Now physicians will have the objective tool to measure, document, and validate a patient’s functional abilities and outcome performance. Virtually all insurance companies, including Medicare, base their medical necessity determination on this functional paradigm. Functional Performance Evaluations can help justify medical necessity in an efficient and effective manner, and also provides important data to help determine how long active treatment can last by re-examining the patient periodically with subsequent Functional tests.

Standardized outcome assessments are a vital part of evidence-based practice. Selecting the most appropriate outcomes assessment, questionnaire or tool, enhances clinical practice by (1) identifying and quantifying body function and structure limitations; (2) formulating the evaluation, diagnosis, and prognosis; (3) informing the plan of care; and (4) helping to evaluate the success of interventions... (Potter et al., 2011).

Functional outcomes can be used to confirm a diagnosis. The daily SOAP notes do not provide evidence for and have never been devised for the purpose of providing medical necessity. Daily SOAP notes only explain what happened that day, how the patient is feeling or reacting to care, what procedures were performed, and what changes in the treatment plan may have happened.

Outcome assessment scales provide a concise, valid way to track function and improvement in function. Anchored numerical scales are recommended for tracking routine progress, particularly pain interference with important activities. Regional or condition functional outcome scales should be routinely used at baseline and periodic follow-ups. More frequent follow-up is recommended with higher frequency care (Washington State Department of Labor and Industries, 2014).

The first Functional Performance Evaluation is used to create a baseline of the patient’s functional abilities. This baseline test will include a comparative to population norm, inclusive of: age, gender, height, weight, and dominant side. Patented software will identify and quantify body function and structure limitation; we will provide the patient with a risk adjusted functional profile.

At a point in the future, after some treatment has happened, subsequent Functional tests are applied to track and monitor the functional changes in what is called a functional performance outcome. This comparative study can aid in treatment planning and the medically necessary treatment modifications.

Post Functional Performance testing allows for the identification of patients with lower function who would benefit from other necessary medical treatment. Subsequent Functional tests will determine functional impairments and decipher specifically whether or not these functional impairments are re-temporary, permanent, progressive, or regressive.

This scientific data will guide a patient’s short-term and long-term goals, helping justify medical necessity until the patient reaches the ultimate goal, maximum medical improvement. The use of standardized tests and measures early in an episode of care establishes the baseline status of the patient, providing a means to quantify change in the patient functioning. Outcome measures, along with other standardized tests and measures used throughout the episode of care, as part of periodic reexamination, provide information about whether predicted outcomes are being realized (American Physical Therapy Association (APTA), 2011).

Conveniently, our patented Functional Performance Evaluation program is a trans-mobile ancillary service in which we send our certified Functional Performance Technologist to your location, with our equipment, to test your patients on site, and provide back to you the results via a detailed report.

Our reports are user friendly supplying an array of comprehensive detail in a 20+ page report, as well as convenient with a quick view two-page summary. Subsequent tests include easy to access and understand comparative side by side statistics of the past two tests.

American Medical Association (AMA) guideline references are found throughout the report. We create simplified, yet detailed reports, that include a regional and full body functional profile that correlates objective functional losses with the patient’s subjective pain complaints.

We have 24 Body Profiles to choose from, covering most musculoskeletal injuries, and they include:

14 Single Profiles: Upper Extremity, Full Spine, Lower Extremity, Cervical, Thoracic, Lumbar, Shoulder, Elbow, Carpal Tunnel, Hip, Knee, Ankle, Fall Risk Assessment, MUA.

10 Combination Profiles: Hand/Finger, Cervical/Thoracic, Cervical/Shoulder, Cervical/Elbow, Cervical/Wrist, Cervical/Lumbar, Lumbar/Thoracic, Lumbar/Hip, Lumbar/Knee, Lumbar/Ankle.

*All tests are done bilaterally

We pledge that each Functional Performance Evaluation performed is done to the highest degree of medical standards as outlined by the AADEP. Our full-time, dedicated staff receives the most comprehensive in-service training available in the field necessary to develop, maintain and improve the skill sets required to perform these evaluations.

Our patented technology has built in symptom magnification tools to help determine an evaluee’s effort. An example of this is seen in our “validity of testing” which is established by the presence of three consecutive repetitions (a maximum of six trials are performed) which fall within a coefficient of variation determined by the AMA guidelines. The software will only accept readings if they fall within the coefficient of variation. It is almost impossible for a human being to purposely under-perform within a small range of variation. These tools prove the reliability and validity of the data obtained.

Functional Performance Evaluations include a series of several different exams that evaluate different aspects of functional musculoskeletal abilities, all combined into one comprehensive report. An important element in using the results of our Functional Performance Evaluation is to understand the “consistency of effort“ demonstrated during an evaluation. The patented proprietary software uses objective statistical correlations with efforts given, in order to determine whether such efforts are consistent.

Validity of testing and consistency of effort are just a couple examples of how our patented technology, with its built-in mechanisms, protocols, and machine learning capabilities, helps create our gold standard evidence-based scientifically valid functional performance evaluation. We are focused and dedicated on continuously improving our technologies, as well as innovating our quality control, to stay in front of performance based functional outcome technology.

Evidence-based medicine: The judicious use of the best current available scientific research in making decisions about the care of patients. Evidence-based medicine (EBM) is intended to integrate clinical expertise with the research evidence and patient values. (William C. Shiel Jr., MD, FACP, FACR)

This practice analysis suggests that there is substantial need to implement more consistent outcome measurement (MacDermid et al., 2013).