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Better data quality


Why does standardising matter?


Functional health is one of the most direct measures of a person’s health related quality of life. It’s a key measurement across healthcare, particularly for older adults. A person’s functional health is made up of a complex combination of several factors from motor function to cognitive ability. Assessing it in a way that gives the same results between different raters (inter-rater reliability), between different patients of the same ability (intra-rater reliability) and even repeating with the same assessor and the same patient (test-retest reliability) is extremely difficult with manual tools.


To combat this fact over the last 50 years since the first formal functional assessment was introduced over 40 new assessment tools have come into widespread use. None of which receive any more assistance from technology than the ones before. The image below shows the breadth of tools available, all aiming to measure functional health. Whether through questionnaires, performance based measures or a combination of both.



This image shows how fractured the system of assessment tools has become [1]. The fact that researchers and clinicians have continued to introduce new tools with the same aim over and over again shows that none of those introduced thus far are considered good enough for use as a gold standard across healthcare.


On top of this available questionnaire based assessments suffer from biased answers and floor and ceiling effects and performance based measures have poor sensitivity....but we’ll save that for another article.


What Vitrue Health is doing about it


Vitrue is aiming to use technology to finally provide tools to clinicians that can reliably measure a patient’s functional health in a standardised way. Our device accurately, sensitively and repeatably measures patient motor function but we also provide software to help capture contextual information. Our goal is to provide tools that directly measure the things technology can measure and provide a way for clinicians to efficiently capture the things technology can’t.


For example, our computer vision based algorithms can sensitively measure the exact range of motion of the shoulder joint and how it has changed pre and post operation.


But it can’t measure contextual information about that injury. Is the patient in pain, is the injury preventing them from completing their daily tasks and are there any constraining factors for their rehab such as cognitive issues. For these insights, Vitrue provides modern digital tools to help clinicians to capture this important information in an efficient and standardised way.


Adding this standardisation and quantified motor function data to patient pathways in no way replaces the vital knowledge and experience brought by occupational and physiotherapists. Our technology does not make decisions on treatment and rehabilitation plans or automatically capture the complex contextual information. What it does do is provide these highly trained clinicians with higher quality information empowering them to make better decisions that ultimately lead to improved patient outcomes.


Investment in occupational and physiotherapy services in healthcare leads to reduced length of stay [2], reduced readmission rates [3], reduced falls [4] and improved patient quality of life [5]. With the value Vitrue provides, these advantages could be magnified even further.


If you’re an occupational therapist, a physiotherapist or other clinician who’d like to hear more or see a demo get in touch! We’re always keen to talk!



References:


[1] Lowe, S. A., Rodríguez-Molinero, A., Glynn, L., Breen, P. P., Baker, P. M. A., Sanford, J. ÓLaighin, G. (2013). New technology–based functional assessment tools should avoid the weaknesses and proliferation of manual functional assessments. Journal of Clinical Epidemiology, 66(6), 619–632. https://doi.org/10.1016/j.jclinepi.2012.12.003


[2] Hartley, P. J., Keevil, V. L., Alushi, L., Charles, R. L., Conroy, E. B., Costello, P. M., … Romero-Ortuno, R. (2017). Earlier Physical Therapy Input Is Associated With a Reduced Length of Hospital Stay and Reduced Care Needs on Discharge in Frail Older Inpatients. Journal of Geriatric Physical Therapy, 1. https://doi.org/10.1519/JPT.0000000000000134


[3] Rogers, A. T., Bai, G., Lavin, R. A., & Anderson, G. F. (2017). Higher Hospital Spending on Occupational Therapy Is Associated With Lower Readmission Rates. Medical Care Research and Review, 74(6), 668–686. https://doi.org/10.1177/1077558716666981


[4] Johnston, K., Barras, S., & Grimmer-Somers, K. (2010). Relationship between pre-discharge occupational therapy home assessment and prevalence of post-discharge falls. Journal of Evaluation in Clinical Practice, 16(6), 1333–1339. https://doi.org/10.1111/j.1365-2753.2009.01339.x


[5] Huri, M., Huri, E., Kayihan, H., & Altuntas, O. (2015). Effects of occupational therapy on quality of life of patients with metastatic prostate cancer. A randomized controlled study. Saudi Medical Journal, 36(8), 954–61. https://doi.org/10.15537/smj.2015.8.11461

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