Accreditation and the use of outcomes-oriented information systems

Rehabilitation programs of all types and sizes must be able to use information technology to respond to both internal and external forces. One can anticipate that consumer-driven care will mean a desire for and access to more public information about health plans, specialty components of health care (eg, rehabilitation), and the quality of plans and providers. Providers need information with which to plan and manage their outcomes and resource allocation, to monitor and improve the quality of services, and to communicate with external stakeholders. The Commission on Accreditation of Rehabilitation Facilities (CARF) has for more than two decades required accredited organizations to have active outcome-oriented program evaluation systems. Yet, accreditation requirements have historically been process-oriented. This process orientation is now evolving toward an outcome orientation, both in the accreditation environment at large, and at CARF. This article describes these outcome-oriented initiatives, including CARF SCoRsSM, a standards conformance rating system under development at CARF, and a project to identify a limited, uniform set of performance indicators for rehabilitation programs. In addition, the article reflects on the significance of a potential National Information System for brain injury to the accreditation and outcomes arena.