by Zoe Leach and John Cortes

Many athletes and service members have more than one injury, illness, or mental health issue at any given time. When using isolated systems, the tendency is to simply treat the most pressing condition in isolation, which is a hallmark of a siloed approach that fails to meet the full needs of the individual. For medical staff to provide more holistic care, they need a unified platform that enables medical and performance staff to collaborate more effectively. In this post, we’ll explore how an integrated electronic medical records (EMR) and athlete management system (AMS) helps organizations better understand the full picture and treat the whole person.

An EMR system is often set up to facilitate the treatment of a single condition, so this is what ends up happening in the present. It also allows practitioners to look back at a patient’s medical history in a retroactive way. While this can provide useful context, it encourages a more retrospective approach to delivering care. In contrast, sports teams and military units usually utilize an AMS to make data-informed decisions in the moment and apply previously learned lessons to improve health and performance moving forward. Bringing the two systems together fosters a more proactive, preventative, and holistic approach that allows subject matter experts to look beyond a single injury, illness, or incident.


Creating a Proactive, Multidisciplinary Approach

By the time an athlete or operator has an appointment with a medical professional, they’ve already got an acute injury or a chronic condition that has progressed to the point of needing treatment. But before their issue reached this stage, there may have been warning signs that presented themselves in the weight room, on the practice field, and in other settings. Having a single AMS and EMR platform allows staff to combine GPS load data, performance metrics from physical tests, and wellness information from wearables to create red flags that might indicate when a problem is developing.

This way, the performance and medical staff can get ahead of it and focus attention on high-risk individuals, rather than wasting valuable time trying to look through every individual, which is difficult in smaller organizations and virtually impossible within larger ones. A single flag might not be cause for concern, but if an athlete is rated as being at moderate or high risk in multiple categories, the appropriate subject matter experts can be automatically notified so they can intervene in a timely manner.

When relying on separate EMR and AMS systems and other disparate data sources, information inevitably gets stuck within certain disciplines and the specific databases they use within their daily workflows. This not only creates a divide between the medical and performance sides of the house, but also within the various specialties that comprise them, leading to a siloed and reductive approach to treating single injuries. Such a narrow perspective makes it difficult to identify underlying physical and mental health issues that could have caused or contributed to the issue at hand and impact the overall availability of athletes and mission readiness of operators. In contrast, bringing the EMR and AMS together puts data in the hands of everyone who needs to see it and encourages an integrative and collaborative approach that provides a continuum of care in which individuals are less likely to fall through the cracks.  

Another challenge that a siloed approach that relies on distinct EMR and AMS applications creates is that separate subject matter experts often have athletes and operators do similar rehab exercises. This means that someone might go to a physical therapy appointment in the morning and do similar movements to those that their strength and conditioning coaches ask them to perform in an afternoon session. In which case, they’re doubling the load exposure, potentially setting their return to play back or predisposing them to reinjury. Whereas with a single, united AMS and EMR platform, each subject matter expert can see what their colleagues are doing with the athlete or operator and when, so that they are only applying appropriate loads and not asking someone to do redundant work that could worsen their condition.


Presenting the Right Information to Leaders and Domain Experts

If an organization is trying to run several separate systems, it can be difficult for decision makers to gauge who is available, whose participation is limited by certain restrictions, and who is totally out of action on that day. Deploying a united AMS and EMR platform makes it easier for high-level leaders such as head coaches and unit commanders to get a real-time, high-level view of the overall status of their teams at any given moment. The visualization flexibility of Smartabase lets the same data be presented in different ways to various specialist roles so that entire medical, performance, and coaching groups have the information they need to provide exemplary individualized care and service.

While leaders might only want to see a 30,000-foot overview of entire groups, subject matter experts like strength and conditioning coaches, physiotherapists, and psychologists can drill down deeper to focus on specific data sets that pertain to their specialty. For example, force plate testing numbers might be of interest in the weight room, while a player’s detailed injury history informs a PT session, and their mental health notes set the stage for a counseling visit. The ability to then zoom out again in the AMS enables practitioners to strike the right balance between focusing on the specifics of their individualized day-to-day work with athletes and operators and keeping the big picture in mind. In doing so, they can take a more holistic approach to overall health and wellness instead of simply playing Whac-A-Mole with each injury or illness that pops up.

