Physical therapy
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== A Survey of the Problem and Threat of Recording in Physical Therapy. (2011) ==
Technopreneurship and Innovation management Program, Graduate school, Chulalongkorn University, Thailand
- Authors
1. Wiwat Amornvanichkij - M.Sc. Student, Technopreneurship and Innovation management Program, Graduate school, Chulalongkorn University e-mail: wiwat.a@hotmail.com
2. Nithima Purepong - Assist.Prof., PhD., Physical Therapy, Faculty of Allied Health Science, Chulalongkorn University, e-mail: vnithima@chula.ac.th
3. Pakpachong Vadhanasindhu - Assoc.Prof., PhD., Technopreneurship and Innovation management Program, Graduate school, Chulalongkorn University, e-mail: pakpachong@hotmail.com
เนื้อหา |
Abstract
Most common problems of descriptive explanation for the physical examination in physical therapy seem to create the variation in interpretation and miscommunication. Purposes of this study were to survey difficulty and complication in the use of physical therapy record on body chart, physical examination and progress note and to study the need for innovative web application prototype format for recording physical examination in physical therapy. Seventy-eight participants out of 81 hospitals, with physical therapy department or unit, in Bangkok were the sample of mailed questionnaire survey.Forty-four respondents (56.41%) indicated that difficulty in reading handwriting was the most common problem of recording on body chart (72.73%) and physical examination (81.82%). The most common threat of recording progress note was no statistical analysis at once (77.27%). The sample surveyed has never experienced web application for recording physical examination in physical therapy (95.45%). Most respondents needed for innovative web application prototype format with statistical reassessment (90.91%) and fast processing (84.09%). The information and communication technology utilizing in this innovative web application prototype would help solve the problems and threats of recording physical examination in different layers of anatomical system of the human body such as skin, muscle, skeleton and inner organ as well as being beneficial to physical therapy profession.
Keywords
Human anatomy, Physical examination, Physical therapy, Progress note, Web application.
Introduction
The descriptive explanation for physical examination in physical therapy by personal handwriting seems to create the distorted interpretation and miscommunication. The disadvantage of marking the point of symptom on body chart is unable to specify any layers of anatomical human – skin, muscle, skeleton and inner organ layer (Moore, 1992). Barry et al (2006) found in his pilot study that electronic form was easier to use and learn than paper form. Buyl and Nyssen (2009) created the framework to transfer information for recording in physical therapy by web application with eXtensible Markup Language (XML).
Two companies started to offer web application service for recording physical examination in physical therapy with orderly managing patient document, including patient appointment and billing, were introduced in United States of America and Canada (Hand On Technology Inc. and Web PT Inc., 2010). The researcher initiated and developed the innovative web application for recording physical examination in physical therapy based on 2 studies and 2 companies above.
This study aimed to survey difficulty and complication in the use of physical therapy record on body chart, physical examination form and progress note and to study the need for an innovative web application prototype format for recording physical examination in physical therapy.
Methodology design
- Data collection
There are 81 hospitals in Bangkok that have physical therapy department or unit. Three hospitals do not separate physical examination in physical therapy record from medical record. Thus, 78 hospitals with physical therapy record were the sample of mailed questionnaire survey, during July 15 to October 15, 2011, to identify the problems and threats of recording in physical therapy.
The questionnaire was divided into 2 sections. The first section concerned with the basic information of participants and satisfactions of routine physical therapy record. The second section covered the needs for web application format for recording physical examination in physical therapy and suggestions.
- Respondents
Forty-four respondents out of 78 participants (56.41%) were gathered after 3 times follow-up by visiting, e-mailing or phoning.
- Data analysis
This study analyzed qualitative and quantitative data with Likert scale, frequency, percentage and rank of the problems and threats in the use of physical therapy paper form and the needs for innovative web application prototype for recording physical examination in physical therapy.
Results
Most respondents (86.36%) were female. Eighty-four percent of the respondents work in private hospital, 14% work in public hospital. More than half (55%) of the hospital surveyed have physical therapy unit or department with 1-10 beds, 34% with 11-20 beds, 9% with 21-30 beds and 2% with 31-40 beds.
The problems of recording on body chart as details shown in Table 1 depicted that difficulty in reading handwriting (72.73%) was the most common problem. Recording with incomplete explanation (61.36%) was ranked the second. Concerning with marking problems, marking in the non specific point accounted for 36.36%, unclear marking 25.00% and marking at the wrong point 18.18%.
The problems of recording physical examination on physical therapy form was difficulty in reading handwriting (81.82%), ranked the first as the most important problems. Recording with incomprehensive symptom (72.73%) was ranked the second important problem.
The threat of recording progress note was no statistical analysis at once (77.27%) and difficulty in analysis with incomprehensive record (75.00%) was ranked the second important threat.
Almost all of the sample surveyed (95.45%) have never experienced the web application for recording physical examination in physical therapy. Two hospitals have experienced the web application. The first private hospital is developing web application for recording physical examination in physical therapy for internal department. The second hospital has ever seen in the hospital in United States of America.
The needs for innovative web application prototype as details shown in Table 2 illustrated that 90.91% needed the innovative web application prototype with statistical analysis, 84.09% emphasized on fast processing. Connecting to institution’s database was ranked the third important (81.82%). Complete human anatomy chart accounted for 79.55%. Many concurrent users and orderly managing data were ranked the fifth (77.27%).
