Ivy IE
The three pillars of the Ivy IE are.
1. Comprehensive Assessment
2. Addressing the chief complaint day 1 (symptom modulation)
3. Closing the Loop
What 3 things will the My Ivy Care app bring into one place for a better patient experience?
HEPs, Outcomes questionnaires and RTM/patient engagement features
This year, Ivy invested in this important initiative to support driving quality care and consistent clinical outcomes.
Clinical Care Meeting
These two patient centric metrics recently replaced the traditional SFQ measure.
% Kept 2+
% Scheduled 2+
True or False: We do not need to worry about clinical outcomes currently because we are switching our platform from FOTO to My Ivy Care - PROMIS in Q4.
FALSE
75%+
What is the percentage of patients that actually complete their HEP through their POC?
30-35%
What report has been shown to drive a 2x improvement clinical outcome score across a 3 month pilot that CDs currently have access to.
The CCM report
Updated biweekly
Kara's biweekly CCM emails linked
Why was the SFQ measure updated this year?
The previous measure was aggregate data for an entire clinic with no insight into patient level data.
Vulnerable underdosed patients were going unnoticed.
Name 3 benefits of Remote Therapeutic Monitoring (RTM).
RTM extends care beyond the clinic, boosts patient engagement, improved clinical outcomes, improves adherence, improves arrival rate to POC appts, and new billing opportunities, is more convenient and patient-centered.
The AVR model is part of the Ivy Comprehensive Evaluation pillar. What is the AVR model?
Awareness
Validation
Response
What outcomes tool will be replacing FOTO later this year?
PROMIS
BONUS: Patient-Reported Outcomes Measurement Information System (PROMIS) is an NIH-funded initiative to develop and validate patient reported outcomes (PROs) for clinical research and practice.
better more comparable scientific rigor, efficiency, and broad applicability in a way that many traditional measures cannot match
What are 3 things a clinician can do to improve their outcome scores?
utilizing the tool. Now let’s make sure the clinical decision making is driving the outcomes we want.
Ask yourself reflective questions:
Are goals and interventions aligned with the patient's functional limitations?
Are we dosing the plan of care (frequency, intensity, duration) in a way that supports outcome improvement and is evidence based?
Are there common themes in patients with lower scores (e.g., chronicity, fear avoidance, low engagement)?
Look for:
Under-dosing (too few visits)
Late discharge planning (overextending care after goals are met)
Lack of progressions or delayed progression of interventions
Review Specific Cases Together
Pick 2–3 recent patient cases with poor outcomes.
Walk through the clinical decisions, outcome score trends, and any roadblocks to progress.
Set a Targeted Action Plan
Shadowing a peer with high outcomes
Utilizing Medbridge for specific clinicla reasoning or body parts based on FOTO scores
Doing a weekly case review together
Setting a 60-day check-in to review new cases and outcome trends
The calculations and measures changed this year for SFQ but the clinical "why" behind the metric remains the same. What is the why?
Minimum Effective Dosage:
•Standard rehabilitation requires 2–3 visits per week at the right intensity to induce therapeutic change. Below this threshold, the physiological stimulus is too weak to trigger adaptation—prolonging recovery and yielding suboptimal outcomes.
The Goldilocks Zone:
•Consistently keeping patients at 2+x/week maximizes the odds of superior clinical outcomes and long-term recovery, while naturally stabilizing clinic operational health.
•
The Bottom Line:
•We aren't just managing schedules—we are protecting the clinical dose our patients need to heal.
Name 2 ways (backed by literature) to reduce clinician burnout.
Connecting "metrics" to quality care
More autonomy
Personal relationships
PTO
venting
Why is the Ivy IE an important treatment framework?
Standardization of care
Ivy data shows that patients who were provided a comprehensive, diversified treatment on IE (including symptom modulation on day 1) were 83% less likely to self discharge early.
Name 3 places can you receive My Ivy Care/Limber support?
Clinical Excellence Vine page
Ask Ivy - FAQ!
Office Hours
DCE
Explain why the Patient Specific Functional Scale (PSFS) was carefully chosen as one of Ivy's outcome measures.
“The PSFS is one of the most personalized, patient-centered tools we have. It allows patients to define what they want to get back to — and that gives us better clinical direction and stronger buy-in. It is highly validated and reliable and responsive." MCID = 2
"Let's utilize this tool as a part of our IE, making it easy for us to create 3 functional goals!"
