Table 1 Key Value-Based Principle to Include in Clinical Practice

Patient centered care

• Recognize that the needs and preferences of each patient are unique

• Use patient decision making support tools

• Patient Expectations, a critical element in patient centered care, are primary drivers to outcomes for many MSK pain conditions.

• Patient decision-making support tools allow a reconciliation between the patient and clinician.

Guideline concordant, integrated care

• Be aware of clinical practice guidelines for dedicated areas of care

• Refresh your knowledge of integrated care models such as Stepped Care and Stratified Care approaches.

• Clinical practice guidelines focus on interventions that have been shown to have a meaningful clinical effect on the condition they represent.

• Stepped care is designed to address appropriate timing, order, and frequency of care (low risk/cost before high risk/cost), which limits care from providers who provide unnecessary early invasive, expensive care options. Use of stepped care for individuals with MSK pain conditions has been shown to reduce overall costs, thus increasing value.

• Risk-stratification identifies patients in high distress who needs immediate psychologically informed physiotherapy, and may lessen treatment time and speed up return to work.

Patient Experience and Outcomes

• Routinely capture outcomes such as Patient-Reported Outcomes Measurement Information System (PROMIS) measures or the Single Alpha Numeric Evaluation (SANE)

• For patient experience, routinely capture the Consultation and Relational Empathy (CARE) or the Patient Perception of Patient-Centeredness (PPPC) questionnaire

• Patient reported outcomes are designed to reflect the patient’s current health status. By using different constructs (e.g., function, pain intensity, and pain interference), the clinician can better understand the patient’s overall progress in their recovery.

• Patient reported experience measures (PREMS) capture patients’ interactions with healthcare systems and the degree to which their needs are being met. PREMS often expose areas of the patient-clinician interaction that are poorly understood but are meaningful.

Cost Effectiveness

• Reduce the use of productivity models that reward productivity and volume

• Adopt models that are tied to correct services and outcomes

• Models that reward increased productivity are inclined to include unnecessary treatment or lower value care.

• Models that are tied to outcomes or “correct practice patterns” will still be profitable for the clinician, but will also yield positive overall results.