Help! I Got a New Job, and They Still Use Paper!

Unless it’s your one-year wedding anniversary, you probably don’t want anyone to give you paper. And if you’ve just started a new job in the rehab therapy industry, you really don’t want anyone to give you paper. When it comes to documentation, paper doesn’t just kill trees—it can kill your new employer’s bottom line. But I don’t have to tell you that, do I? In fact, I’m preaching to the choir, but if you’re reading this article, you likely aren’t the ultimate decision-maker. However, you do have a voice, and you can use it to be an EMR champion at your new clinic. Here’s how:

1. Ask why the clinic still uses paper.

Do they fear EMR? Are they worried about potential costs? Or have they already had a bad EMR experience that forced them to go back to their old ways? Knowing what you’re up against will help you come up with a successful sales strategy.

2. Determine your clinic’s pain points.

Your new clinic is great, but no practice is perfect. So, look for issues that EMR can help resolve. Is your boss spending too much time doing administrative tasks? Is your office overrun with filing cabinets? Are there kinks in your customer service? Is your billing team getting bogged down? Is your clinic struggling to keep up with competition, or to grow its referrals or customer base? Pinpoint the top three needs that aren’t being met or goals that aren’t being achieved.

3. Play EMR matchmaker.

Now that you’ve figured out your clinic’s needs and goals, you can look for the right EMR solution and tailor your pitch to those exact issues. There are many different EMRs on the market, and they aren’t one-size-fits-all. What to look for? A web-based solution that is built for the way you work, meaning it offers:

4. Find the right time to pitch your boss.

The last thing you want to do is interrupt your boss when he or she is in a bad mood, working a full day of back-to-back appointments or elbow-deep in a tough task. If you can, set up a sync on his or her calendar to make sure you get the time you need to present your argument.

5. Make your case.

You’ll want to emphasize the positives of switching to an EMR. Talk about how great this move will be for business, and use research to back up your points. It doesn’t hurt to find clinics in your area that have successfully switched to EMR and use their stories as pseudo case studies. However, don’t skirt around the potential negatives of ditching pen and paper—just be ready to provide a solution to those problems. Your boss needs to make an informed decision. Plus, you don’t want to be stuck with the blame if something doesn’t go according to plan.

6. Be prepared to hear the word “no.”

Switching from paper to EMR can be tough, time-consuming, and terrifying. Even if you work the room like Perry Mason, your boss might not cave easily. Don’t give up. Ask for specific reasons why your boss turned you down and what might change his or her mind in the future. That way, you can adjust your strategy for next time. Are your fellow staff members on board? Rally the troops! There’s strength in numbers, especially if your boss respects staff opinions.

7. If you do make the switch, be all in.

If you’re able to convince your boss to leave pen and paper in the dust, remain a champion throughout the transition process. You worked hard to make the change possible, so now you should work hard to make sure it’s successful.


Deep down, your boss probably knows that adopting EMR technology is worthwhile, but depending on his or her concerns, it might take some time and consistent effort for you to close the deal. Stay positive and stick with it, champ. Need more talking points? Check out the rest of our blog (or this one) for more research and resources to help you fight the good fight.

Use at Your Own Risk: The Downside of Server-Based Systems

Server-based EMR systems are risky business—and not in the fun, dance-in-your-skivvies-and-socks kind of way. These chunky monkeys are chock-full of old technology that expose your clinic to compliance risks and data losses. Here’s why you should steer clear of server-based systems:

Your PHI is only as secure as your clinic.

Most web-based EMR vendors store all their data with top-tier security firms, so you can be sure your patients’ protected health information (PHI) is safe. But if you have a server-based system, all your priceless information is stored on-site—often unencrypted—which makes the responsibility of securing your patients’ PHI yours and yours alone. Unless you’re storing your servers in a bank vault (and who has that kind of space?), you run the risk of a full-on HIPAA breach.

You can lose your data.

Keeping your information safe from PHI predators isn’t the only reason you should stay away from server-based systems. You also have to worry about keeping your information—period. When you use a web-based system, all your information backs up to the cloud. With servers, what you see is what you get—and when you lose the server, you could lose your clinic, too. Studies show that more than 50% of small businesses close up shop within a year of a major data loss. Those odds will never be in your favor.

You have to get down and dirty with upgrades.

If you have a server-based EMR, it’s up to you to maintain your system—and that includes performing all system upgrades. As you know, regulations change quickly and often, so you need your system to stay up to date. If you miss an update—or if your system doesn’t update at all—you’re putting yourself at risk for non-compliance. And that comes with a heap of nasty consequences like penalties, fees, rejected claims, and audits. Think system maintenance sounds tough? You’re right. If the upgrades are particularly difficult—or if you aren’t technologically inclined—you may even have to hire IT staff, which can be quite expensive. You’re better served (pardon the pun) using a system that handles updates for you.


Server-based systems are on the path to extinction for a reason: they can’t provide clinics with the security and reliability of their web-based counterparts. Unless you’re willing to gamble with your practice—and your reputation—ditch the digital dinosaur and move your files to the cloud.

3 Signs Your EMR Fails to Scale

If you’re ready to start expanding your practice, you’ve probably spent a great deal of time making sure your staff is on board and getting your financials in order. But have you considered the impact your EMR might have on the success or failure of your expansion venture? Here are three signs your EMR isn’t built to support a growing clinic:

1. It makes you pay per patient or per visit.

If your EMR vendor charges you per chart or per visit, it’s impeding the growth of your business—and your bottom line. Under this kind of payment structure, increasing the number of patients your clinic treats means increasing the amount you pay your software vendor each month. Instead of working with a vendor that takes a bite out of each piece of your financial pie, look for one with a payment structure that allows you to pay per user.

