Our Unique Approach

Focus on Therapeutic Outcomes (FOTO)

Focus on Therapeutic Outcomes, also known as FOTO, is a web-based assessment system providing patient evaluation tools and aggregate data management services. FOTO is dedicated to standardizing industry communication about the effectiveness of care. Their database is the largest and most valid external directory for rehabilitation that measures functional outcomes for orthopedic, neurological, work hardening/work conditioning, pain management, cardiovascular, pulmonary, and pelvic floor dysfunction patients.

At Physical Therapy Associates, Inc. of NEPA, FOTO allows our physical therapists to measure improvements in patients’ functions and compare the therapists’ performance against a national benchmark. In addition, the use of this program with our patients allows us to gain evidence of functional outcomes and therefore gives the therapist critical information they need to manage their patients’ care. FOTO is risk-adjusted allowing it to be fair and accurate.

The use of FOTO in our three clinics is as follows:


At admission, we ask our patient to complete a short assessment about the functional level of the body part or impairment. We calculate the functional stats measure. This measure is usually scored 0-100, which represents the patient’s functional ability.


During assessment at admission, we also ask the patient a few “risk adjustment “questions. Questions about age, acuity, severity co-morbidities, etc., form risk factors we employ to calculate the predicted change in functional stats (predicted outcome) just after our patient completes the assessment. The predicted outcome is the average amount of change in function similar patients in FOTO’s database have achieved after treatment (at discharge). FOTO’s extraordinary large database enables us to identify large sets of patients with identical risk-adjusted profiles for our patients.


Typically we ask the patient to complete an assessment once every 4 or 5 visits, and at discharge, to track the improvement of the patient’s functional ability during treatment. The patient’s actual change in functional status measure (or actual outcome measure) is determined by simply subtracting the score at admission from the score at discharge or the latest score. This outcome score represents the improvement, or change, in function during treatment.

The implementation of FOTO into our practice has greatly improved our quality of care and has given our therapists the critical information they need to help set expectations and reasonable goals for our patients.

“Since the inception into our clinics, FOTO has put my practice a step ahead of other physical therapy clinics. We are now able to get a true picture of the various factors that could lead to poorer outcomes, such as fear of movement, high somatization, and depression.

This program allows our staff to screen for high-risk adjustments among our patient population. Our therapists can see how they are performing on a national average and become more efficient and effective with their outcomes. Bottom line is that I feel that in today’s health care climate, more effective treatment and a positive outcome is going to be instrumental in maintaining a successful practice.” – Bernard Povanda, PT, COMT

What you can expect

On your first visit, you can expect a very thorough evaluation of your problems with a highly-trained and certified physical therapy clinician.

• 60-minute personal assessment of your pain or injury
• Discussion of your personal goals
• Complete assessment of your condition
• Development of a customized rehabilitation program
• Advanced manual therapy techniques
• In-home exercise treatment recommendations
• Direct referral to a specialist if diagnosis indicates