PSFS is a valuable tool in clinical practice that allows patients to identify and rate their ability to perform specific activities that are important to them. By focusing on the individual’s unique functional goals, the PSFS facilitates personalized care and helps track progress over time. This patient-centric approach empowers individuals to actively participate in their treatment, fostering better outcomes and satisfaction. It is already a part of the clinician's IE as they ask patients about functional deficits. Using and tracking the PSFS is just a formal way for clinicians to establish functional goals and include the patient in those goals. Lastly, it provides quantifiable data that can be used to evaluate the efficacy of interventions and make necessary adjustments to the treatment plan.
When it comes to frequency + arrival rate what is Ivy's "Formula for Success" according to our data?
2x/week + 80% adherence = successful patient outcomes
What is quality improvement in healthcare?
Quality improvement is a critical strategy for improving population health and outcomes while reducing costs.
QI and nationally backed science initiatives work to ensure that research findings are effectively translated into practice, healthcare delivery is optimized, and patient care continuously evolves to meet high standards of quality and safety.
Your clinic Ivy IE % is 62%. Most of your clinicians are at benchmark of 75%. One clinician is showing 29% consistently. How would you approach this clinician?
What are their outcomes?
Curiosity
Behaviors discussion. Walk me through a typical eval for you. Do you perform a comprehensive eval?Do you address the patients chief complaint on day 1? What are your feelings on symptom modulation or manual therapy. What do you know about the AVR model?
Use the workday training as a refresh!
Use the 5 min Ivy IE video.
One of your clinicians consistently says "we have the My Ivy Care app if you want to download it" to their patients. How can you coach this clinician to improve communication surrounding the app?
This HEP phase is the first low stakes phase of getting patients to engage with the app. Eventually, we will ask all outcomes questions, NPS and even give the option for RTM. We need to ensure we capture as many patients as possible on the app now so we are successful later
In order to do that, we have to place value on it so the patient sees it's value.
✅ This helps us stay connected between visits.
✅ This gives you access to your care plan anytime.
✅ Patients who stay engaged between visits tend to get better results.
✅ We'll be able to support your progress even when you're not in the clinic.
✅ This will help us address barriers and avoid set backs
DONT SAY:
we are monitoring your compliance
this is just an option we offer
From your CCM report, you see one of your clinicians in struggling with a patient who seems to be plateauing and is 8-10 points away from meeting their predicted FOTO score at visit number 12. What is the best way to approach this discussion.
CCM
CLINICAL conversation
Reassess Intensity & Progression of Interventions
is 2x per week an appropriate dosing?
At 6 weeks post-op, Taylor should be entering more dynamic and strength-building phases.
Review current interventions:
Are exercises still low-load or passive?
Is quad strength being aggressively targeted?
Are you integrating multi-joint movements and single-leg tasks?
Update Goals
Evaluate the Home Exercise Program
Ask: Is the HEP too easy, repetitive, or not progressing in parallel with clinic work?
Taylor may benefit from:
Higher challenge level
More frequent updates
Use FOTO as a coaching and re-engagement tool:
Pull up the patient’s score trend in session.
Say something like:
“You’ve been doing everything right — showing up, staying consistent, and putting in the work. But your functional score hasn’t changed in two weeks. That tells me it’s time to shake things up a bit and give your body a new challenge.”
Why this works:
It validates Taylor’s effort.
It creates shared ownership of progress.
It uses objective data to explain the clinical need for change.
Your clinic SFQ was always around 1.7. With this new metric you are seeing your clinic % kept 2+ is around 40% (Goldilocks zone is 40-65%) with one clinician well below 40%. What is your best course of action?
Approach with curiously
use research - the first 30 days are where we see the sharpest improvement in function regardless of chronicity.
Minimum Effective Dosage:
•Standard rehabilitation requires 2–3 visits per week at the right intensity to induce therapeutic change. Below this threshold, the physiological stimulus is too weak to trigger adaptation—prolonging recovery and yielding suboptimal outcomes.
The Goldilocks Zone:
•Consistently keeping patients at 2+x/week maximizes the odds of superior clinical outcomes and long-term recovery, while naturally stabilizing clinic operational health.
•
The Bottom Line:
•We aren't just managing schedules—we are protecting the clinical dose our patients need to heal.
You are at an important lunch with a potential referral source and the physician asks you, "If I referred to you, how would I know that you provide quality care to my patients?"
"We achieve predicted benchmark scores for over 70% of our patients"
"our NPS is 95%"
"I pulled our foot/ankle patient outcomes and we achieve 90% predicted benchmark when patients complete their POC"