THE DEVELOPMENT, IMPLEMENTATION AND APPLICATION OF A NATIONAL PHYSICAL THERAPY CLINICAL REGISTRY IN THE NETHERLANDS

F. Driehuis¹, C. Weymans¹, G.A. Meerhoff¹

¹Royal Dutch Society for Physical Therapy (KNGF), Quality Improvement, Amersfoort, Netherlands

Background: Over the past decade there has been a growing interest in the use of data in healthcare, including physical therapy (PT). In 2013 the Royal Dutch Society for Physical Therapy (KNGF) started the development and implementation of their national quality program ‘Quality in Motion’.

Purpose: The aim of this program was to establish a system that stimulates patient-centered care and improves the efficiency and effectiveness of PT care. A key element of this program was the development of a national clinical registry.

Methods: Since 2013 the KNGF has built and maintained a technical infrastructure for the national clinical registry; the National Database Physical Therapy (‘LDF’). The LDF collects data directly from the electronic health record system of participating physical therapy practices. This includes data on the process of PT care (e.g. record keeping) and outcomes of PT care (e.g. patient-reported outcomes [PROMs] and performance tests). Data collected in the LDF are converted into tailored information for PT practices and physical therapists and presented in a user-friendly Dashboard. The Dashboard provides direct feedback information to the physical therapist and PT practice and thereby enables comparison of the practices’ data with a national and regional benchmark. The main objectives of the LDF are
1) quality improvement of physical therapists and PT practices,
2) policy development and advocacy, and
3) scientific research.

Results: Currently the LDF contains data of 7 million patients, > 3000 physical therapy practices and > 20.000 physical therapists. Moreover, it contains 21 million outcome measurements of PT treatments and over 50 million unique treatment sessions. The LDF is the largest clinical registry on physical therapy, in the Netherlands, and is a key element in the KNGF quality registry for physical therapists.
The KNGF also uses the LDF for advocacy and lobby towards national politics to strengthen the position of physical therapy in national healthcare and society. Moreover, data of the LDF are used in negotiations with healthcare insurers and in order to achieve higher reimbursement of physical therapy. Specific examples are presented in detail during the presentation.
Another important aspect KNGF focuses on is the implementation of the (use of) data and the Dashboard within the Dutch PT practices and increase knowledge on its value for (quality of) healthcare. The Dashboard is used to stimulate continuous professional development of PT practices and physical therapists and to facilitate quality improvement, for example by using the data in peer assessment. The KNGF aims at continuous development of the LDF and the related Dashboard.

Conclusions: The LDF provides valuable insights to physical therapists, PT practices and the KNGF. Using various methods, the KNGF uses the LDF to improve quality of patient-centered PT care, to stimulate continuous professional development, to perform scientific research on PT care, and to strengthen the position of PT in national healthcare.

Implications: Further development will focus on broader implementation of the LDF within national quality registries, building knowledge on how to use data within PT practices, and future use of data to stimulate adequate reimbursement of PT care.

Funding acknowledgements: This work is not funded.

Keywords:
Clinical registry
Continuous professional development
Big data

Topics:
Innovative technology: information management, big data and artificial intelligence
Professional issues
Education: continuing professional development

Did this work require ethics approval? No

Reason: Ethics approval was not required.