State of Data Tracking in Current Clinical Practic
In order to effect systemic change in practice, the right set of tools and resources needed to be available and easy to incorporate into existing practice and produce better results than what is found in current clinical practice. Here are our some of our findings about the ways current clinical practice impacts the ways in which we use data from our clinical practice.
- State of the Practitioner and Professional Culture: The practitioner’s job is often busy and stressful, brought about in part by caseload size and accountability requirements. Clinicians may or may not have training in using data for decision making. There isn’t a lot of time to fiddle with data and techniques that may or may not work. They need a collection of useful tools to make their work easier and better.
- State of the Data: Collecting clinical data in ways that is useful for evaluating clinical change is often challenging, due to the time and effort constraints noted above, unexpected changes that may occur within a clinic session, and the difficulty of rectifying clinic notes with observational data – to name a few. Transforming behavior frequencies to percentage scores, re-categorizing observations to account for new circumstances or perspectives, and noting unusual circumstances on new insights in therapy logs are commonly employed to manage the challenges of data collection. Unfortunately, this useful information typically gets recorded onto paper, which requires additional effort to re-represent theses data in ways that facilitate evidence-based decision-making.
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State of the Task: The task of “doing speech therapy” often requires the rapt attention of the practitioner (e.g., listening to speech sounds, observing behavior, engaging with the client to prompt responses, scaffolding interactions, and the like). At the same time, the practitioner must make judgements about the sufficiency of their client’s performance then record their observations of these clinically important behaviors onto some type of media (paper, computer display). Dividing one’s attention between therapy and data collection increases the difficulty of doing effective therapy, particularly in those cases where focused engagement is important. conflict with collecting data, focus on meeting accountability requirements
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State of the Technology: The means to transform and/or re-represent our clinic data are limited by the ways that we have recorded it, the technologies we use to analyze it (if any,) and how the data and/or technologies enhance or limit our cognitive-analytic abilities. Most of the time the transformational potential of our data is impeded by the amount of work required to emancipate it from the paper or Word document in which it was recorded.
Currently, there are a few tracking tools available as programs, spreadsheets, and mobile and web apps. And for those that do exist, their quality and scope vary considerably across the available tools. To date, there is no comprehensive package that provides tracking, graphing, analysis, reporting and data management capabilities.
Our Beliefs
Tracking, graphing and analysis procedures should address real clinical practice (i.e., whether a change has occurred, whether the change is important, due to the intervention, etc.), and to clearly articulate with the current agency requirements, clinic schedules and workload of the practitioner. These tools should alleviate work, not create more of it!
Here are a set of criteria for you to use when evaluating the effectiveness of a single-case tracking and analysis software.
- Enter once, represent many times and in many ways. Data should be entered one time, and immediately available to use in graphs and reports. The practitioner shouldn’t have to expend the time and effort to prepare data for accounting, decision making or presentation.
- Data needs to present itself simply and clearly. Visual distractions should be kept to a minimum. Information should be judiciously and aesthetically displayed to minimize distractions and promote concentration.
- Application controls should be intuitively locatable and only a click away. Like the data, they shouldn’t create distractions or visual noise, yet they should be easy to find and use. Tools should be available to support understanding and data driven decision making.
- Data management and reports should be easy and automatic. The system should be set up to support billing and report writing by providing you with the information you need to efficiently complete these tasks.