The Development of an Outcomes Management System for Acute Medical Rehabilitation

Abstract

In 1993, Continental Medical Systems, Inc. (CMS), a provider of comprehensive medical rehabilitation, devel oped the Total Outcomes and Prediction Program® (TOPP®) to measure and evaluate key medical rehabilitation out comes, quality indicators, and patient satisfaction at its 37 acute rehabilitation hospitals. The broad purposes of TOPP® are to manage patient treatment, improve the cost-effec tiveness of care, and provide outcomes reporting for man aged care and other interested parties. The challenge was to develop a system which could measure, evaluate, and report medical rehabilitation patient outcomes in a way that could be easily understood by multiple audiences, including payers, accrediting organizations, physicians, patients and families, case managers, and CMS clinical staff. Using data from the Uniform Data System for Medical Rehabilitation database, CMS created descriptive outcomes reports for each hospital and for the corporation overall, including performance statistics, outcomes report cards, and quality report cards. These initial reports, as well as updates, quarterly reports, and special ad hoc requests, provide CMS corporate and hospital staff with statistically valid and reliable information to manage the outcomes of medical rehabilitation treatment. TOPP@ has assisted CMS with meeting accreditation standards for outcomes man agement and measurement and has been used in managed care contract negotiations. Future TOPP® efforts will inte grate resource use data, medical acuity and outcomes from acute, subacute, and outpatient rehabilitation levels into CMS' outcomes reporting system.