Table 1 - The Problems and Threats of Recording Physical Examination
List --------------------------------------------- Frequency -- Percentage -- Rank
- The problems of recording physical examination on physical therapy form
Difficulty in reading handwriting ________ 36 _______ 81.82 _____ 1
Recording with incomprehensive symptom ____ 32 _________ 72.73 ______ 2
Recording with incomplete language __________ 7 _________ 15.91 ______ 3
A little time for recording ___________________ 1 __________ 2.27 ______ 4
Informal abbreviation ______________________ 1 __________ 2.27 ______ 5
- The threats of recording on progress note
No statistic analysis at once ___________ 34 _______ 77.27 _____ 1
Difficulty in analysis with incomprehensive record 33 ________ 75.00 ______ 2
Unclear collecting in folders _________________ 18 ________ 40.91 ______ 3
Recording with blank data ___________________ 1 _________ 2.27 ______ 4
Discontinuous treatment _____________________ 1 _________ 2.27 _____ 5
- The problems of recording on body chart
Difficulty in reading handwriting ________ 32 _______ 72.73 _____ 1
Recording with incomplete explanation ________ 27 ________ 61.36 ______ 2
Marking in the non specific point _____________ 16 ________ 36.36 ______ 3
Unclear marking __________________________ 11 ________ 25.00 ______ 4
Marking at the wrong point __________________ 8 ________ 18.18 ______ 5
Table 2 - The Needs for Innovative Web Application Prototype
List --------------------------------------------- Frequency -- Percentage -- Rank
Statistical analysis ___________________ 40 _______ 90.91 ____ 1
Fast processing ___________________________ 37 _______ 84.09 ______ 2
Connecting to institution's database ___________ 36 _______ 81.82 ______ 3
Complete human anatomy chart ______________ 35 _______ 79.55 ______ 4
Many concurrent users _____________________ 34 _______ 77.27 ______ 5
Orderly managing data _____________________ 34 _______ 77.27 ______ 5
No limit memory __________________________ 32 _______ 72.73 ______ 7
High data security _________________________ 26 _______ 59.09 ______ 8
Beautiful human anatomy chart ______________ 17 _______ 38.65 ______ 9
Less time for recording _____________________ 1 ________ 2.27 ______ 10
User friendly ______________________________ 1 ________ 2.27 ______ 10
Discussions
The survey results indicated that the problems of recording physical examination on physical therapy paper form and body chart were difficulty in reading handwriting, recording with incomplete language and explanation, incomprehensive symptom, unclear marking, marking in the non specific point and marking in the wrong point. The threats of recording on progress note were no statistical analysis at once, difficulty in analysis with incomprehensive record and unclear collecting data and related document in folder.
Recording by personal handwriting, incomprehensive symptom and incomplete explanation affected to the distorted interpretation and miscommunication for analysis, reassessment and treatment.
The innovative web application prototype for recording physical examination in physical therapy is necessary to solve the mentioned problems and threats from the survey. From literature review, 2 studies supported the innovative web application for recording physical examination in physical therapy. Barry et al (2006) found that electronic form was easy to use and Buyl and Nyssen (2009) created web application with eXtensible Markup Language (XML). The innovative web application prototype with orderly managing data would help solve the difficulty and complication in the use of physical therapy paper form and reduce time for recording.
The development of the program characteristics will be based on the top 5 rank of needs for innovative web application prototype from this survey. This innovative web application for recording physical examination in physical therapy will be easy and convenient to use that would help increase time for treatment, save cost with paperless for patient document and can be accessed in anytime and anywhere.
The information from this study was the preliminary data in developing the innovative web application prototype. Furthermore, the needs for innovative web application, with no limit memory, high data security and beautiful human anatomy chart, should be developed to be the excellent web application for recording physical examination in physical therapy.
Conclusion
The difficulties and complications of physical therapy record in physical examination on body chart, physical examination form and progress note demand for the information and communication technology utilization. This innovative web application prototype would help solve problems and threats with marking in different layers of anatomical system of the human body such as skin, muscle, skeleton and inner organ and statistical analysis. Besides, it is beneficial to physical therapy profession and serves mission of physical therapy council (2011), to develop efficient and modern information system in physical therapy.
Acknowledgement
We are grateful for the co-operation and good information from all respondents.
References
1. Moore KL., Clinical Oriented Anatomy. 3rd ed. Baltimore: William & Wilkins, 1992.
2. Chentanez, V., Tansatit, T. and M. Human anatomy. 3rd ed. Bangkok: Feungfa publisher, 1996.
3. Purepong, N. Human anatomy in upper limb, lower limb and back. 1st ed. Bangkok: Taweechot publisher, 2011.
4. Barry et al. Electronic clinical records for physiotherapists. The internet journal of allied health science 2006. Volume 4 No.1 (January 2006).
5. Buyl R. and Nyssen M. Structured electronic physiotherapy records. International journal of medical informatics. Volume 78, Issue 7 (July 2009): 473-481.
6. Hand On Technology Inc. Practice management. [Online], 2011. Last search from http://www.rehabsoftware.com. [2011, December 25].
7. Web PT Inc.. Why WebPT?. [Online]. 2011. Last search from: http://www.webpt.com, [2011, December 25].
8. Physical therapy council. [Online]. 2011 Last search from: http://www.pt.or.th/visai.html, [2011, December 25].
