In this Sports Medicine Weekly interview, Dr. Chris Stout, Vice President of Clinical Research and Data Analytics at ATI Physical Therapy, discusses how ATI is leveraging large‑scale patient‑reported outcomes (PROs) and advanced analytics to improve rehabilitation. He explains that ATI collects PRO surveys from virtually all patients across its clinics, capturing pain, range of motion, function, and activity levels at intake, during treatment, and at discharge. The aggregated data feed machine‑learning algorithms that aim to predict which patients may become non‑compliant, allowing early interventions to reduce dropout rates. Stout highlights a collaborative project with Duke University to develop such predictive models. The conversation also covers the shift toward value‑based care and bundled payment models, where physical therapists must demonstrate high‑value outcomes in fewer visits. Both Stout and Dr. Brian Cole note that objective data, rather than intuition alone, will increasingly drive clinical decisions, aligning with broader initiatives like the Precision Medicine Initiative. The interview underscores the growing importance of data‑driven, patient‑centric approaches in physical therapy.
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Welcome to Sports Medicine Weekly on 670 the Score, your on air resource for fitness, nutrition and injury prevention and treatments for today's weekend warrior and professional athletes with renowned specialist of elbows, knees and shoulders, Dr. Brian Cole, along with other health and fitness leaders and your host, Steve Cashel. Sports Medicine Weekly heard every Saturday morning at 8am right here on 670 the Score.
We're visiting this morning with Dr. Chris Stout who is with ATI. And Steve, this is an interesting approach because we often don't think about some of the physical therapy companies and franchises as really getting heavily into data or analytics or even measuring outcomes. And I can tell you now when the financial responsibility now is falling on the practitioners as they're sort of controlling healthcare in terms of utilization, when it falls in the hands of the patient who has more financial responsibility, it's really more important than ever that all the decisions we make when we're delivering healthcare have some evidence behind them. So very excited to have Dr. Stout on this Morning who's with ATI. And until this morning, Chris, I got to tell you, I didn't know that ATI had ventured into this concept of sort of data analytics and objectively looking at outcome metrics and data pertaining to patient care and the medical condition. So great to have you on this morning. What is, what is your primary focus and how do you sort of interact with the data that you guys are collecting and trying to make a difference with patient care and rehabilitation?
Well, thanks. It's good to be on the show, you guys. Thank you. Our key thing is being able to take a look in a very consistent, quantified kind of way of how our patients get better. We take all comers into our clinic. So everybody may have a similar kind of diagnosis around their knee, but their age, their activity level, other kinds of, of lifestyle issues and medical history issues will make a difference in how that patient gets treated as an individual. So my job is to take a look at all those different cases, all those different kinds of clients throughout all the different clinics with all the different kinds of therapists we have and see what are the key kinds of things that help those patients get better.
Okay, so first of all, these are studies that you're doing now on the entire patient population that comes through ati, or are these through the guys of specific research where you're defining a population and looking at them specifically?
No, it's more so the former. We are taking all the patients. Of course, a patient has an option to not have data collected or not want to have that data shared, but we have a pretty good response rate of people wanting to be engaged and have those instruments done. They're called pros, which is called A or, which stands for patient reported outcomes. So they're just basically survey instruments. But there's a real push in medicine and healthcare and rehab now to have the patient's perspective, the patient centric focus in terms of how they're feeling, how is their range of motion, how is their level of pain, how is their functionality and whatever it is they're doing, their activities of daily living, or if they're weekend warriors and athletes or what have you. So we collect those data at the beginning of care, throughout an X number of visits, during the time of their care and then at discharge, and get a complete picture and profile for how their care went as well as other kinds of health history and how that impacted how their treatment went.
Visiting with Dr. Chris Stout, ATI Physical Therapy. I'm Steve Kasha with Dr. Brian Cole. This is Six Seventy the Score. Listening to sports Medicine weekly talking about how predictive analytics and machine learning are changing health care. And I was doing some research on you, Dr. Stout, to prepare for this segment. Then I see this phrase here, machine learning, what does that mean?
