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Speak and Spell: Sounding Out Common Healthcare Jargon

Imagine: It’s 1985 and you’re fresh out of batteries. And that—unfortunately—means your spelling mentor (housed in bright red plastic) is out of commission for the night. It looks like you’ll be going to bed early—and without the familiar, robotic voice of Speak & Spell to coax you into dreamland. Okay, so you’re probably wondering what an old-school children’s toy has to do with you—or this post. Well, that’s a great question, and the answer lies in the alphabet soup that makes up the modern glossary of healthcare jargon. As a PT, you’re bombarded with new terms that pop up left and right. In fact, with so many new vocab words and acronyms, you might not feel much different than you did as a child in our hypothetical ’80s drama—ready to call it a night. But luckily for you, the human mind doesn’t require batteries (yet) and you won’t have to go to bed early if you can’t make it through this list. With that being said, let’s get to sounding out a few of the most common healthcare jargon terms:

EHR: Electronic health record

Electronic health records (EHRs) are digital records that focus on the overall health of the patient. These systems typically include the patient records, notes, and other medical information that’s easily accessible across multiple specialties and healthcare organizations.

EMR: Electronic medical record

EHR and EMR might seem like interchangeable terms. However, the two are distinctly different. An electronic medical record (EMR) is a digital version of paper documentation. These records typically contain data that can be easily tracked and accessed within a practice. However, they’re not typically designed to integrate with systems in other settings (e.g., labs and specialty medical offices).

FLR: Functional limitation reporting

Floor? Flower? But, without the letters o, w, and e? Well, not quite. Functional limitation reporting (FLR) doesn’t really sound like any of those words. However, it does sound like The Centers for Medicare and Medicaid Services (CMS) will continue looking for new ways to inform the development rehab therapy payment structures—and FLR is part of these attempts. To satisfy FLR requirements, all eligible Medicare providers must report on their Medicare patients’ functional limitations to objectively demonstrate the connection between rehab therapy and patient progress.

HIPAA: The Health Insurance Portability and Accountability Act of 1996

HIPAA sounds a lot like the word hippo. But this law doesn’t spend its time snoozing underwater. Rather, it serves to maintain privacy policy standards in order to protect patients’ sensitive health information per the Privacy Rule. This rule impacts how “covered entities” (e.g., healthcare providers, clearinghouses, health plans, and business associates) handle protected health information (see PHI below).

PHI: Protected health information

“And I’m PHI, PHI falling.” Uh, not quite. Protected health information (PHI) is any health information—in any form—that could individually identify a patient. Typically, PHI refers to patient demographics, but it also includes a variety of other data points that healthcare professionals collect.

PQRS: Physician Quality Reporting System

You might find yourself (or the nearest five-year-old) reciting PQRS as you sing through the alphabet. Or, if you treat Medicare patients, you might find yourself cursing these four letters. PQRS is a CMS system that encourages eligible professionals and group practices to provide measurable data on their quality of care by reporting on a series of measures. As of 2015, practices that do not meet the standards for satisfactory reporting will incur a penalty that will negatively impact reimbursements rates in 2017. Fun, right?

As it turn out, you don’t actually need those glowing green letters to decode the latest healthcare jargon.


How to Decipher Healthcare Jargon (Acronym Alphabet Soup)

If you’ve been reading the latest in healthcare regulations, rulings, and requirements, you’ve probably done a good deal of head-scratching. Not only is the writing clear as mud (I’d be remiss not to plug the benefits of good copywriters here), but the US government has also created its own language of initialisms—not all that surprising if you consider the government’s track record (think CIA, FBI, NSA, etc.).

But before you get bogged down with these new two-, three-, and five-letter words—and start shouting out a few choice four-letter ones—we thought we’d give you a helping hand. Here’s how you can decipher this acronym alphabet soup—sans Cracker Jack decoder ring.

HIT: Health information technology (or health IT) is the electronic exchange of health information.

