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SANE AND FLR: A PAINLESS AND TIMELY OUTCOME MEASURE?

 
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SANE AND FLR: A PAINLESS AND TIMELY OUTCOME MEASURE? - April 7, 2014 4:44:12 PM   
RehabEdge

 

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Posted with permission from IN TOUCH PHYSICAL THERAPY BLOG for RehabEdge Forum discussion

By Harrison Vaughan

The FLR (Functional Limitation Reporting) is upon us at full force. For those therapists out there who do not see a high Medicare percentage like I do…well I don’t like you. Our front desk and therapists don’t work on the sexagesimal system (timekeeping in a base of 60 such as minutes/seconds) but in units of 10 and 30. (FLR due every 10th visit or 30 days, whichever is first and lucky for us, they never fall on the same time). If you want to get paid, get used to it.

I am not the first, and certainly not the last, to pout about more paperwork. My patients frown more, seemingly to be less at their current disability; but at the “re-eval day” when I bring out the standard clipboard, pen and paper (aka an outcome measure such as neck disability index, oswestry, DASH, etc). Its grunt time to pull out the reading glasses and answer research devoted tools that say they assist in clinical outcomes.

I have always brought out an old school method by asking my patients, “from 0 – 100%, where do you put yourself currently in regards to your prior level of function?”. I thought I made it up and felt smart, but it is actually an outcome measure used in research. Therefore, I’m behind the times like usual. It is called the Single Assessment Numeric Evaluation, or SANE.

The SANE is an outcome measurement tool used to record the patient’s self-reported function. It is implemented on a scale of 0-100 and correlated with a scale of function from 0-100%. The 100% representing full function (or function prior to injury) and 0% representing no function.

The SANE takes seconds, doesn’t require me to scan in another document into a patient’s chart, is functional for the patient sitting in front of you, can be adjusted for any region of the body, and overall makes sense. I would say the SANE is a “painless and timely outcome measure”.

The question remains, does this outcome measure (which has only been correlated to work well with established knee and shoulder outcome measures and doesn’t have an MDC or MCID) work for Medicare’s FLR?

For those who treat Medicare patients and have to fill out the FLR, don’t you think the SANE most closely correlates with FLR percentages than say, an Oswestry?
Post #: 1
RE: SANE AND FLR: A PAINLESS AND TIMELY OUTCOME MEASURE? - April 8, 2014 10:15:53 AM   
Tom Reeves DPT ATC

 

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I have used that for years and didn't know that it had a name. I would say that with some it correlates, with some it doesn't. On those patients who catastrophize, it has no correlation. ("I'm no different" then find that the questionnaire shows a 30% improvement, or the reverse can be true on the polly anna patient (I'm 90 % better! then their DASH is the same as before) I would say that it is interesting but I wouldn't put any scientific value on it. my two cents.

(in reply to RehabEdge)
Post #: 2
RE: SANE AND FLR: A PAINLESS AND TIMELY OUTCOME MEASURE? - April 8, 2014 11:16:38 AM   
Harrison Vaughan

 

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From: Harrison
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Hey Tom,
Yeh I didn't know it was a standardized form too. I agree it has its limitations, just like any test. I would say for the most part it can be effective and considering no time lost hardly, I find it works well.

Harrison

(in reply to Tom Reeves DPT ATC)
Post #: 3
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