satisfaction, pain resolution, return to function and types of treatments most commonly administered to patients, these entities can see the effective approach of a multidisciplinary center motivating them to send referrals.

Dating back to Year 2000, Prizm spine centers were the only spine centers in the nation publishing data to referral sources and health insurance companies on the following spine outcomes metrics:

  • Patient severity at intake
  • Percent of patients receiving therapy as part of their treatment in the spine center
  • Percent of patients receiving spinal injections as part of their treatment in the spine center
  • Percent of patients receiving spine surgery as part of their treatment in the spine center
  • Use of pain medication at intake and after 3 to 6 months of treatment in the spine center
  • Functional status across 3 separate activities, at intake and after treatment
  • Analog pain scales at intake and after 3 to 6 months of treatment in the spine center
  • Patient satisfaction across 7 metrics

 

The trend in medicine today is to explore non-surgical solutions to various health problems. The same trend is occurring in the specialty of spine care. Compared to other countries, back pain sufferers in the United States receive twice as much back and neck surgery. Non-surgical approaches are too often overlooked for surgery.

The clinical outcome report card is useful in showing case managers and insurance providers both the short- and long-term effectiveness of a non-surgical first approach to spine care.

To compile a report card, it is first necessary to meet with large employers, managed care organizations and workers compensation carriers in the area where their concerns related to the treatment of spine care are documented. For example, a managed care company may complain that they are seeing a higher than average rate of spine surgeries performed. Others may complain about excessive drug use by back pain sufferers. These concerns are noted and used to compile a list of questions intended for graduates of the spine group Prizm is representing.

We subsequently work to create a clinic that is based on the needs of both the employer and back pain sufferers, making it consistent with the market's desire for providers that track the outcomes of each patient. The spine center carefully documents clinical outcomes, relief of symptoms, functional status and patient satisfaction.

The outcomes presented are provided by an outside firm that specializes in tracing spine outcomes and is involved with several other spine centers nationally comparing outcomes and developing new techniques to make the center as effective as possible.

Results in the report card are based on phone interviews by an RN with a random sample of patients three months after the patient's first visit. This is the most unbiased, statistically relevant method for outcomes analysis.

The statistics are then distributed to show results. Prizm is also able to help centers of excellence compile databases to ensure the report cards are sent to the most relevant managed care decision makers for the spine center.

 

Prizm developed the first Clinical Outcomes system able to generate a report card for payors
Click here to view PDF

 

DOWNLOAD WHITE PAPER:
2020 vision: Where is spine care headed for spine physicians & hospitals?

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