Invited presentation on innovative models of technology and big data to rehabilitation medicine and case management.

1. Evidence-Based
Approach to
Comp and
Rehab:
New Tools and
Actionable Approaches
Chris E. Stout, PsyD
Department of Research and Data Analytics, ATI
College of Medicine, University of Illinois, Chicago

2. Please note that this is a March 2014 presentation.
While you can see most of what was displayed, you cannot
hear what I said, and I wish you could.
You may reach me via http://about.me/DrChrisStout
if I may be of help to you in your work.
Cheers,
Chris

5. OFFICIAL DISCLAIMER:
Cool stuff we’ll not be covering

7. It’s nice to work with workers’ comp
outcomes because…
Outcomes are VERY Quantified
– RTW at the same job description and PDL
or not?
– How many days passed before RTW?
– Nice, clean, and tidy!

9. Surgeon’s Perspective on a
Good Outcome
•
•
•
•
•
No anesthesia issues
No surprises during or after
No complications
Good wound healing
No post-op infection

10. But how does the story end?
Is the patient back at work?
Quickly?
At the same PDL as prior to injury?
With the same job classification?

12. Just the facts, er,
evidence…

13. Evidence is predicated on
clinical outcomes

16. So, evidence-based practice ROCKs!
Right…?

18. Half of what is taught in medical school will be
wrong in 10 years’ time, the problem is we
don’t know which half.
Sydney Burwell, MD, former Dean,
Harvard Medical School

19. It took an
average of 17
years for new
knowledge
generated by
RCTs to be
incorporated
into practice.
–IOM

20. Not a problem of too little,
but too much

21. Just for Coronary Heart Disease…
• 3600 statistical articles are published
on average each year
• Do you know how long it would
take you to keep up…?

24. If you read 1 article/15 minutes
You would have to read >10
articles
For 2 hours/day
7 days/week
Forever…

25. OK,
So,
now
WHAT?

26. It’s about
tech…

28. Onset
Location
Duration
Character
Aggravating/Alleviating
Relieving factors
Timing & severity

29. Got an image?
Onset
Location
Duration
Character
Aggravating/Alleviating
Relieving factors
Timing & severity

30. • 75% hit rate for NEJM’s
weekly puzzler via
cut-and-paste
• 96% if fill in the fields

31. There are a number of resources
available

34. EvidenceUpdates
• A joint collaboration of
BMJ Group and the
Health Information
Research Unit at
McMaster University
• Best new evidence
tailored to your interests.
• 2-step process shrinks
~50,000 articles/year
(from >140 clinical
journals) down to the
most important 1 - 2
articles per month
= "noise reduction" of
over 99.9%.

37. And, wouldn’t it be cool if surgeons could
have their latest post-op protocol available
to their rehab-referrals?
They already do (and for free).

41. And I have been doing some
experimenting….

42. I was always frustrated with the
disconnect of getting evidence-based
practice in real-time to the clinician
while with the patient

43. But we may have
cracked the code

44. PRN Tx
Guideline
Consult (brought to
you by your EMR)

46. As a nice side-effect of
building this we found…

59. And now for something
completely different…

63. It’s about
tools…

68. Curated Library

77. >15,000 prior-managed bills were loaded and rerun
against the ODG Treatment UR Advisor for each ICD9CPT combination on frequency, number of visits,
recommendations from ODG Treatment, and the "Bill
Review Payment (or ODG Approval) Flags" divided
into Green, Yellow, Red…

78. Green, OK to auto-pay up to ODG Codes for
Automated Approval max number of visits;
Yellow, OK to auto-pay up to 25th %tile
number of visits
Red, need to review

80. Evidence-based practice is sort of
like MoneyBall

81. Evidence-based practice is not…

82. Evidence-based practice is not…

84. Please be in touch
Chris.Stout@ATIPT.com
or visit DrChrisStout.com and get
these slides (and a lot more)