Have you tried using APTA’s Hooked on Evidence and found it a little frustrating? The article extractions are great, but you still have to synthesize all of that information in order to provide the best evidence-based physical therapy to your patients. Who has time for that?
Do you wish there was a website that would not only review medical literature, but synthesize it into quick, usable information that you can easily apply to clinical situations? Well you are in luck! APTA’s PTNow is the answer.
At PTNow you’ll find Clinical Summaries for a particular diagnosis, like COPD or Parkinson’s Disease, that take the clinician through an evidence-based overview, disease classification, screening, examination, diagnosis, prognosis, intervention and medical management.
The site’s designers have also created smaller printable sheets with this information – perfect for printing and reviewing just before you see a patient. There are also clinical cases, clinical tools and a media library with videos of assessment and intervention techniques.
Another great feature is the systematic reviews search feature in the EBP library, which links the user, “to systematic reviews published within the past 5 years that synthesize evidence relevant to physical therapist practice.” You can even save the items you have looked up into a personal online repository called My PTNow. Or discuss topics with fellow clinicians in the Communities section.
There are only a few diagnoses supported so far, so it has a long way to go. The site’s editors are actively soliciting contributions. But for a site that has only been operating for about a year, it’s pretty great, and definitely worth checking out.
Here is a portable Clinical Summary for Total Knee Arthroplasty from PTNow. To access PTNow for more of these, plus all of the other information, you need to be an APTA member. Once the information reaches a critical mass, and becomes the “go-to” site for PTs and PTAs seeking the best available care to their patients, it will be worth nearly the entire membership fee.
While this database is a fabulous enterprise, I can’t help but feel just a twinge of caution. Consider that if other stakeholders, such as third-party payers are given access to this information, it potentially could be used to guide reimbursement of physical therapy. This should be a carefully thought out process.
Currently, the Guide to Physical Therapist Practice is the standard to which PT practice is held. It lists just about any possible exam and intervention technique out there, thereby preserving the clinical judgment of the PT to choose the tools he or she deems appropriate.
Listing only those tools and techniques that have the best evidence in a database such as PTNow, might cause third party payers to start reimbursing only those treatments backed by scientific evidence. This would of course limit the use of other interventions that could potentially have merit, but are not yet backed by scientific research. Without the freedom to try different interventions, case studies don’t get written, which is unfortunate, because often a case study will lead to experimental research. Yes, the same experimental research necessary for the reimbursement mentioned above.
If we short-circuit this process in any way, it could potentially limit the variety of treatments available to PTs developing care plans. We have already recently seen CMS deny reimbursement for TENS in patients with chronic low back pain, unless the patient is enrolled in a clinical study. The reason? No “persuasive scientific evidence,” according to CMS. Food for thought.
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