EMR: Electronic medical records are digital versions of a clinicians’ paper charts. Together, they make up an electronic medical record system, which contains the treatment history of patients within one clinic or group.

EHR: Electronic health records are also digital versions of clinicians’ paper charts. However, electronic health record systems are designed to share information among providers across healthcare organizations (e.g., hospitals and physician’s offices).

PHR: Personal health records are patient-managed, online health records that can come from a variety of sources. For perspective, EMRs and EHRs are provider-managed health records.

HIPAA: The Health Insurance Portability and Accountability Act of 1996 contains the Privacy Rule, which establishes how certain groups, clearinghouses, organizations, and businesses must handle protected health information (see PHI below).

PHI: Protected health information is individually identifiable health information relating to the past, present, or future of any of the following:

  • Physical or mental health or condition
  • Provision of health care
  • Payment for the provision of health care

BA: A business associate is a person who, or an organization that, performs a HIPAA-regulated function or activity on behalf of a covered entity (e.g., an EMR).

CE: A covered entity is a healthcare provider, a health plan, or a healthcare clearinghouse that transmits HIPAA-covered health information.

BAA: A business associate agreement is a contract between a covered entity and a business associate that outlines how each party will address PHI in accordance with HIPAA guidelines.

There you have it—we’ve deciphered some of the most common two-, three-, and five-letter initialisms courtesy of Uncle Sam. Did we miss a piece of healthcare jargon that has you in a huff? Leave us a note in the comments section, and we’ll help you crack its code, too.


Physical Therapy EMR, Practice Management Software, and Billing System: What’s in a Name?

Say my name, say my name. When no one is around you, say PT EMR, PMS, and billing system, I love you—if you ain’t runnin’ game. Huh? Destiny’s Child may have said it best; but while rehab therapy providers aren’t runnin’ game, they might feel played by all of the indistinguishable healthcare jargon that directly impacts their workflow. So, what’s in a name? Could it be that you are at the crib with a misunderstanding? Here’s what you need to know about EMR, practice management software, billing systems, and how each one impacts your processes:

Physical Therapy EMR

You are, in fact, on PhysicalTherapyEMR.net, so I’m going to take a wild guess that you at least have an idea of what an EMR is. But do you know what your EMR really does? According to this WhatIs article, “An electronic medical record (EMR) is a digital version of the traditional paper-based medical record for an individual. The EMR represents a medical record within a single facility, such as a doctor’s office or a clinic.” And based on that broad definition, your PT EMR should contain everything your practice would document on paper—but in digital form. Some EMRs also include practice management, and they might even integrate with your preferred billing system. (Hint: An ideal EMR should offer reporting capabilities as well as billing integration options).

Practice Management Software

Speaking of practice management: Practice management (PM) software helps employees handle the day-to-day tasks involved in running a practice. These can include managing patient demographic information, scheduling appointments, and tracking business metrics through automated reports. Keep in mind that your EMR and your billing system may offer practice management capabilities as well. In fact, software systems that combine documentation and billing functions with practice management capabilities actually make a lot of sense, because the information that a PM system manages is already contained within the EMR or the billing system. And having all of this information right at your fingertips—in a readable, digestible format—makes any rehab therapy software system even more valuable.

Physical Therapy Billing System

When it comes to billing systems, the typical workflow revolves around an electronic process. That’s because, aside from payers like workers’ comp and auto insurance, claims are typically processed electronically—which requires software to handle the work. This SearchHealthIT article states it best: “Electronic medical billing is the process by which a health care provider electronically submits a bill, or claim, to a health insurance company, or payer, for the rendering of medical services.” Without a billing system (and software) in place, providers wouldn’t be able to submit, track, and process their claims. And in the interest of streamlining your workflow, you should look for a billing system that integrates with your EMR and includes PM functionality.

 

So, there you have it. A great EMR offers integrated practice management and billing systems so you have the ability to better manage your practice. And finally? Yeah, yeah, yeah, yeah, yeah, yeah—where my PTs at?