2. It limits your number of users, records, or patients.

This one should be pretty obvious. If your EMR caps the number of users, records, or patients you can have, it also caps your clinic’s potential for growth. To keep up with your growth, switch to an EMR that makes it possible—and easy—to add patients, users, records, and clinic locations. Better yet—choose an EMR that offers volume-based discounts to growing practices.

3. It doesn’t give you access to crucial data.

To grow your practice, you need to be able to dig into your business metrics and identify areas where you may be missing out on revenue. Your EMR should provide you with valuable metrics on both your patients and your practice. Look for a multitude of reporting options that allow you to analyze all areas of your business, including:

  • inactive patients
  • patient cancellations and no-shows
  • claim statuses
  • units billed
  • number of patients per therapist
  • types of documents created
  • missed notes
  • referral sources

Additionally, look for an EMR that gives you insight into how regulations like FLR, PQRS, and MPPR are impacting your bottom line.

Behind every great clinic is a great EMR; can you say as much about your system? Make sure your EMR gives you the data space, financial freedom, and business intelligence you need to grow. Don’t settle for an EMR that penalizes you for being successful—or one that doesn’t allow you to be successful, period.

One-Size-Fits-All Software Zaps Productivity

Have you ever worn one-size-fits-all clothing? If not, let me give you a word of advice: it’s not actually made to fit everyone. If you wear it, you’ll likely spend half your day tugging, twisting, and jerry-rigging your outfit so it works for your body. Sounds pretty annoying, right? Now imagine applying that same one-size-fits-all approach to EMR software. As a 2010 UC Davis study discovered, implementing that kind of technology could spell disaster for your practice.

This four-year study focused on roughly 100 physicians—specializing in either internal medicine, pediatrics, or family practice—from six primary care offices, all of which were part of a large primary care physician network affiliated with an academic medical center. These offices had implemented a multimillion-dollar information technology system that “digitized patient records and allowed for electronic prescriptions and messaging.” The three researchers collected data on work hours and output levels from before and after implementation to analyze the impact the EMR had on productivity.

The research findings suggest that the one-size-fits-all approach doesn’t work. After an initial—and expected—drop in productivity post-implementation, researchers found that the internal medicine physicians and their staff were able to adjust to the new technology. And once they did, they rebounded to a slightly higher level of productivity. However, the pediatric and family practices involved in the study never returned to their original productivity levels.

Why? According to Heman Bhargava, associate dean and professor of management and computer science at the UC Davis Graduate School of Management, this kind of software can’t accommodate the needs of every practitioner. In fact, there’s a “‘mismatch between technology design and the work-flow requirements and health administration expectations for individual care units.’” Bhargava affirms that “‘the ideal technology design should vary by physicians’ requirements and work-flow demands.’”

Would you settle for a shirt made to fit what an industry has deemed “average” in size and shape? Certainly not. (And who wants to be considered average, anyhow?) So why would you settle for an EMR that isn’t tailored to your physical therapy practice? A therapy-specific EMR is designed to mimic the workflow of your clinic, meaning the documentation, scheduling, practice management, billing, and compliance features are built for the way you work. And that allows you to document efficiently, maintain full HIPAA compliance, decrease patient no-shows, save time and hard-earned dollars, and grow your business.

One-size-fits-all software can’t offer the kind of specialization your industry requires, and spending precious time adjusting a non-therapy specific software to fit your clinic’s unique workflows and documentation needs isn’t simply a mild irritation; it’s a serious problem that affects your clinic’s overall productivity—and, ultimately, your bottom line. You chose to specialize in physical therapy; you deserve to work with a software company that chose to specialize in PT, too. Still not sure what the big deal is? See for yourself.

EMR Compliance + Clinic Compliance = Complete HIPAA Compliance

Got EMR? Great! But don’t assume that means you’ve got total compliance. Your EMR company has (or should have) compliance safeguards to ensure that their systems are secure, but your EMR is just one part of the compliance equation. To truly keep your clinic’s protected health information (PHI) secure, you must account for all the variables, like access to your facility, workstations, and devices as well as staff training on proper procedure.

According to the new HIPAA Security Rule, covered entities are obligated to “maintain reasonable and appropriate administrative, technical, and physical safeguards for protecting e-PHI.” If you are a covered entity—i.e, a “health care provider who transmits health information in electronic form in connection with a transaction for which the Secretary of HHS has adopted standards under HIPAA”—then you must:

  • Ensure the confidentiality, integrity, and availability of all PHI they create, receive, maintain, or transmit.
  • Identify and protect against reasonably anticipated threats to the security or integrity of the information.
  • Protect against reasonably anticipated, impermissible uses or disclosures.
  • Ensure workforce compliance.

While you know that ensuring compliance is mandatory, tackling the HIPAA security requirements can seem a bit overwhelming and time-consuming. Where do you start? Well, let’s break it down. A recent article from Healthcare IT News outlines some of steps you should take to keep your clinic compliant, including:

  • Learn the ins and outs of your EMR’s security features, then ensure they are properly configured and enabled.
  • Establish—and routinely evaluate—your policies, procedures, audit trails, and security measures to ensure total compliance with HIPAA requirements.
  • Designate a HIPAA compliance officer at your clinic.
  • Clearly communicate each staff members’ HIPAA compliance responsibilities.
  • Restrict PHI access (through user authentication or encryption) to only those whose individual’s job roles and/or responsibilities require it.
  • Conduct an annual HIPAA security risk analysis.
  • Mitigate and address security risks—like deficient security, lack of administrative and physical controls, and easy access to workstations or systems where you keep PHI.

Relying exclusively on your EMR to keep your PHI secure doesn’t add up to complete clinic compliance. Ultimately, it’s your responsibility to protect all your patient data. To mitigate your risk for HIPAA violations, you must create your own physical, technical, and administrative safeguards.