Focus on Therapeutic Outcomes, also known as FOTO, is a web-based assessment system providing patient evaluation tools and aggregate data management services. FOTO is dedicated to standardizing industry communication about effectiveness of care. Their database is the largest and most valid external directory for rehabilitation that measures functional outcomes for orthopedic, neurological, work hardening/work conditioning, pain management, cardiovascular, pulmonary and pelvic floor dysfunction patients.
At Physical Therapy Associates, Inc. of NEPA, FOTO allows our physical therapists to measure improvements in patients’ functions and compare the therapists’ performance against a national benchmark. In addition the use of this program with our patients allows us to gain evidence of functional outcomes and therefore gives the therapist critical information they need to manage their patients’ care. FOTO is risk adjusted allowing it to be fair and accurate.
The use of FOTO in our three clinics is as follows:
INTIAL FUNCTIONAL STATUS MEASURE -At admission, we ask our patient to complete a short assessment about functional level of the body part or impairment. We calculate the functional stats measure. This measure is usually scored 0-100, which represents the patient’s functional ability.
PREDICTED CHANGE IN FUNCTIONAL STATUS MEASURE – During assessment at admission, we also ask the patient a few “risk adjustment “ questions. Questions about age, acuity, severity co-morbidities, etc., form risk factors we employ to calculate the predicted change in functional stats (predicted outcome) just after our patient completes assessment. The predicted outcome is the average amount of change in function similar patients in FOTO’s database have achieved after treatment (at discharge). FOTO’s extraordinary large database enables us to identify large sets of patients with identical risk adjusted profiles for our patients.
ACTUAL CHANGE IN FUNCTIONAL STATUS MEASURE – Typically we ask the patient to complete an assessment once every 4 or 5 visits, and at discharge, to track the improvement of the patients functional ability during treatment. The patient’s actual change in functional status measure (or actual outcome measure) is determined by simply subtracting the score at admission from the score at discharge, or the latest score. This outcome score represents the improvement, or change, in function during treatment.
The implementation of FOTO into our practice has greatly improved our quality of care and has given our therapists the critical information they need to help set expectations and reasonable goals for our patients.