Basically, it's the ability to have what are called algorithms. So you might think of them as formulas or programs to be able to have more information come into them and then come out with a different kind of outcome, a different kind of decision. So there's actually a learning process with the more kinds of data and information that come into that program to be able to make a better prediction. So to take it out of the realm of medicine for a second, you might think about how does the Weather Channel predict the weather, Lick their finger and stick it out the window and see which way the wind's blowing. They look at pressure systems, they look at historic data, they look at temperatures, they look at water temperature. So there's a variety of different kinds of metrics, a variety of different kinds of variables that come into play to have them say, what's it going to be doing at 9 o' clock today and 10 o' clock today and 11 o' clock today? And that same kind of programming, if you will, or algorithm or machine learning process is being applied to medicine and healthcare primarily, at least at this point. There's been a lot of success in the diagnosis, but I think we'll start to see it being applied more in treatment approaches and as Dr. Cole said, in treatment decision making.
Tell me we're going to have to wind down. But I want to know, take it home in terms of something that you in the near term will do that you think will have an effect in how you utilize therapy indicated for certain patient groups and so forth. What are you finding most interesting in the data collection and looking at it so far as far as making decisions going forward?
I would say maybe two things. One on the kind of quasi non clinical would be that we're working collaboratively with Duke University to have a predictive algorithm that says identify what patients may not be compliant with care so that we can perhaps intervene earlier and not have as high a dropout rate in certain kinds of clinics and situations and payer sources on the other side. I think as we move more towards value based care rather than traditional fee for service kinds of things, that we'll see the responsibility on physical therapists to be able to provide the best value, the best outcomes within the shortest number of visits and be again able to keep that at a patient centered kind of approach.
Again, we're visiting with Dr. Chris Stout, ATI Physical Therapy. Dr. Koh, I had a question for you. So taking what Dr. Stout is doing with ATI and some of the predictive analytics, how does that help you then as a doc? I mean, do you guys ever work directly with some of these physical therapy facilities and companies?
Yeah. So the way that I see it, and it's sort of, when we talked about it initially, I think that what you may not know, Steve, is that a lot of healthcare is going to be delivered in what we call bundles. In other words, a small number of parties, stakeholders at the table, will control the entire healthcare initiative. So let's just say you need a joint replacement. It may come to pass that a hospital or an orthopedic group would come to someone, maybe it's the government, CMS or what have you, and say this is the price in totality for your joint replacement. It includes the preoperative assessment, it includes the surgical experience, it includes the anesthesia, the implant and all the post operative physical therapy. So all of a sudden you're asking the hard questions. If you're given one aliquot of money to manage all of this, right. And cover the expenses and take into consideration all the risk associated with it. You have to know if doing physical therapy, for example, makes a difference.
Sure.
And like you alluded to, if patients are not compliant, does that compromise their outcome? Does that send them back to the emergency room where they end up with another surgery? So I think that what I can tell you, kudos to ATI for taking this seriously because I'm not aware of this type of approach on an ongoing basis in a physical therapy space. Usually these are initiatives that happen in an academic center and so forth, but they're super important. Yeah, they're complicated and they may be complicated for our listeners to understand. But the bottom line is that everyone is paying attention to what he says. Pros, patient reported outcomes and data drives all of our decision making. It's not an art necessarily in every respect. We can actually get objective data to make decisions within the best interest of our patients. And now when the pocketbook is brought into the equation, it's become much more complex and we're all fiscally respons super important stuff and things that I think you and I are going to be hearing a lot about in the near future.
Final thoughts. Dr. Stout?
Yeah, I just want to echo what Dr. Cole said. I think these are becoming more and more present in a variety of different kinds of systems. At the wind down of President Obama's administration, he came up with something called the Precision Medicine Initiative, which I think is sort of a harbinger. It still exists in the current circumstances. And I think these kinds of things, Medicare, we'll start to pay attention to and we'll see a lot of I think innovative kinds of approaches using data based kinds of decisions.
Wonderful stuff. Appreciate it. Dr. Chris Stout from ATI Physical Therapy. He is the vice president, Department of Clinical Research and Data Analytics. Thanks so much, Dr. Stout, for joining us here on Sports Medicine Weekly.
My pleasure, gentlemen. Thank you.
We're back with more of our show after these messages.