Unfortunately, this is what usually happens when using a siloed approach. An athlete or operator gets hurt and all energies of the performance and medical teams are directed to treating this issue. Then if the individual falls ill, the attention can shift to managing their sickness, as it can seem more pressing in the moment. With an AMS, there’s no need to be so reactive, take an either/or view of isolated issues, or concentrate on someone’s worst status to the exclusion of everything else. By combining performance and health data in one centralized platform, staff can emphasize a patient-centric approach.


Enhancing Collaboration and Communication

An AMS like Smartabase not only increases the efficiency of such specialists in their own area, but also elevates the overall effectiveness of the medical and performance staff. Daily and weekly injury reports bring greater clarity to multidisciplinary meetings, while automatically color-coding each squad member as green, yellow, or red makes it immediately clear what their availability status is to simplify selection decision-making. When needed, more detailed context can be obtained via additional notes, metrics like the number of training sessions and games missed, and other supplementary information that’s just a click away in the AMS. Rather than just seeing updates on a single issue, the staff can jointly review every acute and chronic physical and mental condition that is impacting an individual’s performance and overall wellness. They can then revert back to a team view to see the group’s present availability, the total number of injuries and illnesses, and breakdowns of these by type.

Implementing a unified EMR and AMS across an organization further encourages an integrative approach by streamlining daily communication between staff members. If they were using separate platforms, the medical team would spend more time looking at the former while the performance and coaching group would devote most of their attention to the latter. While this reflects the unique nature of their roles, being able to access both types of information in one place makes it much easier for team physicians, PTs, and other medical professionals to see which actions are being taken by their colleagues in other departments and vice versa for head and assistant coaches, S&C specialists, etc.

Administrators can also set up automatic notifications so that every relevant role is notified when a player reports an injury, illness, or mental health issue. Such alerts are extendable to certain interventions so that staff members stay in the loop on athletes’ and operators’ return-to-play/mission readiness status rather than wondering what other team members are doing or having to go and ask for updates.


Pursuing Holistic, Person-First Care

Such collaborative AMS features are highly impactful for any team, institute, or national governing body that oversees season-by-season sports and wants to go beyond simply treating individual incidents one by one. They can be just as beneficial to those organizations that manage groups that are on a rolling schedule. For example, Smartabase is helping the UFC Performance Institute (UFC PI) to manage every aspect of its fighters’ health as they move through a continuous calendar. Using a customized app, competitors submit training logs and daily wellness questionnaires that, when combined with input from wearables and other devices, give trainers, sports scientists, and other roles a complete combination of objective and subjective data.

A truly multidisciplinary approach empowers UFC PI to make informed decisions while looking at each fighter from every angle and to closely monitor athlete wellbeing. A similar method is being utilized by Special Forces groups whose operators need to maintain ongoing mission readiness so that some can be deployed anywhere in the world at a moment’s notice while others are returning from operations. This kind of multifaceted view that considers the athlete and operator as a person first doesn’t merely focus on their physical state, but also takes into account their psycho-emotional health. Just as individuals can securely and safely manage their objective health data in a HIPAA-compliant way in Smartabase, so too does the platform give them the peace of mind of entering subjective data confidentially.

It’s tempting for sports scientists and other practitioners to get fixated on numerical outcomes, which can dismiss how an injured or ill athlete is feeling and overlook the fact that perception is largely reality. By encouraging someone to log a few simple responses via surveys completed on a mobile device, medical and performance staff demonstrate that they’re taking mental health into account. Sometimes an athlete’s or operator’s recovery and return to readiness can be delayed or even halted by depression, fear of reinjury, or another mental obstacle. Adding their unique experiences and perspectives into the mix alongside objective data, visualizing both, and including them in a flagging system, Smartabase helps remove such roadblocks and makes it more likely that the whole person is being treated, not just their current injury or illness.  


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