Why good data matters
When a person has a serious medical event, like a stroke, a major injury, or a complex surgery, their recovery journey is just beginning. Rehabilitation, which includes services like physical therapy, occupational therapy, and speech therapy, is the essential step that helps them regain their ability to walk, talk, and live an independent life.
Globally, the need for these services is growing. The World Health Organization (WHO) has identified this as a major priority, encouraging all countries to integrate rehabilitation into their core healthcare systems.
Georgia has made significant progress in this area. The country has a legal framework for providing these services and, in 2022, took the landmark step of including adult rehabilitation in the Universal Healthcare Program (UHCP). The new National Strategy for 2023-2027 shows a commitment to improving care.
However, to fully achieve these goals, a key challenge must be addressed: the data is not consistent.
Currently, information about rehabilitation services is collected in different ways by different service providers. This makes it difficult to get a clear, complete picture, which is essential for planning where to build new services, how many therapists to train, and which treatments are the most effective.
Our study aimed to assess the adequacy of the HIS for rehabilitation in Georgia to support the planning, monitoring, and expansion of rehabilitation service developments in the country.
How we assessed the situation
To get a comprehensive understanding, our research team used a two-part approach:
- We reviewed all the official government laws, regulations, and policy documents related to health information system. This showed us how the system is designed to work on the study.
- We conducted 24 in-depth interviews with the people who use this system every day. This included doctors, therapists, and managers at six different rehabilitation facilities (four funded by the UHCP and two private clinics). We also spoke with two key policymakers to understand the view from the national level.
What we found
We found a system that has grown over time, with different parts being added as new needs arose. This has led to four main challenges, which are all opportunities for growth.
First, the information is fragmented. We found that dedicated service providers spend time entering similar patient information into different, unconnected systems for different agencies. This creates a heavy administrative burden and means that all the valuable data isn’t stored in one place.
Second, much of the data “can’t be read” by the system. We found that some of the most critical information, like a patient’s actual progress, is often saved in a unstructured format (PDF file). A human can read a PDF, but a computer cannot analyze the data within it.
Third, to compare health outcomes, everyone needs to be “speaking the same language.” In healthcare, this means using standardized “codes” to describe a diagnosis, a treatment, or a patient’s level of function. We found that while a standard code for diagnoses (ICD-10) is used, there is no single, unified system for coding rehabilitation interventions or, most importantly, a patient’s functional status. While government-funded clinics are required to use a tool called the Functional Independence Measure (FIM), other clinics may use different tools or none at all. This lack of standardization makes it difficult to compare outcomes or identify which treatments are most effective.
Finally, a similar challenge exists for data about the healthcare workforce. Information on doctors, nurses, and therapists is also collected in different, overlapping systems. This fragmentation makes it challenging to get a simple, real-time answer to a question like, “How many physical therapists are currently working in the country?”.
Turning data into action
Georgia has already taken big steps by making rehabilitation a national priority. The next step is to ensure that rehabilitation data is standardized, digital, and connected.
Addressing these gaps requires a standardized data collection framework emphasizing programmatic and functional outcomes, patient-centered measures, and the comprehensive use of existing electronic systems.
By improving how data is collected and shared, Georgia can make better decisions about where to invest, which programs to expand, and how to help people recover faster and live more independently.
Authors: Nino Kotrikadze, Akaki Zoidze, George Gotsadze
